As big insurance announces record profits, skyrocketing out-of-pockets (finally) take center stage.
Politicians–and the media–are finally beginning to catch on: it’s not just skyrocketing premiums that are breaking the budgets of middle-class American families.
As more and more Americans realize they can’t use their health insurance because of ever-increasing out-of-pocket requirements–even as insurance companies report record profits–they’re beginning to demand attention from lawmakers.
Politicians–and the media–are finally beginning to catch on: it’s not just skyrocketing premiums that are breaking the budgets of middle-class American families. It’s also what they have to pay out of their own pockets before their coverage kicks in.
Consider these headlines over just the past few days:
While seniors on Medicare will get much-needed financial assistance paying for their medications if Congress caps their out-of-pocket drug costs at $2,000 a year, other struggling Americans are asking: What about us?
And it’s not just a few. As that Montana story noted, the top concern of the state’s voters is that out-of-pocket costs are too high, with people struggling the most with the cost of deductibles.
Another story this week showed that out-of-pocket costs are also the top concern of Michigan voters.
These stories appeared at the same time the country’s biggest health insurers told Wall Street investors they made so much money during the first six months of this year that 2022 is on track to be their most profitable year ever.
Here’s the headline from The Street about the better-than-expected profits UnitedHealth Group reported earlier this month:
That came just days after this headline over an NPR story:
That Forbes article cited above did a good job of explaining the dire straits many families now find themselves in:
The shortcomings of insurance plan design in the U.S. have led to a new category of uninsured patients—those who are functionally uninsured. This population is burdened with deductibles so high they cannot afford to seek and pay for medical care that isn’t covered prior to meeting their deductible and out-of-pocket maximum. While maintaining health insurance is more critical than ever, the risk transfer has placed a greater burden on the insured individual. This has produced an affordability crisis even with coverage through an insurance product.
Among the bills the New Democrat caucus supports is one that would reduce out-of-pockets for most people who get their coverage through the Affordable Care Act’s state marketplaces.
While that bill has merit, Rep. Kathy Manning (D-NC) and Sen. Raphael Warnock (D-GA) are the lead sponsors of a bill that would go much further. It would cap prescription drug out-of-pockets for all privately insured Americans at $250 a month for individuals and $500 a month for families.
As Manning and Warnock noted when they introduced the bill, one in four Americans taking a prescription drug has reported skipping doses or cutting pills in half due to costs.
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Those surveys of voters in Michigan and Montana should serve as a clear warning to political candidates this year: Capping out-of-pockets for Medicare beneficiaries is good but not nearly good enough. In Montana alone, nearly seven in ten voters said they are more likely to support a candidate who makes reducing health care costs–out-of-pocket costs in particular–their top priority.
Lowering out-of-pockets is the singular focus of the growing coalition of organizations and businesses I lead. We will make sure candidates go on the record about what they will do to address this growing American crisis.
Please check out the Lower Out-of-Pockets NOW coalition and share your stories with us.