Worry less, spend less - Families Usa Skip to Main Content

Worry less, spend less

By Kate Blocher,


Health care costs have risen sharply over the years, and a greater share of the costs has been shifted to the consumer in the form of rising deductibles and higher copayments and co-insurance. To help consumers with these costs, the Affordable Care Act caps how much money insured people will have to spend out of their own pockets for health care services that are covered in the new law’s essential benefits package.

Families USA’s report, Worry Less, Spend Less: Out-of-Pocket Spending Caps Protect America’s Families, looks at how many Americans are in families that will spend less on health care thanks to these new caps, and how much money could be saved. Here are just a few of the findings:

In 2011 alone, 15 million Americans are in families that will likely spend less on essential health care due to these caps;

This out-of-pocket spending is estimated to exceed the caps by $24.7 billion; and

Nearly three-quarters (71.4 percent) of Americans who will spend more than the out-of-pocket caps are in working families.

In addition, Families USA looked at how many people in each state are in families that will have out-of-pocket spending that exceeds these new caps, and by how much. To see these results, click here.

During a time when our economy is still recovering, and many people are struggling with their day-to-day finances, these numbers are incredible. But what’s more shocking is when you consider who will benefit from these out-of-pocket caps, and how they will affect the insurance market as a whole.

It is obvious that these new protections will help those who suffer from expensive chronic conditions, such as heart disease or diabetes—but for those of us who are healthy, it is the unexpected illness or surgery that can result in mountains of debt. With these new protections in place, an unexpected injury will no longer bankrupt a family.

But looking beyond the financial help these caps will bring, they will also have an effect on the insurance market as a whole. Currently, there are millions of Americans who are either uninsured or underinsured who end up not being able to afford the full cost of their care. As a result, those costs get shifted to insured customers in the form of higher premiums. By limiting the amount families have to pay for out-of-pocket care, as well as greatly increasing the number of Americans with comprehensive coverage through the essential benefits package, health reform is working to reduce costs for everyone.

Capping out-of-pocket spending will benefit millions of Americans, from people who suffer from chronic illnesses, to those who face high medical costs in a given year. This is just one more way that the health care law  ensures that everyone has access to quality health coverage that provides them with the peace of mind they need.