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Less Health Insurance, Higher Costs

Most Americans get their health insurance at work. It’s not surprising, then, that widespread job loss seen during the recession — 13.7 million people are unemployed — has brought with it widespread loss of health insurance.

That was the gist of a report out last Wednesday from the Commonwealth Fund, a foundation that strongly advocates for health care access and fully supports the Affordable Care Act.Despite its clear pro-reform position, Commonwealth is known for producing even-handed reports on the state of affairs in health care. It conducted a survey of 3,033 adults in 2010 and found that in the last two years a majority of people (57%) who lost a job with health benefits also lost insurance coverage. That added an additional 9 million Americans to the ranks of the uninsured, the Commonwealth Fund estimates.

“There are few affordable options for health insurance comparable to employer coverage, and consequently millions of adults who have lost their jobs and benefits are going without insurance,” the report states.

Here are some additional findings from the survey:

  • 24% of working-age adults (an estimated 43 million people) said they and/or their spouse lost their job within the past two years.
  • 41% (an estimated 75 million people) said they hadn’t been able to get needed health care because of cost.
  • 71% of people who tried to buy insurance in the individual market in the last three years had trouble doing so because of high cost, a health condition that was excluded from coverage, or a plan that didn’t fit their needs.
  • 32% of working-age adults (an estimated 49 million people) spent 10% or more of their income on out-of-pocket costs and premiums in 2010. That’s up by 18 million people since 2001.

Taking Action

What can you do if you’re struggling to pay for health care? There are no silver bullets, but that doesn’t mean we’re powerless.

A few points to keep in mind:

  • You can negotiate with your doctor or hospital on price and there are tools available to help you shop around for the least expensive, yet high quality, site of care. You can read more about that at this previous post and this one, which both offer money-saving tips.
  • If you have a pre-existing health condition and have been turned down for coverage on the private market, it’s worth exploring the Pre-existing Condition Insurance Plans available since last July as a result of health reform. These plans aren’t cheap, and there are limits to qualifying, but the government did reduce prices this year for PCIP plans by about 20%. It’s worth a look.
  • If you’re out of work or have recently incurred very high medical costs, you should check to see if you qualify for government benefits. Even if you make too much money to qualify for Medicaid, many states have a Medicaid spend-down option, which allows people to subtract medical bills from their income in order to qualify. You can search for government programs at or by calling 800-FED-INFO, or at a resource offered by the Foundation for Health Coverage Education (FHCE).
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