Coverage adequacy could be next major healthcare policy issue

Wallet being squeeze by a vice

Now that 91 percent of the U.S. population has some type of health insurance, adequacy of coverage could become the next big political issue, predicts Drew Altman, president and chief executive officer of the Kaiser Family Foundation.

Since 2010, the number of uninsured in the country has dropped by 20 million. At the same time, deductibles have risen for everyone, not just those insured through the Affordable Care Act, Altman writes in a blog post for the Wall Street Journal. Consumers who have insurance through large employers saw a 256 percent increase in deductible payments over the last decade, while wages rose just 32 percent, according Altman.

Deductible payments increased from 24 percent of cost-sharing payments in 2004 to 47 percent 10 years later. At the same time, co-pays dropped 26 percent, making deductibles consumers’ No. 1 health-cost concern, Altman writes.

Rising deductibles have effectively moderated the growth of spending on healthcare, he notes, but at the cost of creating a significant burden for many families and erecting a barrier to care access for those with chronic illnesses. And, if the economy weakens, employers may rely more on even higher deductible plans to control healthcare costs.

High deductibles have also altered the relationship between patients and their healthcare providers by increasing patient concern for the cost of care, though real price comparisons remain challenging, according to Altman. Indeed, previous research has questioned the concept that imposing high deductibles on health plans encourages individuals to shop around for better healthcare prices.

Historically, the healthcare industry has largely lined up on the Republican side of the aisle, but Democratic proposals that increase benefits or limit cost-sharing could be better for the industry than Republicans’ continued focus on increasing the share of healthcare costs borne by consumers, Altman adds.

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