New Analysis: Individual Insurance Market Not a Viable Option for Most

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The individual health insurance market is not a viable option for the majority of those Americans who lack another source of coverage, say Commonwealth Fund researchers. A <a href="/publications/issue-briefs/2009/jul/failure-protect-why-individual-insurance-market-not-viable">new analysis</a> based on Fund survey data shows that nearly three-quarters of people who attempted to buy insurance on their own in the past three years did not purchase a policy, with the majority citing that plan premiums were too high. <br /><br />In addition, 57 percent of survey respondents reported it was very difficult or impossible to find coverage they could afford; 47 percent said it was very difficult or impossible to find a plan with the coverage they needed; and 36 percent were denied coverage or charged more because of a preexisting condition or had the condition excluded from their coverage. <br /><br />People enrolled in an individual market plan spend far more out-of-pocket and on premiums than those with employer-based coverage: the average family covered by an employer plan spends $2,250 out-of-pocket on health expenses, while those with individual insurance spend an average of $6,750. Adults with individual market coverage are also more likely to have high deductibles and face limits on what their plans will pay. More than two of five adults with coverage through the individual market report not getting needed health care because of the cost. <br /><br />"People buying their own health insurance are paying significantly higher premiums than those with employer-based coverage but are getting less for their money," said Sara Collins, Ph.D., a coauthor of the study and a Commonwealth Fund vice president. "It is critical that health reform proposals set minimum benefit standards and provide adequate premium subsidies to ensure that families who lose their job-based benefits can purchase affordable coverage that gives them access to timely care and protects them from catastrophic health care costs."