adults ages 19–64 with individual coverage or who thought about or tried to buy it in past three...
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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
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