Lower income marketplace enrollees still have trouble with healthcare costs

Lower income individuals with one or more dependents reported difficulty paying their monthly premiums for marketplace plans, but better educational initiatives could help this subset select a plan with lower deductibles and copayments, according to an issue brief from the Kaiser Family Foundation.

Nearly two-thirds of adults that had difficulty paying the premium on their marketplace plan reported an income that is 250 percent below the poverty level, according to the brief. Although low-income enrollees receive tax credits and cost-sharing reductions though the Affordable Care Act, 45 percent of enrolled adults that had difficulty paying their premium were not confident they could afford usual medical costs. Nearly 80 percent were not confident they could afford major medical costs.

Nearly half of those that reported difficulty paying their premium had at least one dependent child, reflecting an additional financial strain for low-income adults.

Marketplace enrollees who had difficulty paying their premium were more likely to visit a doctor for specific health needs and take a prescription drug, but were less likely to understand  what their plan covered and how much they had to pay for services. KFF noted that improving health literacy and education surrounding marketplace plans could help lower-income enrollees select the appropriate plan with lower deductibles and copayments.

Between marketplace plans and Medicaid expansion, 20 million adults have gained health insurance since 2010, leading to an uninsured rate that has hit a record-low nine percent. However, analysts have found that lower-income marketplace enrollees still spend a larger percentage of their income on healthcare costs compared to those with higher incomes.

To learn more:
- read the KFF issue brief