Out-of-Pocket Spending Caps Findings

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Health Action 2014
January 23-25

Hyatt Regency Washington on Capitol Hill

Key Findings

Introduction

American Families Will Benefit from Out-of-Pocket Caps

In 2011, nearly 15.0 million Americans under the age of 65 are in families that will spend more than the out-of-pocket caps for covered services in the Affordable Care Act’s essential benefits package.
Spending by these families will exceed the caps by $24.7 billion in one year alone.

Working Families Will Save with Out-of-Pocket Caps

Nearly three-quarters (71.4 percent) of the Americans who will spend more than the out-of-pocket caps are in working families.
Nearly 10.7 million people who will spend more than the out-of-pocket caps are in families where at least one person is employed full- or part-time.

Help for Families of Small Business Employees

Nearly 6.3 million people in families where the head of the household is employed by a small business (those with fewer than 100 employees) will spend more than the out-of-pocket caps.
More than two in five Americans (42 percent) who will spend more than the out-of-pocket caps are in families where the head of the household works for a business with fewer than 100 employees.
Of those in families of small business workers, more than four out of five (83 percent) have a head of household who works for a business with fewer than 25 employees.
Families of small business employees will spend nearly $10.3 billion more than the out-of-pocket caps.