Study finds employer-sponsored health insurance comes up short

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U.S. adults -- and especially women -- are increasingly finding healthcare to be unaffordable with employer-sponsored health insurance plans, according to a research letter published on December 27 in JAMA. Dental care was deemed to be the most unaffordable.

Researchers from New York University (NYU), led by doctoral student Avni Gupta, MPH, used the U.S. Centers for Disease Control and Prevention's National Health Interview Survey to analyze data from 2000 to 2020 for more than 238,000 adults ages 19 to 64 years old who obtained their healthcare coverage through an employer or union. Dental care was consistently the most unaffordable of all healthcare services (JAMA, December 27, 2022, Vol. 328:24, pp. 2448-2450).

"People with health insurance coverage provided by employers generally think they are protected, but our findings show that health-related benefits have been eroding over time," co-author José Pagán, PhD, said in a statement.

Average of respondents reporting healthcare services to be less affordable
  Medical care Prescription medications Mental healthcare Dental care
Men 2.7% 2.7% 0.8% 5.4%
Women 3.9% 5.2% 2.1% 8.1%

"Lower incomes and higher health care needs among women could be driving these differences in reported affordability," Gupta said in a statement. "Employer-sponsored insurance plans need to redesign their benefit packages to reduce sex-based disparities."

Although affordability for some services has improved recently, nearly all services were considered to be less affordable compared to the early 2000s, according to the researchers. For example, approximately 6% of women found medical care to be unaffordable in 2020 compared to 3% in 2000. Meanwhile, about 3% of men considered medical care to be unaffordable in 2020 compared with 2% in 2000.

Furthermore, both men's and women's inability to afford dental services persistently remained the highest of all services every year from 2000 through 2020, according to the authors.

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