Andrea Clay’s 17-year-old daughter was sick and becoming dehydrated last month.
In previous years, the Stafford County mom would have taken her daughter to the hospital for intravenous fluids.
This year, she gave her a bottle of Gatorade.
“I want to be clear: We were not compromising her health, but you think twice about seeking care when you have a $9,000 deductible,” Clay said. “We stayed home a lot longer than we would have if we had decent insurance.”
Clay and her husband are among a rising number of insured Americans who are delaying health care treatments because of cost.
As a cancer survivor, Crawford Clay had trouble getting insurance before the Affordable Care Act.
Now, he’s covered. But he’s paying a high price.
Both Andrea and Crawford Clay work, but neither can get insurance through their jobs. So they went to the health insurance marketplace last year.
They found a family plan that costs $475 per month after subsidies—an amount they could afford. But the insurance includes a $9,000 deductible.
“It ought to be considered catastrophic insurance, because it’s not wildly helpful,” Clay said.
Both of their daughters—including one who attends James Madison University—have been sick this fall. And Clay quickly learned the cost of each test—a rapid strep test costs $47, versus $25 for the one that takes longer. A simple blood oxygen monitor costs $7 per use.
“We have to do it because these are our kids, but it adds up,” Clay said. “There are hard, hard choices out there. When your kid has the sniffles, do you go to the pediatrician?”
It’s a question many Americans are asking these days. Thanks to the ACA, more people than ever have health insurance.
But 1 in 3 Americans delays health treatments because of cost, according to a recent Gallup poll.
Each November, the polling company asks Americans if they have put off any treatments in the past 12 months for themselves or a family member. This year, more respondents than ever said “yes.”
The numbers don’t vary widely from previous years. Last year, 30 percent of respondents said they put off treatment. This year, 33 percent did.
But this year, the number of insured people putting off treatments has risen, from 25 percent in 2013 to 34 percent in 2014.
And a report from the Commonwealth Fund showed that 13 percent of Americans with health insurance spend at least 10 percent of their annual income on out-of-pocket health care costs.
The rising costs are an unintended consequence of the ACA, said Doug Gray, executive director of the Virginia Association of Health Plans.
“Everyone now gets covered for the same price, regardless of their health conditions,” Gray said. “So a person who is young, sick, old or healthy pays the same price. Under the old approach, if you were very sick, you had very high premiums. Now older, sick people are covered but younger, well people have a bigger price to pay.”
Insurance companies and employers share that cost with consumers in two ways: premiums and deductibles.
Insurance premiums have been rising over the past few years. In 2015, many federal employees will see their health insurance premiums rise by about 20 percent.
And many employers who didn’t use deductibles now do, Gray said. For most people, the increase in deductibles isn’t as steep as the one the Clays have, he said.
And higher deductibles encourage consumers to become savvy about health care expenses, Gray said.
The out-of-pocket expenses are rising as health care costs continue to climb.
“It is not likely that health care costs will go down,” Gray said. “The real question is whether they will stabilize or increase at a slower rate.”
Amy Umble: email@example.com