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By Kara Brandeisky
May 21, 2015

Americans gave Obamacare plans high marks in a survey out today from the Kaiser Family Foundation. Three-quarters of those enrolled in health plans through the marketplace say they’re satisfied with the choice of primary care doctors, 73% express satisfaction with their doctor’s visit copays, and 65% say they’re satisfied with their premiums. Overall, 40% say they’ve mostly benefitted from the Affordable Care Act, while only a third say they’ve mostly been negatively affected.

But there’s one nagging problem. Even though Americans are generally happy with Obamacare plans, a large minority—38% of marketplace enrollees—say they still “feel vulnerable to high medical bills.” (A similar proportion of people in non-Obamacare plans agree.)

Most alarmingly, Americans enrolled in plans that meet ACA requirements are more likely to struggle with medical bills than Americans enrolled in plans that do not meet ACA requirements. Americans in ACA-compliant plans are also more likely to report skipping care because of cost. Even though the Affordable Care Act outlawed annual and lifetime coverage maximums—the health insurance provisions that saddled the insured with hundreds of thousands of dollars in medical debt and doomed the sick to bankruptcy—more than half of Americans enrolled in ACA-compliant plans say they’re worried they won’t be able to afford the health care services they’ll need in the future.

One culprit may be high deductibles. In a previous survey, the Kaiser Family Foundation found that Obamacare silver plan enrollees have an average $3,453 deductible, meaning they need to pay more than $3,000 out-of-pocket before insurance would cover part of the cost. On average, Americans enrolled in bronze plans need to pay more than $5,372 out-of-pocket before insurance kicks in.

Unsurprisingly, people with high-deductible plans, whether ACA-compliant or not, feel more financially vulnerable. Only 7% of Americans on high-deductible plans say their health insurance is an “excellent” value for the cost, compared with 19% of Americans on lower deductible plans. And fewer than a third of Americans on high-deductible plans say they could pay a $1,500 medical bill without borrowing money—which is a problem, because a $1,500 bill is a real possibility with a $3,000-plus deductible.

How to save on medical care:

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