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Some Don't Have Enough Coverage

25 million Americans ages 18–64 are underinsured.

In addition to the uninsured, another 25 million Americans age 18-65 are considered to be “underinsured.” This means that they have health insurance, but their out-of-pocket costs are still too high, compared to their incomes, for them to afford the medical care they need. In Ohio, for example, 45% of adults reported that they had unpaid medical bills. For more information, please see Ohioans’ Experiences with Going into Debt to Pay for Healthcare one-pager. The number of underinsured adults grew by 60% between 2003 and 2007. Underinsured Americans say that they have trouble getting care and are very stressed about their finances.

Why are some people with health insurance unable to afford medical care? Insurance policies usually do not cover all healthcare costs. The insured person is responsible for deductibles (an amount you pay before the insurance company pays anything) and coinsurance and co-payments (an amount you pay along with what the insurer pays when you get care), and these can be very high.

In addition, insurance companies may not pay anything for certain services. Mental health care, for example, is very limited or not a part of many insurance benefits. Insurance policies may also set annual or lifetime limits on how much they will pay for certain kinds of care or for all medical care. After insured Americans reach that limit, they have to pay 100% of the costs on their own. The majority of people who declare bankruptcy because of medical debt have insurance.

Source

Schoen, Cathy, Sara R. Collins, Jennifer L. Kriss, Michelle M. Doty. 2008. How many are underinsured? Trends among U.S. adults, 2003 and 2007. The Commonwealth Fund. http://www.commonwealthfund.org/Content/Publications/In-the-Literature/2008/Jun/How-Many-Are-Underinsured--Trends-Among-U-S--Adults--2003-and-2007.aspx.

Since 1997, The Health Foundation of Greater Cincinnati has invested over $111 million in projects that improve the health of the Cincinnati area. With major healthcare reform imminent, the Health Foundation aims to be a source for credible, timely information that can inform people in our region about the healthcare reform debate. While we do not support any specific plan or approach, we do support certain principles that we believe would improve access to healthcare and make our region healthier.

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Please visit http://www.healthfoundation.org/reform for more information.