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Despite ACA, Out-of-Pocket Medical Costs Lurk

Margaret Dick Tocknell, for HealthLeaders Media, April 27, 2011

While the families had room in their budgets for necessities, health insurance premiums, and moderate levels of out-of-pocket costs, that was not the case with high levels of out-of-pocket costs. In each income range examined, some families would struggle to afford all their healthcare expenses because of high out-of-pocket costs.

For example, 10.8% to 17.5% of families with incomes between 100% and 200% of the FPL could not afford all their necessities plus health-related costs when they had high out-of-pocket medical costs. At 200% to 300% of FPL high out-of-pocket medical costs meant about a quarter of families could not afford all their necessities plus health-related costs. Families with incomes over 500% of FPL ($111,750 for a family of four) were found to have room in their budgets for healthcare even with high out-of-pocket costs.

"Our analysis is promising, as the vast majority of people will be better off because of the premium subsidies and cost-sharing limits in the Affordable Care Act," said Jonathan Gruber, an economics professor at MIT and the lead author of the report. "However, the concerns about high out-of-pocket costs are notable and should be addressed so that people who become very sick don't face out-of-pocket costs that they are unable to afford."

See Also:

Family Health Plan Premiums 'Increasingly Unaffordable'

Medicare Could Save $7.6B by Raising Eligibility Age to 67


Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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