Underinsured in America

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A new study in Health Affairs takes up an issue often neglected in debates over health care, but quite important: namely, the underinsured. These people have coverage, but it’s usually inadequate, leaving them vulnerable to high out-of-pocket costs and often forcing them to forego essential care. About 12 percent of adults, some 16 million, fell into this category in 2003, which can be tacked onto the estimated 45 million without insurance at all. Most of the underinsured were either minorities, had low incomes, or were sick.

The other big story here is that the vast numbers of underinsured are the result of an increasing trend in America. Employers, wracked with health care costs, are responding by pushing more and more of the financial burden for coverage onto the workers themselves, whether that includes higher deductibles, patient cost sharing, or restricting benefits. As a result, many workers are left without adequate coverage, and end up seeking out less care in the end. (Cost-sharing, almost by definition, hits the poor and the sick the hardest.)

It’s doubtful that this trend can be reversed, and at any rate, it probably shouldn’t be. Employers were never meant to be in the business of providing health care, and that goes double in an age where workers switch jobs frequently and firms need to be competitive in the global economy. Eventually, the government will have to take over the business of managing care. That’s inevitable. The problem is that unless the transition period is well-managed—which is certainly not the case right now—then we’re in for a long period of time where companies are slowly and steadily loading the costs onto the backs of their workers and more and more employees become unable to afford adequate care. Eventually it will all hit a crisis point and voters will demand some sort of national health care system. But who knows when that will be? The interim period, meanwhile, will be devastating.

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THE TRUTH...

is the first thing despots go after. An unwavering commitment to it is probably what draws you to Mother Jones' journalism. And as we're seeing in the US and the world around, authoritarians seek to poison the discourse and the way we relate to each other because they can't stand people coming together around a shared sense of the truth—it's a huge threat to them.

Which is also a pretty great way to describe Mother Jones' mission: People coming together around the truth to hold power accountable.

And right now, we need to raise about $400,000 from our online readers over the next two months to hit our annual goal and make good on that mission. Read more about the information war we find ourselves in and how people-powered, independent reporting can and must rise to the challenge—and please support our team's truth-telling journalism with a donation if you can right now.

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