Skip to main content

Perspectives on Essential Health Benefits Workshop Report (2012) / Chapter Skim
Currently Skimming:

14 Assessing Affordability and the Potential for Underinsurance
Pages 149-156

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.


From page 149...
... MEPS MEPS, which is conducted by AHRQ, surveyed a nationally representative sample of approximately 12,000 households and 31,000 people in 2008. The Household Component, in particular, collected detailed information on family income, demographics, health status, chronic conditions, use of and expenditures for health care services, 149
Read the entire page →
From page 150...
... Banthin said, is because the total OOP spending includes premiums. Comparatively, she said, the uninsured have a lower financial burden because they do not pay premiums and because "they may restrict their health care services in order to avoid having to pay out-of-pocket." However, when Dr.
Read the entire page →
From page 151...
... . For families without a very high financial burden (i.e., spending less than 20 percent of family income on OOP health care spending)
Read the entire page →
From page 152...
... . As shown in Figure 14-2, both uninsured and underinsured individuals are at high risk of foregoing needed care and of having financial stress related to outstanding medical bills or medical debt (Schoen et al., 2008)
Read the entire page →
From page 153...
... with below-average income have high out-of-pocket health care costs even when insured. SOURCE: Schoen, 2011.
Read the entire page →
From page 154...
... TABLE 14-1 The Commonwealth Fund's Analysis of Premiums as a Proportion of Income, Out-of-Pocket Maximum, and Actuarial Value for Plans Established Under the ACA Income Premium as % income, Poverty Threshold 2011 Single or Family Silver level Out of pocket maximum Actuarial value <133% S: <$14,484 2% $1,983 94% F: <$29,726 $3,967 133 to 150% S: <$16,335 3 to 4% $1,983 94% F: <$33,525 $3,967 150 to 200% S: <$21,780 4.0 to 6.3% $1,983 87% F: <$44,700 $3,967 200 to 250% S: <$27,225 6.3 to 8.05% $2,975 73% F: <$55,875 $5,950 250 to 300% S: <$32,670 8.05 to 9.5% $2,975 70% if silver F: <$67,050 $5,950 300 to 400% S: <$43,560 9.5% $3,967 70% if silver F: <$88,200 $7,933 SOURCE: Schoen, 2011. Based on Collins et al., 2011.
Read the entire page →
From page 155...
... 2008a. Effects of increased patient cost sharing on socioeconomic disparities in health care.
Read the entire page →

Key Terms

  • health affairs
  • medical bills
  • commonwealth fund
  • cost sharing
  • health benefits

  • essential health
  • medical debt
  • family income
  • health insurance
  • medical expenses

  • oop expenses
  • financial burdens
  • financial stress
  • total oop
  • pay medical

  • care services
  • silver level
  • cathy schoen
  • oop health
  • care service

  • level plan
  • uninsured families
  • poor families
  • oop costs
  • care costs

  • federal poverty
  • poverty level
  • insurance plans
  • prescription drugs
  • insured people


    • This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
    More information on Chapter Skim is available.