Medical Debt goes hand-in-hand with Obamacare

Millions of Americans will get health insurance through the Affordable Care Act that will protect them from potentially ruinous medical expenses, but a new USA TODAY analysis shows the health plans they can choose still leave them vulnerable to thousands in deductibles and other out-of-pocket costs each year. 

Medical insurance deductibles for plans on the federal exchange covering 34 states average $3,000, and those for the least expensive, bronze-level plans average $5,082, according to the USA TODAY analysis of deductible data for HealthCare.gov. Those costs, according to a recent study, may still be more than many people can afford.

The USA TODAY analysis also found the lowest out-of-pocket limits on HealthCare.gov plans were $4,350 for individuals on bronze plans and $8,700 for families, although these were not the norm and are likely paired with high premiums. 

Even relatively modest cost sharing can prove unaffordable because expenses are often unexpected, and most Americans have less than $3,000 to cover such costs, according to a new Kaiser Family Foundation report on medical debt among the insured concludes.

The new health care law requires consumers' portions of health care expenses — known as cost sharing — to be capped at $6,350 for individuals and $12,700 for families. 

Many plans have lower limits on out-of-pocket costs than the federal limit, but the plans increasingly also have separate deductibles for prescription drugs. And expenses for drugs that aren't covered by plans or for out-of-network physicians aren't applied against limits.

That makes it more likely consumers, especially those with chronic health conditions such as asthma or high blood pressure, will be hitting these out-of-pocket maximums, says Matt Eyles, executive vice president at consulting firm Avalere Health. 

"The ACA is an important safety net, but it doesn't necessarily solve the problem of high up-front medical expenses for those who don't have ability to pay for them," Eyles says.

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