Changes To Health Care Could Help 'Underinsured'

To be considered underinsured, a New York health research group says you have to spend more than 10 percent of your income on health bills — half that if you are poor or near poor. Those who are underinsured will find some relief in the health care bills being considered in Congress. The bill being dabated in the Senate Finance Committee, for example, would still require middle income people to pay as much as 12 percent for their health insurance premiums alone.

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JULIE ROVNER: This is Julie Rovner.

Families like the Martins who find themselves with huge medical bills despite having coverage are finding themselves with more and more company, says Sara Collins. She's with the Commonwealth Fund, a New York-based health research group.

Ms. SARA COLLINS (Vice President, Affordable Health Insurance Program, The Commonwealth Fund): In 2007, 25 million people had such high out-of-pocket costs that they were considered underinsured, and that's up from 16 million in 2003.

ROVNER: So what does it mean to be underinsured? The Commonwealth Fund says it's when you have to spend more than 10 percent of your income on health bills, half that much if you're poor, or near-poor. In some ways, Collins says, being underinsured leaves people worse off than not having any health insurance at all.

Ms. COLLINS: Because if they're paying a premium for coverage that actually leaves them very unprotected, so people who are underinsured are almost as likely to say they have a lot of problems paying their medical bills. They're almost as likely to say they didn't get needed healthcare because of the cost of that care as people who are uninsured.

ROVNER: That would change under most of the bills now moving through Congress, Collins says, although not as much as some people would like.

Ms. COLLINS: The things that the bills do that's really quite important, is they would establish minimum benefit package. So there would be much more transparency in terms of what you're purchasing and then some minimum standards in terms of what insurance companies could sell on the market.

ROVNER: The bills would also limit how much plans can charge in total premiums and out-of-pocket costs, and they eliminate annual and lifetime benefit caps. That means a sick person would no longer be able to outspend his or her insurance.

But while families like the Martins would almost certainly no longer have 45 percent of their income consumed by their medical bills, the relief wouldn't be complete. The bill being debated in the Senate Finance Committee, for example, would still require middle-income people to pay as much as 12 percent just for their health insurance premiums alone.

Julie Rovner, NPR News, Washington.

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INSKEEP: Our series, Are You Covered, is produced in partnership with Kaiser Health News, which is a nonprofit news service. By the way, it's an editorially independent program of the Kaiser Family Foundation which is not affiliated with the insurance provider Kaiser Permanente.

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