Written by Adam Knopsnyder
In order to determine the most effective public policy to ensure that all Americans have affordable healthcare access, it is key to have a comprehensive understanding of the facts surrounding the issue. When trying to obtain universal health care in a country, there are two main obstacles in doing so: an individual’s ability to obtain coverage and an individual’s ability to financially afford that coverage. The aim of this post is to explain the issues Americans face when trying to get and pay for health insurance, so that future proposed healthcare policies can attempt to address these two central problems.
One of the easiest ways to determine Americans’ overall ability to gain health care coverage is through the use of government statistics of uninsured individuals. According to the United States Census Bureau, in 2018 there were 27.5 million people who did not have any medical insurance coverage, which is approximately 8.5% of all American adults (Berchick et al., 2019). In addition, the same report found that nearly 5.5% of all children in the US go without health insurance as well (Berchick et al., 2019). These statistics show that there is huge insurance coverage problem in the United States that needs to be addressed. Furthermore, the 2018 report found that out of all Americans who are insured, 34.4% of that population is insured by the public option (Berchick et al., 2019). With the information provided by this government report, it becomes clear that public option serves as a crucial aspect in the infrastructure of the US healthcare system.
In addition to those who are outright uninsured, there is a whole other category of Americans who are technically insured, but are unable to afford care. This particular group of people are known as the underinsured. Those who are underinsured are considered to fall into at least one of the following three categories: an individual’s out-of-pocket costs, excluding premiums, over one year are equal to 10% or more of their household income; an individual’s out-of-pocket costs, excluding premiums, over one year are equal to 5% or more of household income for individuals living under 200% of the federal poverty level; and/or an individual’s deductible constitutes 5% or more of their annual household income (Collins et al., 2020). In a study conducted in 2020, researchers found that 43.4% of all US adults between the ages of 19 and 64 who had insurance were considered underinsured under the above categories (Collins et al., 2020). Even though this portion of Americans are able to utilize their healthcare, the reality is the total costs of using that medical insurance is regularly too much for a person to afford, often causing them to go into debt. The problem of underinsurance relates directly to addressing the overall concern of an individual’s ability to financially afford medical insurance. Given the current data, a large population of the United States is currently uninsured or underinsured which creates the need for public policy initiatives that attempt to reach universal coverage in the United States.
Berchick, E. R., Barnett, J. C., & Upton, R. D. (2019). Health Insurance Coverage in the United States: 2018. 44.
Collins, S. R., Gunja, M. Z., & Aboulafia, G. N. (2020, August 19). U.S. Health Insurance Coverage in 2020: A Looming Crisis in Affordability. https://doi.org/10.26099/6aj3-n655