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Study: Health Coverage No Guarantee Against Medical Debt

July 5, 2011

INDIANAPOLIS - Health insurance is no guarantee that individuals or families won't have medical debt that they'll have to struggle to pay off. A new study takes a look at who has trouble paying the bills and found that even those with coverage often struggle with out-of-pocket costs. About forty percent of Hoosiers carried medical debt last year, or said they had trouble paying health care bills in 2010.

Economist Patricia Herman is the author of the study, which looked at adults ages 19 to 64. She points to gaps in coverage as one factor at play.

"Unfortunately, in this country, a lot of people's insurance is tied to their jobs. What if you lose your job? And, you can lose your job when you're sick. Those combinations leave people exposed."

At the same time, she says, even people with continuous coverage carry medical debt, with those outstanding balances totaling around $3000 on average. Other factors for medical debt include consumers misunderstanding the coverage they purchase, and the sheer cost of medical care, which can lead to higher-than-expected out-of-pocket expenses.

Economist Sara Collins, who is vice president for affordable health insurance at the Commonwealth Fund, expects the problem of coverage gaps to mostly be addressed when the Affordable Care Act is fully implemented.

"When you lose your job, you might not have an affordable place to buy health insurance, may not be able to even go onto COBRA because you can't afford the premiums. So the Affordable Care Act is really going to reduce that by making coverage a lot more accessible."

But Collins says there are still questions to be addressed about controlling health care costs and out-of-pocket expenses.

The study will be published in the August issue of the American Journal of Public Health.

Deb Courson Smith, Public News Service - IN