Among US adults with insurance, 28 percent were underinsured in 2018–up from 23 percent in 2014. (Photo: Shutterstock)
Since the passage of the Affordable Care Act (ACA) uninsurance among Americans has dropped 8 percent—but a new problem, “underinsurance,” has risen at the same time, creating a significant group of insured Americans who struggle with health care costs.
The 2019 Biennial Health Insurance Survey, released on Feb. 7 by the Commonwealth Fund, finds that nearly 30 percent of Americans were underinsured and may have trouble affording their health care.
The problem of being underinsured
The study found that among US adults with insurance, 28 percent were underinsured in 2018, up from 23 percent in 2014. “Underinsured” is defined as those who have high health insurance deductibles and out-of-pocket medical expenses relative to their income, and are more likely to struggle paying health care bills or to skip treatment because of costs.
The report noted that becoming underinsured has been a problem for both those on the individual market and people covered through employer-based plans. “The greatest deterioration in the quality and comprehensiveness of coverage has occurred among people in employer plans,” the report's authors note. “Twenty-eight percent of U.S. adults who have health insurance through their employer were underinsured in 2018, up from 20 percent just four years earlier. At the same time, people who bought plans on their own through the individual market or the marketplaces were the most likely to be underinsured, with 42 percent reporting a lack of adequate coverage in 2018.”
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