Adults ages 19–64 with individual coverage or who thought about or tried to buyit in past three years who: Total

Health problem

No health

problem<200% poverty

200%+ poverty

Found it very difficult or impossible to find coverage they needed

34% 48% 24% 43% 29%

Found it very difficult or impossible to find affordable coverage

58 71 48 72 50

Were turned down or charged a higher price because of a pre-existing condition

21 33 12 26 18

Never bought a plan 89 92 86 93 86

Figure ES-1. Individual Market Is Not anAffordable Option for Many People

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

Figure ES-2. Adults with Higher Deductibles Are More Likely to Spend a Greater Share of Household Income on

Family Out-of-Pocket Expenses and Premiums

4036

55

67

25 22

3643

0

25

50

75

100

Total <$500 $500–$999 $1,000+

Spent 5% or more of inc ome on out-of-poc ket c os ts

Spent 10% or more of inc ome on out-of-poc ket c os ts

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

Annual deductible

Percent of adults ages 19–64 insured all year with private insurance

Adults ages 19–64 with individual coverage or who thought about or tried to buyit in past three years who: Total

Health problem

No health

problem<200% poverty

200%+ poverty

Found it very difficult or impossible to find coverage they needed

34% 48% 24% 43% 29%

Found it very difficult or impossible to find affordable coverage

58 71 48 72 50

Were turned down or charged a higher price because of a pre-existing condition

21 33 12 26 18

Never bought a plan 89 92 86 93 86

Figure 1. Individual Market Is Not anAffordable Option for Many People

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

Figure 2. Adults Insured in the Individual Market Are Less Likely to Give Their Health Plans High Ratings

22 2214

31 32

20

0

25

50

75

Total ESI Individual

Very good

Excellent

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

53 54

34

Percent of adults ages 19–64 insured all year with private insurance

Figure 3. Percent of People Who SayThat Employers Do a Good Job Selecting

Quality Insurance Plans to Offer Their Workers

7468

7569 70

75 76

0

25

50

75

100

Total <200% 200%+ <20 20–99 100–499 500+

Percent of adults ages 19–64 insured all year with ESI

ESI = employer-sponsored insurance.

^ Based on respondents who are covered by their own employer’s insurance.

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

% FPL Number of employees in firm^

Figure 4. Percent of Employees Who Are OfferedTwo or More Health Plan Choices

5445

56

25

38

48

71

0

25

50

75

100

Total <200% 200%+ <20 20–99 100–499 500+

Percent of adults ages 19–64 insured all year with ESI

% FPL Number of employees in firm^

ESI = employer-sponsored insurance.

^ Based on respondents who are covered by their own employer’s insurance.

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

Figure 5. Did You Choose the Plan with theHigher or Lower Deductible?

Higher25%

Lower44%

Deductiblewas the same

4%

ESI = employer-sponsored insurance.

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

Don’t know/ refused

20%

Percent of adults ages 19–64 insured all year with ESI

No plans have a deductible

7%

Figure 6. More than Half of Adultswith Individual Market Coverage Have

Annual Premium Costs of $3,000 or More

13 1322

7 5

32

0

25

50

75

Total ESI Individual

Annual premium $6,000 or more

Annual premium $3,000–$5,999

ESI = employer-sponsored insurance.

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

20 18

54

Percent of adults ages 19–64 insured all year with private insurance

Figure 7. Two of Five Adults withIndividual Coverage Spent 5 Percent or More

of Income on Premium Costs

16 14

43

5 4

25

0

25

50

75

Total ESI Individual

Spent 5% or more of income on premium

Spent 10% or more of income on premium

ESI = employer-sponsored insurance.

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

Percent of adults ages 19–64 insured all year with private insurance

Figure 8. More than One-Third of Adults with Individual Coverage Have Annual Deductibles

of $1,000 or More

12 12 11

10 8

37

0

25

50

75

Total ESI Individual

Annual deductible $1,000 or more

Annual deductible $500–$999

ESI = employer-sponsored insurance.

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

22 20

48

Percent of adults ages 19–64 insured all year with private insurance

Figure 9. Adults with Individual CoverageAre More Likely to Spend $5,000 or More Annually

on Personal Out-of-Pocket Expenses

27 27 33

4 3

8

0

25

50

75

Total ESI Individual

Annual out-of-poc ket c os ts $5,000 or more

Annual out-of-poc ket c os ts $1,000–$4,999

ESI = employer-sponsored insurance.

