Larry Levitt: Is Employee Health Insurance Failing Americans?
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Larry Levitt's slides from the Center for Health Journalism webinar, "Is Employee Health Insurance Failing Americans?" 7.23.19 More info: https://www.centerforhealthjournalism.org/content/employee-health-insurance-failing-americans
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Larry Levitt: Is Employee Health Insurance Failing Americans?
- 1. Trends in the Availability and Affordability of Employer Health Insurance USC Center for Health Journalism July 23, 2019 Larry Levitt Executive Vice President, Kaiser Family Foundation @larry_levitt
- 2. Employer-provided health insurance is by far the largest source of coverage Medicaid/Other Public 22% Medicare 14% Non-group 7% Uninsured 9% Employer Coverage 49% Total Population = 317,022,500 million SOURCE: Kaiser Family Foundation, “Health Insurance Coverage of the Total Population,” 2017.
- 3. 67.3% 66.1% 65.9% 64.4% 62.5% 62.7% 62.5% 60.4% 60.7% 59.7% 57.6% 56.3% 55.6% 56.5% 56.3% 55.9% 57.5% 57.3% 58.4% 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 Percent of Non-Elderly Population Enrolled in Employer-Sponsored Coverage, 1999-2017 SOURCE: Kaiser Family Foundation analysis of the National Health Interview Survey, 1999-2017. The share of non-elderly people with employer-sponsored insurance has declined over the past 20 years
- 4. 26% 0% 50% 100% 150% 200% 250% 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Workers' Earnings Deductibles NOTE: Average general annual deductibles are among all covered workers. Workers in plans without a general annual deductible for in-network services are assigned a value of zero. SOURCE: KFF and KFF/HRET Employer Health Benefits Surveys. Consumer Price Index, U.S. City Average of Annual Inflation (April to April); Seasonally Adjusted Data from the Current Employment Statistics Survey (April to April). Deductibles in employer plans have increased eight times as fast as wages 212% Average deductible in 2018: $1,573 per person
- 5. SOURCE: KFF Analysis of IBM MarketScan Database and the KFF Employer Benefit Survey. “Deductible Relief Day”: Day of the year when average health spending among people with large employer coverage exceeds the average deductible in that year
- 6. 13.4% 7.5% 4.3% 18.5% 12.0% 7.4% 14.0% 7.9% 4.5% 0% 5% 10% 15% 20% 25% 30% 199% of FPL or less* 200-399% of FPL* 400% of FPL or more* Average shares of income going towards premium contributions and medical care, by poverty and family member health, 2017 No One in Fair/Poor Health Someone in Fair/Poor Health * Differences by health status are statistically significant within poverty category. SOURCE: Kaiser Family Foundation analysis of 2018 Consumer Expenditure Survey ASEC. Poorer and sicker families pay high shares of income out-of- pocket for premium contributions and cost sharing
- 7. 55% 53% 51% 53% 67% 62% 60% 63% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 2007 2010 2013 2016 Percent of Non-Elderly Households with Liquid Assets in Excess of $2,000 (in 2016 Dollars), 2007-2016 Single Person Multi-Person NOTE: Liquid Assets include the sum of checking and saving accounts, money market accounts, certificates of deposit, savings bonds, non- retirement mutual funds, stocks and bonds. Elderly Households are those in which the Head of Household or his/her Spouse is older than 65. SOURCE: KFF Analysis of the Survey of Consumer Finance, 2007-2016 A large share of families do not have enough resources to meet typical deductibles and cost-sharing amounts
- 8. 27% 25% 20% 14% 13% 9% 40% Problems paying/inability to pay medical bills Difficulty affording pre-deductible bills Difficulty affording "surprise" bills Difficulty affording Rx copays Difficulty affording Dr. visit copays Difficulty affording monthly premium Four in ten with employer coverage report at least one challenge with health care affordability SOURCE: KFF/LA Times Survey of Adults with Employer-Sponsored Health Insurance (Sept. 25-Oct. 9, 2018). See topline for full question wording. Percent who say they or a family member experienced each of the following in the past 12 months: Yes to any affordability challenge
- 9. 17% of people with employer coverage say they had to make a difficult sacrifice in the past year to pay health care and insurance costs. Here are the sacrifices some of them described: SOURCE: KFF/LA Times Survey of Adults with Employer-Sponsored Health Insurance (Sept. 25-Oct. 9, 2018). See topline for full question wording. I had to work 3 jobs at once. 1 full time and 2 part time jobs. Working from 4:30AM until 11PM. We pay all our bills late and several have gone to collections. Me not eating so my kids can. I was homeless for 4 months to pay bills. Allowing my health to deteriorate because it’s too expensive to keep up with the cost of care. I had to let my child remain ill for longer than I was comfortable with because I couldn’t afford the $10 co-pay for her to see her pediatrician.
- 10. 40% 49% 41% 40% 27% 65% 51% 32% 49% 29% Total Highest deductible Higher deductible Lower deductible No deductible Household income: less than $40,000 $40,000-<$75,000 $75,000 or more Any chronic condition No chronic condition Lower incomes, higher deductibles, and chronic conditions associated with higher rates of affordability challenges SOURCE: KFF/LA Times Survey of Adults with Employer-Sponsored Health Insurance (Sept. 25-Oct. 9, 2018). See topline for full question wording. Percent who report at least one affordability issue:
- 11. 15% 16% 12% 11% 8% 6% 6% 3% 3% 3% 2% SOURCE: KFF/LA Times Survey of Adults with Employer-Sponsored Health Insurance (Sept. 25-Oct. 9, 2018). See topline for full question wording. Those with chronic conditions more likely to experience financial impacts of health care affordability challenges Chronic condition No chronic condition 36% 35% 28% 26% 19% 14% 13% 7% 7% 7% 2% Put off vacations or major purchases Cut back spending on food, clothes, household items Increased their credit card debt Used up all or most of their savings Taken an extra job or worked more hours Borrowed money from friends or family Taken money out of long-term savings Taken out a loan Sought the aid of a charity or non-profit Changed their living situation Used the internet to raise funds Percent who report doing each in the past 12 months in order to pay for health care or insurance costs:
- 12. 80% 71% 60% 48% 20% 28% 40% 52% No deductible Lower deductible Higher deductible Highest deductible Well Not well People in high deductible employer plans less likely to feel U.S. Insurance system works well for people like them SOURCE: KFF/LA Times Survey of Adults with Employer-Sponsored Health Insurance (Sept. 25-Oct. 9, 2018). See topline for full question wording. How well do you think the current health insurance system in the U.S. works for people like you?
- 13. Millions of surprise medical bills among privately insured Americans each year KFF analysis of 2017 data from large employer plans show: • 18% of ER visits by those with large employer coverage included at least one out-of-network charge • 16% of in-network inpatient stays include at least one out-of- network provider charge • Rates vary by state
- 14. Emergency visits with potential surprise bills
- 15. Inpatient stays with potential surprise medical bills
Notes de l'éditeur
- More detail pending: Explain study/Truven data of … million claims from large employer health plans. … Most ER visits are to in-network facilities but involve out-of-network charges by other providers : ER doc, anesthesiologist, radiologist, etc…