MANAGED CARE April 2010. ©MediMedia USA
Even before the onset of the recession, almost 1 in 5 Americans — 19.1 percent of the nonelderly population — lived in families spending more than 10 percent of their before-tax dollars on health care. The findings from the Center for Studying Health Systems Change paint a grim picture of the financial burden of health care — the ratio of total out-of-pocket spending for health care services and premiums to total family income.
Further, middle- and high-income people with private insurance experienced the largest increase in financial burden. Since data in this study predated the recent recession, the author, HSC senior fellow Peter J. Cunningham, PhD, postulates that the economic factors of the last two years are likely to have both increased the number of people lacking medical insurance and decreased access to, and affordability of, private insurance coverage.
The number of nonelderly people living in families spending more than 10 percent of their before-tax dollars on health care fluctuated among states, from a low of 12.4 percent in California to a high of 26.4 percent in Alabama. Cunningham says that the just-passed health care reform law “has the potential to reduce the state variation in high financial burden among the uninsured population.” This is significant because “states with both high uninsurance rates and high financial burdens among the insured should be a concern for both state and national policymakers, as prior research has shown that uninsurance rates in an area can have detrimental spillover effects.”