Health care is unaffordable, even for those who are insured

Health care costs continue to rise, making access to necessary care increasingly unaffordable, even for those who have insurance. On MedPageToday, Paul Shafer, assistant professor at Boston University School of Public Health, explains the growing issue of being underinsured and dives into a potential solution: monthly out-of-pocket caps. He discusses his recent JAMA Network Open study in which he employed a hypothetical monthly cap on out-of-pocket costs for in-network care of $250 or $500. Their analyses showed that nearly a quarter (24.1%) to more than a third (36.8%) of enrollees with commercial insurance would experience a reduction in annual out-of-pocket costs under those limits, respectively, with declines in annual out-of-pocket costs of nearly or more than half.  

Shafer notes that implementing this model would “not be a trivial effort”; it could be piloted, evaluated, and considered as an option in plan offerings. Nonetheless, Shafer’s MedPageToday article is a call for insurers, employers, and policymakers to shift how they view health insurance affordability. Read the full post here! 

Research for this piece was supported by Arnold Ventures. 

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