Work­ers’ health care share av­er­ages about $1,500

- Jayne O’Don­nell @jay­neodon­nell USA TO­DAY

Pre­mi­ums paid by work­ers cov­ered by their com­pa­nies’ health plans have risen only mod­estly over the past five years, but work­ers who get sick still face higher de­ductibles that af­fect far more peo­ple, a sur­vey out Wed­nes­day shows.

More than 80% of em­ploy­ees have to pay an av­er­age of $1,478 be­fore their health in­surance cov­ers the bulk of the cost for health care — up from slightly more than half of work­ers in 2006, says the sur­vey by the Kaiser Fam­ily Foun­da­tion and the Health Re­search and Ed­u­ca­tional Trust.

De­spite the slow­ing in pre­mium growth, these monthly in­surance pay­ments have in­creased four times faster than in­come since 1999, the sur­vey showed. The Cen­sus Bureau re­ported Tues­day that the typ­i­cal U.S. house­hold’s in­come in­creased about 5% in 2015 af­ter barely budg­ing in the eight years since the start of the Great Re­ces­sion.

The new nor­mal in em­ploy­er­pro­vided in­surance can be hard for many to ac­cept. If you tell a typ­i­cal consumer there has been a “his­tor­i­cal mod­er­a­tion in health care costs, they will look at you side­ways,” says Drew Alt­man, CEO of the Kaiser Fam­ily Foun­da­tion. “We’re in a pe­riod of a slow rev­o­lu­tion to skimpier, less com­pre­hen­sive cov­er­age that’s been hap­pen­ing grad­u­ally with no na­tional de­bate.”

That’s cer­tainly true of high de­ductible plans, which are more or less pop­u­lar de­pend­ing on your sit­u­a­tion — and bud­get. “As a sweep­ing con­clu­sion, when faced with a high de­ductible and a low pre­mium, then peo­ple like them,” health economist Mark Pauly says. “But they hate them when they have a claim.”

The chal­lenge comes when em­ploy­ees aren’t given a choice and the plans don’t make sense for the work­ers be­cause of other fac­tors, says Pauly, a pro­fes­sor at the Whar­ton School at the Uni- ver­sity of Penn­syl­va­nia. Pauly ques­tions whether high-de­ductible plans should be of­fered to peo­ple be­low a cer­tain in­come on the Af­ford­able Care Act ex­changes, where the higher-de­ductible bronze and sil­ver plans are the ones most fa­vored.

Far fewer peo­ple were in poverty last year, ac­cord­ing to the new Cen­sus Bureau re­port, as 2.4 mil­lion more peo­ple found per­ma­nent full-time jobs. Still, it is low-in­come work­ers who are most likely to opt out of em­ployer-pro­vided in­surance and to post­pone care that they have to pay out of pocket for, Pauly says.

The “real dan­ger” sur­round­ing the in­crease in high-de­ductible plans is when lower-in­come peo­ple put off care and get sicker be­cause they can’t af­ford it, Alt­man says.

Though the ACA tends to get the blame for changes in em­ployer-pro­vided in­surance, Alt­man says he doesn’t think the amount and preva­lence of de­ductibles — or higher costs borne by work­ers — are re­lated to the law. Pauly says the ACA has prob­a­bly in­flu­enced em­ploy­ers’ de­ci­sions to shift to higher-de­ductibles plans. “If gov­ern­ment thinks they’re a good idea, why shouldn’t they?” Pauly says.

Em­ploy­ers fa­vor high-de­ductible health plans cou­pled with health sav­ings ac­counts that work­ers and em­ploy­ers can con­trib­ute pre-tax dol­lars to, the sur­vey found. Health care at­tor­ney Nancy Tay­lor, who rep­re­sents many large em­ploy­ers, says com­pa­nies are in­creas­ingly re­ward­ing peo­ple for par­tic­i­pat­ing in well­ness screen­ings and con­tribut­ing money into their HSAs.

“We’re in a pe­riod of a slow rev­o­lu­tion to skimpier, less com­pre­hen­sive cov­er­age.” Drew Alt­man, Kaiser Fam­ily Foun­da­tion Pre­mi­ums show only grad­ual in­crease, but more peo­ple face high de­ductibles

 ?? WHAR­TON ?? Mark Pauly
WHAR­TON Mark Pauly
 ?? GREEN­BERG TRAURIG ?? Nancy Tay­lor
 ?? ROBIN HOL­LAND ?? Drew Alt­man

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