Dive Brief:
- A new study by Families USA has found that despite the expansion of health coverage, high deductibles mean it's still often cheaper for people to go to the ER than to arrange a visit with a physician.
- The advocacy group argues that simply having health insurance does not guarantee that enrollees can actually utilize their plan to obtain healthcare.
- The group's report points toward plans with deductibles of $1,500 or more as the most likely leading cause for patients skipping medical tests, treatments and follow-up care.
Dive Insight:
The report suggests reconfiguring silver plans to offer lower deductibles.
"State policymakers could require that every insurer in their state offer at least one silver plan that covers basic outpatient services and prescription drugs before the deductible is paid. Federal policymakers could take a similar step and require insurers in all states to offer a plan like this," report co-author Lydia Mitts told Northeast Public Radio.
According to Mitts, such plans would not automatically mean higher premiums. Families USA looks to the examples of state marketplaces in New York, Connecticut and California, where there are standardized plans that exempt routine care from the deductible.
"Connecticut's marketplace is a really good example of this," Mitts says. "They've created a standard silver plan that covers doctor's visits, including primary care visits and specialty care visits, tests and lab work, generic prescription drugs and a number of other outpatient services before the deductible is paid."