Dive Brief:
- A new study by Avalere Health has found that most Americans insured through exchange plans who reach out-of-pocket maximums will be underinsured, despite ACA subsidies and lower out-of-pocket caps.
- Individuals who enrolled in lower-value plans (Bronze or Silver) are likely to meet their out-of-pocket maximum each year.
- For example, a man earning $23,000 (just over 200% of the poverty level) will have a reduced out-of-pocket maximum of $5,200; that's 23% of his annual income, more than twice the Commonwealth Fund's definition of underinsurance.
Dive Insight:
Reading these stats, we're forced to ask: what is the benefit of the new health exchange policies if they require chronically-ill people living close to the poverty line to somehow cough up thousands per year in healthcare costs? Does anyone really think that policies of this kind will help those who simply cannot afford to power through this gap? It's hard to see how this state of affairs supports the "Affordable" in the law's title.