- More than 40% of U.S. adults of working age didn't have reliable health insurance in the first half of this year, according to a new report out from The Commonwealth Fund.
- People of color disproportionately lacked comprehensive coverage and were more likely to struggle financially with medical bills. More than a third of Latino adults, small business workers and low-income adults were uninsured in the past year, a situation that could worsen due to the COVID-19 pandemic, the study's authors warned.
- A fourth of working-age adults with adequate coverage reported problems affording their medical bills or debt in the past year. For uninsured or underinsured adults, that figure rose to half, with Black Americans much more likely than Whites to report medical bill problems (45% versus 35%).
The Commonwealth Fund survey of almost 4,300 adults aged 19 to 64, conducted between January and June this year, didn't find statistically significant changes in coverage from the last time it was conducted, in 2018. But it does highlight a "persistent vulnerability" in the U.S. healthcare system: unreliable insurance coverage, according to Sara Collins, the study's lead author.
A lack of comprehensive insurance coverage has saddled Americans with rising medical debt amid a pandemic that's infected almost 5.5 million people in the U.S. and killed almost 172,000 to date, the study suggested, as the economic toll wrought by the novel coronavirus is highlighting the problems with yoking insurance coverage to employment.
Some 27 million Americans may have lost job-based insurance between March and May amid historic unemployment, according to the Kaiser Family Foundation.
The growth in the number of underinsured Americans, people who have insurance with high out-of-pocket costs or deductibles relative to their income, over the past decade is mostly due to employer health plans with inadequate coverage, The Commonwealth Fund said. From 2010 to 2020, the share of commercially insured adults with deductibles of $1,000 or higher more than doubled from 22% to 46%.
A fourth of adults with employer plans were underinsured in the first half of the year, according to the report
Researchers suggested several policy changes that could help expand coverage to a broader swath of Americans, including expanding Medicaid in the 12 states that have yet to do so, bolstering premiums and cost-sharing subsidies in the Affordable Care Act marketplace and giving people with unaffordable employer insurance subsidized access to the exchanges.
States could also ban non-ACA compliant plans like short-term health insurance, bare-bones plans touted by the Trump administration as an alternative to beefier coverage that discriminate against women and patients with preexisting conditions.