Like many Americans, Hector, a resident of Revere, Massachusetts, was overwhelmed by health care costs. He had insurance through his employer, but he could barely afford his $600 a month premiums, and he quickly learned that his coverage was not enough to keep his out-of-pocket costs manageable. Needing treatment for hearing, liver and heart conditions, Hector faced deductible costs from hospital care, $175 co-pays per visit with his specialist, and ongoing prescription costs of more than $100 a month. He soon found himself in $2,000 of medical debt.

Hector’s story is far from unique; the Journal of the American Medical Association (JAMA) recently published research that paints a grim picture of the state of medical debt in the United States. Americans owe almost twice as much in medical debt as previously known – $140 billion in unpaid medical bills held by collection agencies. It is an indication of how unaffordable health care remains for many households.

The research points to the need to address the Medicaid coverage gap in states that have not expanded the program under the Affordable Care Act (ACA). However, beyond this, more work is needed to address the issue of medical debt and the affordability of care even for those with insurance coverage. While uninsured individuals are twice as likely to have medical debt as insured individuals, 16 percent of those with insurance still have medical debt.

The health insurance coverage many Americans have today is not enough to prevent them from being overwhelmed by costs. Health care policy leaders and advocates should pursue opportunities to focus not only on achieving universal coverage, but also on ensuring that coverage is actually offering affordable access to care. Policy options that should be considered in this effort include enhancing premium subsidies, funding more generous coverage with lower out-of-pocket costs, broadening eligibility for subsidized coverage, eliminating cost-sharing for high-value care, and enhancing cost containment structures (such as rate review).

To read the full article by Alex Sheff, please click here.