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It may not seem like much — just an extra hundred dollars or so a year.
But the steady upward creep in
health insurance deductibles has easily outpaced the average increase in a worker’s wages over the last five years, according to a new
analysis released on Tuesday by the Kaiser Family Foundation.
Kaiser, a health policy research group that conducts a yearly survey of employer health benefits, calculates that deductibles have risen more than six times faster than workers’ earnings since 2010.
Those workers’ deductibles have climbed from a yearly average of $900 in 2010 for an individual plan to above $1,300 this year, while employees working for small businesses have an even higher average of $1,800 a year. One in five workers has a deductible of $2,000 or more.
But as wages have stagnated, the steady increase in deductibles is squeezing an already beleaguered middle class. While employers have generally felt some relief from the burden of ever-rising health care costs in recent years, workers are feeling increasingly vulnerable to high medical bills.
Some are making difficult choices about what care they can afford. About two years ago, Beth Landrum, a 52-year-old teacher, who is insured through her husband’s job as an engineer, saw the deductible on her family’s plan increase to $3,300 a year.
Ms. Landrum decided to delay having the
M.R.I. her doctor recommends she get every three years. Ten years ago, she had a noncancerous
brain tumor that required surgery and radiation. “My doctor’s really mad at me because I haven’t had the
M.R.I.,” she said, but she and her husband say they need to save toward the cost.
She is particularly concerned because they could owe thousands of dollars in medical bills if something unexpected happened, like a hospital stay, because their current plan asks them to contribute much more toward the cost of care. “It’s really scary,” Ms. Landrum said.
Consumers who have to pay the higher deductibles may feel they had little choice about needing care. Matt Freedman, 34, chose a plan last year that had a $6,000 deductible. “I knew it was a risky plan,” he said, but he considered himself healthy and unlikely to accrue sizable medical bills. After minor surgery, however, he developed a serious infection that led to a hospital stay. “You never think something terrible is going to happen,” he said.
People who buy coverage through the state marketplaces may also face high deductibles. Rebecca Bullard, 27, chose a plan this year with a $6,000 annual deductible so she could afford the $129 a month in premiums. When she worried that she had cracked a rib after playing roller derby, she chose to ask friends on social media about what to do rather than go to the doctor. Although she had a plan with a $2,500 deductible before, she had not been worried about what she would pay out-of-pocket. “Now I don’t even want to go to the doctor,” she said.
What concerns policy experts and employers is evidence that higher deductibles are making people forgo care, even when they have serious conditions.
“It may be tamping down on unnecessary care, but we’re seeing a lot of evidence of skimping on necessary care,” said Sara R. Collins, vice president for health care coverage and access at the Commonwealth Fund, a nonprofit group that conducted
a survey last fall about the effect of out-of-pocket health care costs on consumers.
Forty percent of people with private
health insurance whose deductible equaled 5 percent or more of their income said they had decided not to go to the doctor when they were sick or had chosen not to get a test or go to a specialist, according to the survey.
