Our infographic shares new data about the high out-of-pocket costs that consumers with non-group health insurance experience.
Non-Group Health Insurance: Many Insured Americans with High Out-of-Pocket Costs Forgo Needed Health Care
Our report finds that one-quarter of consumers who buy insurance on their own still have problems being able to afford needed care.
Ruth Petran has celebrated Mother’s Day with her children for the past 33 years, but this Mother’s Day is special. Ruth says it’s the kind of Mother’s Day that wouldn’t have been possible without the Affordable Care Act. This is the first Mother’s Day that Ruth will celebrate as a grandmother, as well as a mother. For years, Ruth worried that her daughter’s private insurance policy without maternity coverage would force her to delay having children. Thanks to the ACA’s protections that mandate maternity coverage for all consumers, Ruth’s daughter, could access the insurance she needed to start a family and give Ruth the grandchild she had been hoping for.
The second open enrollment period just ended—and it was a tremendous success. The fact that enrollment systems functioned much better this time around certainly made it easier for people to enroll. But there’s no doubt that the commitment and creativity of 23,000 certified application counselors, navigators, and in-person assisters across the country have made big contributions to enrollment gains. In this enrollment period, we saw navigators and assisters reach new heights of creativity as they strove to find consumers and help them sign up for health insurance.
Both a call to action and a roadmap for progress, Families USA’s latest report, Health Reform 2.0 lays out a path for securing high-quality, affordable health care to all Americans—regardless of income, age, race, or ethnicity—and for achieving the “Triple Aim”: improving health, enhancing quality of care, and reducing health care costs.
Health Insurance Marketplace Experts: Savvier Consumers Prioritizing Health Care Needs over Premiums
With the second open enrollment period three weeks under way, we continued our series of talks with enrollment experts and journalists on December 3. Speakers shared how enrollment is unfolding in four of the federally facilitated marketplaces: Missouri, Illinois, Michigan, and Florida. There was general consensus among the experts that the emerging trend for second enrollment is that consumers renewing their coverage are savvier shoppers—thinking about how their health plans will meet their health needs rather than only focusing on the cost of monthly premiums. And they are asking more targeted questions about benefits and providers
By partnering with health insurance companies, enrollment assisters gain access to plan information and health literacy resources. Assisters can more easily obtain answers to consumer questions about the marketplace plans available to them and troubleshoot consumer problems.
When health plans design their provider networks, they need to ensure that these networks are adequate and provide meaningful access to care. The Affordable Care Act established the first-ever federal rights guaranteeing private insurance consumers access to adequate networks.
Much like a cell phone, an insurance plan is only as good as its network. Protections enacted at the federal and state levels are an important step toward strengthening private insurance provider networks. The Affordable Care Act created the first-ever provider network protections for private insurance consumers. These protections require health insurance marketplace plans to have adequate networks to meet their enrollees’ medical needs in a timely manner.
Whether they need guidance with improving outreach, helping consumers understand their health coverage, or using the media to spread the word, resources are available to help navigators and assisters be successful.