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

31 30

41

Percent of adults ages 19–64 insured all year with private insurance

Figure 10. Adults with Higher DeductiblesAre More Likely to Spend $1,000 or More

on Personal Out-of-Pocket Expenses

27 2535 42

4 2

5

13

0

25

50

75

100

Total <$500 $500–$999 $1,000+

Annual out-of-poc ket c os ts $5,000 or more

Annual out-of-poc ket c os ts $1,000–$4,999

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

Annual deductible

31 27

40

55

Percent of adults ages 19–64 insured all year with private insurance

Figure 11. One-Quarter of Adults Spent 10 Percentor More of Their Household Income Annually on Family

Out-of-Pocket Expenses and Premiums

40 38

65

25 24

43

0

25

50

75

100

Total ESI Individual

Spent 5% or more of inc ome on out-of-poc ket c os ts

Spent 10% or more of inc ome on out-of-poc ket c os ts

ESI = employer-sponsored insurance.

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

Percent of adults ages 19–64 insured all year with private insurance

Figure 12. Adults with Higher Deductibles Are More Likely to Spend a Greater Share of Household Income on Family

Out-of-Pocket Expenses and Premiums

4036

55

67

25 22

3643

0

25

50

75

100

Total <$500 $500–$999 $1,000+

Spent 5% or more of inc ome on out-of-poc ket c os ts

Spent 10% or more of inc ome on out-of-poc ket c os ts

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

Annual deductible

Percent of adults ages 19–64 insured all year with private insurance

Figure 13. Low-Income Households at Most Riskfor Spending Greater Shares of Income on

Family Out-of-Pocket Expenses and Premiums

40

5761

3730

25

42 40

21 18

0

25

50

75

Total <$20,000 $20,000–

$39,999

$40,000–

$59,999

$60,000+

Spent 5% or more of inc ome on out-of-poc ket c os ts

Spent 10% or more of inc ome on out-of-poc ket c os ts

Annual income

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

Percent of adults ages 19–64 insured all year with private insurance

Figure 14. Adults with High DeductiblesAre More Likely to Avoid Needed Health Care Because of

Cost

168 11 12

2522

1217 19

3127

1926 24

44

0

25

50

75

Did not fill a

prescription

Did not see

specialist when

needed

Skipped

recommended

test, treatment,

or follow-up

Had medical

problem, did not

see doctor or

clinic

Any of the four

access

problems

<$500 $500–$999 $1,000+

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

Percent of adults ages 19–64 insured all year with private insurance

Figure 15. Adults with Higher Deductibles Are More Likely to Have Health Plans That Limit Total Dollar Amount Plans

Will Pay for Medical Care Each Year

3430

40

48

0

25

50

75

Total <$500 $500–$999 $1,000+

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

Annual deductible

Percent of adults ages 19–64 insured all year with private insurance who report plan limits

Figure 16. Problems with Health Insurance Plan,by Deductible

19 23

6

37 35

11

40 40

15

0

25

50

75

Had expensive medical

bills for services not

covered by insurance

Doctor charged more than

insurance would pay and

you had to pay difference

Reached limit of what

insurance company would

pay and left w ith

expensive bills

<$500 $500–$999 $1,000+

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

Percent of adults ages 19–64 insured all year with private insurance

Figure 17. Adults with High DeductiblesHave Problems Paying Medical Bills

or Are Paying Off Medical Debt

148 6

172323

913

2735

20

5

17

31

41

0

25

50

75

Not able to pay

medical bills

Contacted by

collection

agency*

Had to change

way of life to

pay medical

bills

Medical bills/

debt being paid

off over time

Any medical bill

problem or

outstanding

debt

<$500 $500–$999 $1,000+

* Includes only those individuals who had a bill sent to a collection agency when they were unable to pay it.

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

Percent of adults ages 19–64 insured all year with private insurance

Figure 18. Adults with Higher DeductiblesAre More Likely to Rate Their Current

Health Insurance Coverage “Fair” or “Poor”

1915

23

41

0

25

50

75

Total <$500 $500–$999 $1,000+

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

Annual deductible

Percent of adults ages 19–64 insured all year with private insurance who rate plan “fair” or “poor”

Figure 19. Adults with Higher DeductiblesAre Less Satisfied with the Quality of Health Care They

Have Received in the Past Year

4954

42

29

0

25

50

75

Total <$500 $500–$999 $1,000+

Percent of adults ages 19–64 insured all year with private insurance who are “very” satisfied

Source: The Commonwealth Fund Biennial Health Insurance Survey (2005).

Annual deductible