Twenty-eight percent of working-age adults with health coverage all year were underinsured in 2016, up from 23 percent in 2014, a new Commonwealth Fund analysis finds. People who are underinsured have high deductibles and out-of-pocket expenses relative to their income.

Based on findings from the Commonwealth Fund’s 2016 Biennial Health Insurance Survey, the report shows that more than half the underinsured had medical bill problems or medical debt, while nearly half went without needed health care because of cost. Underinsurance affects people with all types of health coverage, the researchers say. More than half the 41 million people estimated to be underinsured have coverage through an employer.