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COLUMN: High deductibles highlight healthcare disparities



The Affordable Care Act, or Obamacare, was created with the intention of increasing access to and decreasing the costs associated with healthcare and health insurance.

Political opinions aside, it appears to have, at the very least, decreased the amount of uninsured 
people in America.

For the first time ever, the uninsured rate for all ages has dropped below ten percent of the population to 9.2 percent, according to 
forbes.com.

Through health insurance exchanges, as well as the Medicaid expansion, millions of people have gained access to medical insurance, which is fantastic from a humanitarian 
perspective.

Furthermore, the ACA has not lead to the vast increases in premium costs critics of the law theorized. Though rates have increased throughout time for many, on average, these increases have been significantly smaller than would be 
expected without the ACA, according to vox.com.

However, the system is most definitely not perfect, which is highlighted by the incredibly high deductibles some people are on the hook for. In some cases, it has been cheaper to not buy insurance, since their deductibles are higher than their actual healthcare 
expenditures.

The Internal Revenue Service defined a high-deductible health plan as health insurance with an annual deductible of at least $1,300 for individual coverage or $2,600 for family coverage for 2015. The maximum annual out-of-pocket and deductible expenses are capped at $6,450 for an individual and $12,900 for a family, respectively. These caps theoretically protect consumers from financial ruin. For those receiving subsidies to pay for premiums, these caps might only prevent absolute bankruptcy, but still be a huge financial setback.

Unfortunately, many of the largest cities in the United States have median deductibles of thousands of dollars, meaning at least half of the plans in those cities are considered “high-deductible.” These high deductibles can scare away many from buying insurance, especially the young, healthy buyers that are needed to keep the 
system working.

However, there are a few factors that help offset these costs. “All plans must cover preventive services like mammograms or colonoscopies without a deductible or co-payment,” according to the New York Times. A number of plans help pay for some items and services, like generic drugs or visits to a primary-care doctor, before patients meet the 
deductible.

“In addition, people with particularly low incomes can obtain discounts known as cost-sharing reductions, which lower their deductibles and other out-of-pocket costs if they choose mid-level silver plans,” also according to the New York Times. This assistance helps alleviate insurance costs for those with incomes of 100 percent to 250 percent of the poverty level for a family or individual.

Overall, buying insurance still makes sense for many people, even if such plans don’t significantly lower the cost of healthcare for them. It serves as a preventative measure against total financial responsibility for the tens of thousands of dollars an accident or destructive disease could 
accrue.

That doesn’t mean the ACA has entirely fulfilled its purpose. Even with subsidies, there can and has been a failure on an individual basis to adequately reduce the costs of healthcare or 
insurance.

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