The key reason consumers struggle to afford healthcare is that 25% of working-age adults with private insurance have high medical cost burdens and high deductibles, according to a new extensive measure of healthcare costs from The Commonwealth Fund.

Researchers conducted approximately 2,700 interviews with consumers by phone to determine healthcare cost burdens for the report. The percentage of adults with high cost burdens was unchanged from 2014 but the report's Healthcare Affordability Index shows more than half of adults with low incomes carry those burdens.

The Commnonwealth Fund Healthcare Affordability Index is part of a new report, “How High is America’s Healthcare Cost Burden?” by Sara Collins, vice president for Health Care Coverage and Access at The Commowealth Fund.

High health plan deductibles and co-payments have a negative effect on consumers’ willingness to seek needed care or prescription medications, according to the report."High deductibles are a major reason people struggle to afford healthcare. Forty-three percent of all those surveyed and 51% of low-and moderate-income people said their deductible is difficult or impossible to afford,” according to The Commonwealth Fund. "Thirty-four percent of low-income adults - an individual making less than $23,340 a year - reported difficulty affording their co-payments and co-insurance.”  

Results from the Healthcare Affordability Index in the report show that 13% of privately insured adults had unaffordable premiums compared to the 25% who said they had high healthcare cost burdens as a result of premiums.

"Consumers feel the effect of healthcare costs every time they pay their premiums or reach into their pockets at the doctor’s office," Collins said. "Our index looks at how working-age adults are spending money on healthcare, using a fairly conservative measure of affordability to highlight how many people have costs that likely make it difficult to afford other necessities like food and housing."Ten percent of the privately insured adults tracked in the index had unaffordable deductibles, compared to the 43% surveyed who said their deductibles are difficult or impossible to afford.

“A large share (32%) of adults with higher incomes reported it was difficult to afford their deductibles," according to the report. "People had fewer problems affording co-payments and co-insurance when they visited a doctor or filled a prescription. However the lowest-income adults reported struggling with these costs. One-third (34%) of adults with incomes under 200% of poverty said it had been difficult or impossible to afford their copayments or coinsurance when they had gone to the doctor or filled a prescription in the past year."

The researchers concluded in the report that ultimately it's consumers' perceptions of cost and understanding of their health plans that matter the most. If people believe their deductibles or co-payments are unaffordable, it will affect the way they make healthcare decisions.

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