Question
Will the candidate protect families from insurance plans that charge high deductibles or other out-of-pocket costs that they can't afford?
The Issue
In order to protect consumers from the high costs of health care, insurance policies must cover the medical services that people need to be healthy, and they should protect people from unaffordable out-of-pocket costs. When insurance plans don’t cover needed services at affordable prices, families are forced to make difficult decisions that may affect their well-being, both physically and financially. When faced with out-of-pocket costs (“cost-sharing”— deductibles and copayments) that they cannot afford, people are more likely to delay care, skip prescriptions, or go without medical services entirely.10
In spite of the consequences of high cost-sharing, some policy makers promote health care plans that deliberately require individuals to pay more out of pocket, such as Health Savings Accounts (HSAs) coupled with high-deductible health plans. Believing that comprehensive insurance coverage encourages American families to receive “too much” health care, supporters of these plans want consumers to pay more of their health care costs upfront to discourage them from getting too much care.
However, with health insurance premiums rising much faster than wages, millions of insured American families are already paying significant amounts out of pocket for their health care, and these costs have become a financial burden.11 Many families and individuals are saddled with medical debt. More than a third of insured people with high health care costs have to take substantial financial risks, such as running up high levels of credit card debt or taking out a loan or mortgage against their home, to pay medical bills.12 And, when medical debt becomes too great to bear, the consequences can be catastrophic. Bankruptcy is often the last resort for families with medical debt, and half of all bankruptcies are due, at least in part, to medical costs.13 The healthy and the wealthy may be able to get by with plans that require higher deductibles and more cost-sharing, but many Americans have already stretched their budgets to the limit to pay for health care.
The Positions
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Senator McCain: Senator McCain’s health care plan encourages and expands HSAs coupled with high-deductible health plans, in which consumers must pay more in out-of-pocket health care costs before they receive covered health care services.14 |
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Senator Obama: Senator Obama’s health care plan limits the amount of money that Americans have to pay out of their own pockets for health care. His plan creates a National Health Insurance Exchange in which participating insurance companies will be required to cover all essential medical services with (yet to be defined) limits on the costs that they charge consumers, including deductibles, premiums, and copayments. |
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Footnotes
10 Kaiser Public Opinion, Economic Problems Facing Families (Washington: Kaiser Family Foundation, April 2008).
11 Kim Bailey and Beth Wikler, Too Great a Burden: America's Families at Risk (Washington: Families USA, December 2007).12 Cathy Schoen, Michelle Doty, Sara Collins, and Alyssa Holmgren, "Insured but Not Protected: How Many Adults Are Underinsured?" Health Affairs Web Exclusive (June 14, 2005): W5-289 – W5-302.
13 David Himmelstein, Elizabeth Warren, Deborah Thorne, and Steffie Woolhandler, "Illness and Injury as Contributors to Bankruptcy," Health Affairs Web Exclusive (February 2, 2005): W5-63 – W5-73.
14 John McCain, Remarks by John McCain on Health Care on Day Two of the "Call to Action Tour," April 29, 2008, available online at http://www.johnmccain.com/Informing/News/Speeches/2c3cfa3a-748e-4121-84db-28995cf367da.htm. |
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