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Recent Reports Show Employees, Healthcare Providers Feel Struggle of Premium Increases  

18 Jan, 2024 F.J. Thomas

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Sarasota, FL (WorkersCompensation.com) – According to evidence presented before the House Committee on Ways and Means in September, the No Surprises Act has had a detrimental effect on healthcare revenue, resulting in an 84 percent increase in provider bankruptcies.

For those cases where providers can collect, a recent Guardian report indicates that patients with health coverage now represent the largest percentage of outstanding bad debt. In 2018, the amount of bad debt due by patient balances after insurance totaled 11.1 percent, with only 5.2 percent at over $7,500. In 2021, that percentage increased to 57.6 percent, with 17.7 percent over $7,500 owed.

Part of what analysts believe is driving up the increase in outstanding debt is the “Obamacare” or Exchange plans, most of which have at least a $1,000 deductible. In most cases, these plans are allowed to require as much as $9,450 out of pocket from patients, in addition to the monthly premiums they charge. 

According to a recent report from Manhattan Institute, in 2021 around 56 percent of the U.S. population was covered by private insurance, and around 35 percent were covered by State and Federal programs. Only 8 percent of the population was uninsured. 

On average, in 2021 patients with insurance received around $7,278 in healthcare services and paid around $934 out of pocket. By comparison, the uninsured received around $1,639 in healthcare services, and paid $612. Additionally, of the 6 percent of the population that were admitted to the hospital, only 1.6 percent of the uninsured received inpatient treatment. Comparatively, insured patients had higher medical bills at $21,710 for inpatient services and $547 out of pocket, compared to $13,480 and $2,265 out of pocket for uninsured patients. 

A study published this month in JAMA Network Open suggests that providers may not be seeing relief anytime soon, as increases in wages have not been large enough to offset the increases in insurance premiums and out of pockets costs. 

The study found that even for those employers that do adjust their premiums according to wage, lower wage employees still pay out a larger percentage of their income to healthcare premiums. Additionally, the study found that for the last three decades Black and Hispanic workers have paid out a greater proportion of the increase in healthcare premiums as a percentage of their income. 

Overall, the researchers estimate that over the last three decades, the lost median cumulative family income due to just premium payouts is around $125K. The total represents an annual amount of $4,166 in additional income after taxes would be required in order to absorb the loss. 


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    About The Author

    • F.J. Thomas

      F.J. Thomas has worked in healthcare business for more than fifteen years in Tennessee. Her experience as a contract appeals analyst has given her an intimate grasp of the inner workings of both the provider and insurance world. Knowing first hand that the industry is constantly changing, she strives to find resources and information you can use.

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