health insurance costs are overwhelming middle class americans
Jenn Ryan
Jenn Ryan
March 27, 2024 ·  5 min read

Health Insurance Costs Are Overwhelming Middle-Class Americans

Most Americans know the struggles that come with trying to meet their health insurance deductible, especially when faced with a devastating illness or medical emergency.

Lee-Ellen Macon, 57, is one such person. She’d already been through breast cancer, but earlier this year, she found out her cancer had come back and was now stage IV. Her insurance deductible was $4,000, and as a mom of two kids on a public school teacher’s salary, she’s been struggling to meet this amount and has already blown through her savings.

Macon is far from alone. It takes an average of a third of a year to meet an insurance deductible, and for some Americans, they won’t meet it at all that year [1]. What this means is that individuals and families have to pay out-of-pocket before the insurance will begin covering certain medical costs. 

My own deductible is $7,900—and healthcare coverage for my husband and I costs over $540 every month, and that’s after a federal tax credit. We haven’t used our insurance once this year.

Health insurance premiums and deductibles have exceeded middle-class Americans’ income growth in the past decade. This means we’re paying more of what we earn towards healthcare costs that don’t even necessarily cover basic treatment or more extensive costs.

A new report from The Commonwealth Fund analyzed data from 40,000 employers in the nation and reported back what they found about rising healthcare premiums and deductibles over the last decade.

Americans Are Paying a Growing Percentage of Their Income Towards Premiums and Deductibles

In the last decade (2008-2018), health insurance premiums grew an average of 4 percent every year. But the average income growth over the same time period only ranged from 1.5 percent to 3.8 percent. On average, employees are paying an average of 6.8 percent of their income for health insurance premiums (as of 2018) [2].

However, in 9 states, premium costs were 8 percent or more of the average income, with 10 percent in Louisiana, where Macon lives. In every state, the cost of healthcare premiums and deductibles outpaced income growth.

Southern states (of which 8 of the previously-mentioned 9 are) have a lower average income, but pay more of that income towards their health insurance costs. These states also tend to have sicker residents [3].

The Effect of Rising Health Insurance Costs on Our Health

The effect of these high deductibles and premiums don’t go without consequence on our health. People who have high deductibles often skip or delay recommended medical tests, and may even forgo prescription medication. 

In addition, 45 percent of adults in the United States aged 19-64 are “inadequately” insured [4].

Low-wage hourly workers are particularly at risk, as they can’t manage the high cost of premiums and so may opt to forgo health coverage completely [5].

Hourly workers who receive lower wages are also the most likely to be uninsured and not have access to coverage through a job, and some aren’t eligible for financial assistance for healthcare coverage.

However, they’re not the only people going without medical care. Faced with high deductibles and premiums, people are choosing to skip preventative care for major health conditions and chronic diseases [6]. Not to mention, when they do seek care, they often face medical bills they can’t afford. Medical bills are one of the primary causes of bankruptcy in the United States [7].

In addition, others find it difficult to manage healthcare costs and at the same time, support their family’s health through other means—think healthy food. How are we supposed to pay for health insurance and purchase nourishing foods to support our wellbeing, which naturally tends to be more expensive than boxed or processed items [8]?

What Are We Getting for These Increased Premiums?

What exactly are we getting for these increased costs? While we are supposedly getting better imaging and diagnostics through technology, and a one-year increase in life expectancy, the thing is that people are forgoing these diagnostic measures because they don’t want to pay out of pocket [9].

Which, of course, seems understandable. Why would you pay for care when you already pay for your health insurance premium every month—and more importantly, would you even be able to afford to?

In addition, our healthcare ranks low compared to other countries. So the cost of this care is expensive while the quality of care is subpar compared to peer nations [10]

We need better solutions to control these costs while also increasing our quality of care. And I’m not just talking about diagnostics. While some preventative care is covered, not everything is, just as certain diagnostic tests aren’t covered.

For example, my plan doesn’t cover “primary care visit to treat an injury or illness”, diagnostic tests including x-rays or bloodwork, emergency room care or transportation, or any type of drugs without first meeting the deductible. People shouldn’t have to choose between getting by and getting access to these care options.

As for Macon, she’s had trouble paying her bills, is unable to get her car repaired, and is now on short-term disability at just 60% of her former pay. For those who are interested, you can find her GoFundMe here.

As for me and my husband, we’ll continue to invest in our own forms of preventative healthcare, which include eating healthy and exercising, as well as taking care of our mental health. In the meantime, we can only hope that when (or if) a medical disaster does strike, we can swing that $7,900 deductible.

Sources

  1. https://www.ajmc.com/focus-of-the-week/the-average-american-now-pays-enough-oop-to-meet-their-deductible-on-may-19
  2. https://www.commonwealthfund.org/publications/2019/nov/trends-employer-health-care-coverage-2008-2018
  3. https://thinkprogress.org/people-living-in-the-south-have-shorter-sicker-life-expectancies-than-other-americans-4c504dde4e94/
  4. https://www.commonwealthfund.org/publications/issue-briefs/2019/feb/health-insurance-coverage-eight-years-after-aca
  5. https://www.nber.org/digest/aug05/w11063.html
  6. https://www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/
  7. https://www.thebalance.com/medical-bankruptcy-statistics-4154729
  8. https://www.wellness.com/blog/13284506/is-it-really-more-expensive-to-eat-healthier-your-guide-to-cheap-healthy-eating/jenn-ryan
  9. https://www.rand.org/pubs/research_briefs/RB9605.html
  10. https://www.epi.org/publication/health-care-report/
  11. https://abcnews.go.com/Health/middle-class-americans-crushed-rising-health-insurance-costs/story?id=67131097