Employees Start To Feel The Squeeze Of High-Deductible Health Plans

Enlarge this image toggle caption Nick Krug/Los Angeles Times Nick Krug/Los Angeles Times

Workers with a steady paycheck already know that wages have been stubbornly slow to rise. Meanwhile, those who get health insurance through a job have seen their deductibles shoot up. In fact, says Noam Levey, a health care reporter for the Los Angeles Times, deductibles have, on average, quadrupled over the last dozen years. As a result, even some people who have health insurance are having trouble affording medical care. We talked with Levey about his latest reporting into how the issue is affecting workers and their families.

Interview Highlights

On why he decided to embark on this project:

We've spent so much time fighting about Obamacare over the last 10 years and talking about the uninsured that I think we lost sight of this quiet revolution that's happened with health coverage for the tens of millions of Americans who have coverage through an employer. These are the people who've seen deductibles rise astronomically — rising four times in the last dozen years from about $350 on average to $1,350 on average. In some cases, people are seeing $4,000, $5,000, even $6,000 deductibles that they have to pay out of their own pocket before their health insurance kicks in. Needless to say, many, many Americans can't afford those kinds of bills.

On what he heard in talking to people:

We heard some really heartbreaking stories. So we did a nationwide poll with the Kaiser Family Foundation as part of this project. One of the things that we found was that half of Americans who get job-based coverage say they or an immediate family member in the last year have put off going to the doctor, not filled the prescription or delayed some other kind of medical care because of concern about cost. We found one in five had depleted their savings to pay a medical bill in the last year and one in six reported that they have had to make some kind of difficult sacrifice in order to pay a medical bill.

Some of them were really gut wrenching. We talked to a 27-year-old chef in western Virginia trying to start a family with his young wife. His wife had a miscarriage. They got such huge medical bills he had to take two extra jobs and was working from 5 a.m. until 11 p.m. some days.

These are people with health insurance. This used to be something we heard about all the time for people who didn't have health insurance, but in many cases these are middle-class people making $75,000 or $100,000 a year. But if they get a $5,000 or $6,000 medical bill — a family of four, kids in school — it's hard for a lot of people to come up with that kind of money.

On what's coming next in his reporting

We're going to be looking particularly at how these high deductibles are problematic for people who have serious medical conditions — diabetes, heart disease, even cancer. One of the things we found particularly troubling is that these people who should be going to the doctor, even they are cutting back on their treatment.

We're going to be looking at how these high-deductible plans are exacerbating inequality at a time when this is a major issue for Americans about who's getting the gains in our economy. If you're living paycheck to paycheck and you get sick, it's really tough for that group of people.

One of the other things that's amazing, and I know NPR has looked a little bit at this, is that the growth of online charities and crowdfunding sources like GoFundMe is being driven in large part by people seeking to pay medical bills. And one of the amazing things about those people is that many of them have health insurance.

Noam Levey reports for the Los Angeles Times and can be found on Twitter: @NoamLevey.