For the research letter, authors from HHS’ Agency for Healthcare Research and Quality examined Medical Expenditure Panel Survey Household Component data for adults age 19 to 64 with employer-sponsored health coverage. The data, which spanned 2011-15, included a main sample of adults with family income less than 250 percent of the federal poverty level, and considered 20 chronic conditions.
Researchers defined family out-of-pocket healthcare financial burden as the ratio of the total amount a family spent out-of-pocket on healthcare and premiums divided by the family’s total disposable income. For the study, a 20 percent financial burden reflected high out-of-pocket costs, according to the authors.
Among all adults with high-deductible health plans during the study period, 7.3 percent saw a 20 percent burden. However, among low-income high-deductible plan holders with no chronic conditions or one chronic condition, the prevalence of high out-of-pocket costs grew to 20.6 percent. Bump that up to at least two chronic conditions, and 46.9 percent of low-income adults with a high-deductible plan faced burdensome out-of-pocket healthcare expenses.
“For clinicians and patients, high out-of-pocket costs for low-income adults with employer-sponsored insurance may create a barrier to achieving effective treatment to manage multiple chronic conditions,” according to the authors. “Although only 22 percent of the overall low-income population had full-year employer-sponsored insurance, their financial burden is of concern.”
For the full research letter, click here.
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