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Medical Coverage Woes Reach Middle Class

Number of Underinsured In U.S. Reaches 25 Million, a 60% Increase Jump, Study Shows
WebMD Health News
Reviewed by Louise Chang, MD

June 10, 2008 -- Twenty-five million U.S. adults are in danger of financial hardship, debt, or bankruptcy from medical bills, even though they have health insurance, a study released Thursday concludes.

The report shows that the number of underinsured Americans -- many of them middle-class -- jumped 60% between 2003 and 2007. That's in addition to the 47 million Americans whose health and finances are at risk because they lack health coverage altogether, it concludes.

"As a nation, we are losing ground," says study researcher Cathy Schoen.

"Today in the U.S., you can have insurance all year long but still go into medical debt or face bankruptcy when you get sick," says Schoen, a senior vice president at The Commonwealth Fund, a nonprofit health care think-tank.

The report defined people as "underinsured" if they were insured all year but spent 10% or more of their income on medical expenses. Low-income people who spent 5% of their income on medical bills and anyone whose insurance deductibles were 5% or more of their income also qualified as underinsured in the study.

Many employers are paring back coverage in their health plans as a way to cut costs. Increasingly employers are turning to plans with higher deductibles, higher co-pays, or other features requiring workers to spend more of their own money.

Small businesses and workers who buy their own coverage on the individual market are the most vulnerable to cutbacks that can lead to underinsurance, says Karen Davis, president of the Commonwealth Fund.

The number of middle-class people who now qualify as underinsured "nearly tripled" during the study, Schoen says.

Researchers also warned that underinsured are likely to skip doctors' visits, leave prescriptions unfilled, or forgo needed treatment in an effort to save money.

"The underinsured look a lot like the uninsured," Schoen says.

The study included a telephone survey of 3,501 adults from across the U.S. from June 6 through Oct. 24, 2007. It published today in the online version of the journal Health Affairs.

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