House Testimony Focuses on America's Underinsured Problem

eAlert c61782ae-4388-416d-ad64-28f2c704c5f8

For a hearing held today by the U.S. House of Representatives Committee on Energy and Commerce, Subcommittee on Oversight and Investigations, Commonwealth Fund vice president and health insurance expert Sara R. Collins, Ph.D., was invited to testify about the growing problem of "underinsurance" in the United States, what it means for working families, and how health reform will help.

Collins said that in addition to the 46.3 million people who lacked any health insurance in 2008, as reported by the Census Bureau in September, 25 million working-age adults in 2007 had such high out-of-pocket costs relative to their income that they could be considered underinsured — an increase from 16 million in 2003. Underinsured adults were defined as those who spent 10 percent or more of their income on out-of-pocket health costs, excluding premiums (or 5 percent of income for those living under twice the poverty level), or those whose deductibles amounted to 5 percent or more of income.

As Collins explained, underinsurance is a problem for Americans who are enrolled in health plans that do not provide comprehensive coverage, those with expensive medical bills for services not covered by their plans, and those who purchased coverage in the individual insurance market. She told members of the House subcommittee that the America's Health Choices Act (H.R. 3200) would "go a long way toward reducing the problem of underinsurance." In addition to covering about 97 percent of legal residents by 2019, the bill would reduce the number of underinsured and the number of people who accumulate medical debt by: replacing the individual insurance market with a new regulated insurance exchange, preventing insurers from underwriting on the basis of health, establishing a new minimum benefit standard, and providing premium subsidies and cost-sharing credits.

With working families in crisis from a combination of declining job, income, and health security, Collins said the "time has never been more urgent for policymakers to find consensus and forge ahead on implementing solutions to the nation's worsening health insurance problem, while placing the health care system on a path to high performance."