High Satisfaction With Employer Coverage, but Financial Challenges Persist

While most people with employer-sponsored insurance were satisfied with their coverage and used positive words to describe their health plan, people with low incomes, chronic conditions, or high deductibles faced healthcare affordability challenges.

Most people with employer-sponsored insurance are satisfied with their health plans, but nearly half still said they had trouble affording healthcare, according to the results of a new survey from Kaiser Family Foundation and the Los Angeles Times.

The survey found 69% used the words “grateful” and “content” to describe their health plan and smaller proportions used negative words like “frustrated” (26%), “confused” (23%), or “angry” (14%). Views tended to be tied to the deductible level of the individual’s plan, the survey found.

Among respondents, 15% said they had no deductible, 44% had a deductible of less than $1000 for an individual or less than $3000 for a family, 20% had a deductible between $1500 and $2999 for an individual or between $3000 and $4999 for a family, and 21% had a deductible of more than $3000 for an individual or more than $5000 for a family.

“The experiences and attitudes of people with employer coverage differ vastly depending on whether they are in a higher or lower deductible plan,” the authors of the survey report wrote. “The higher the deductible, the more likely an individual is to have negative views of their health plan, and the more likely they are to experience problems affording care or to put off care due to cost.”

Despite being largely satisfied with their insurance, the respondents did highlight healthcare financial troubles even with their employer coverage. For instance, 27% said they or a family member had problems paying or were unable to pay medical bills in the past 12 months. In addition, they said they or a family member had difficulty affording medical bills before meeting the deductible (25%), unexpected medical bills (20%), co-pays for prescription drugs (14%), co-pays for doctor visits (13%), or the monthly health insurance premium (9%).

Even with employer coverage, respondents said they had to make sacrifices to pay their healthcare bills. Among those respondents who said they had affordability issues, 66% said they put off vacations or major purchases; 65% said they cut spending on food, clothes, and household items; 50% increased their credit card debt; 46% used up all or most of their savings; and 34% said they took an extra job or worked more hours.

Lower incomes, higher deductibles, and having any chronic condition were all associated with healthcare affordability issues. Half (49%) of patients with the highest deductible reported affordability issues compared with 27% of patients with no deductible. Two-thirds (65%) within household income less than $40,000 reported affordability issues compared with 51% of those with income between $40,000 and $75,000 and 32% of those with household income of $75,000 or more. Half (49%) of respondents with someone covered by the plan who had any chronic condition reported affordability issues compared with 29% with no one with a chronic condition.

The survey also found that 78% of respondents with employer coverage say the cost of care is too high for people like them, and they mainly blamed pharmaceutical companies and insurance companies. Only 1% each said pharmaceutical companies and health insurance companies deserve no blame. Sixty-one percent and 57% said pharmaceutical and insurance companies, respectively, deserve “a lot of blame.” Smaller proportions assigned a lot of blame to hospitals (32%), the Affordable Care Act (29%), the Trump administration’s recent actions (28%), doctors (15%), and employers (7%).