Consumers With Job-Based Health Insurance Still Struggle With Costs

Consumers With Job-Based Health Insurance Still Struggle With Costs

Meeting high deductibles among the biggest challenges
A mother reviews paperwork

Self-employed individuals aren’t the only ones struggling with health insurance costs. Many Americans who get health insurance coverage through their jobs are finding health care costs to be prohibitive, too, a new survey shows.

In a survey of 1,407 adults with employer-sponsored health insurance conducted by the Kaiser Family Foundation and the Los Angeles Times, 40% of respondents said they had problems in the past year paying medical bills, insurance premiums or out-of-pocket health care costs. Not only that, but nearly half said they or someone in their household had delayed or decided against receiving medical treatment or getting a prescription because of high costs.

When asked what the biggest health care cost-related problem was for them and their family, 31% said medical bills they were responsible for before meeting their deductible. That was followed by:

  • 23% who said unexpected medical bills, some of which they thought would be covered
  • 16% who said medical bills they knew would not be covered
  • 11% who said co-pays for prescription drugs
  • 10% who said co-pays for doctor appointments
  • 8% who said monthly insurance premiums

Those with higher deductibles were more likely to wrangle with costs, the survey found. Among respondents with deductibles of $3,000 or more for an individual or $5,000 or more for a family, more than half said their emergency savings would not cover the deductible.

Employer-sponsored health care coverage also seems to fall short for Americans with chronic health conditions — defined by the Centers for Disease Control and Prevention as a condition that lasts a minimum of a year and requires continuing medical attention. Approximately 54% of those who get health insurance coverage through their jobs said they or a family member covered by their insurance has a chronic condition. Of those respondents, about half said they’ve had difficulty paying medical bills, premiums or out-of-pocket costs; in contrast, only about 30% of those in families without chronic conditions complained about health care costs.

Many of the respondents struggling with health care costs said they have had to cut back in other areas of their life. For example, 66% delayed vacations and major purchases while 65% have reduced spending on necessities such as food, clothes and other household items. Others have racked up debt or had to look for new sources of income to cover the cost of medical care:

  • 50% said they increased their credit card debt
  • 46% went through all or most of their savings
  • 34% got a second job or worked more hours
  • 25% borrowed from family and friends
  • 24% took money out of long-term savings
  • 13% took out a loan

Healthcare costs are so steep that it’s important to choose the best health insurance plan for your personal situation. If your employer offers multiple options, make sure you understand all of them and how much money you will be expected to pay on a monthly basis if you need routine medical services or if you have a major health challenge. A tax-deductible Health Savings Account (HSA), which lets you put away money to offset future health expenses, might be helpful for some as well.