Healthcare affordability is getting increasingly out of reach for ordinary Americans. The combination of soaring premiums, high deductibles, copays, and exemptions is putting increasing strain on household budgets, and making it extraordinarily difficult for employers to remain competitive.
The Healthcare Affordability Crisis
Too many Americans are burdened with medical debt and going bankrupt because of it—even with insurance.
In this evolving landscape, insurance alone isn’t enough. Families, employers, and policymakers need to start thinking creatively, and applying out-of-the-box solutions to help make quality healthcare accessible and affordable for all Americans.
Americans are Skipping Healthcare
Even with insurance, high deductibles, copays, coinsurance costs, and prescription drug costs create a massive obstacle between American families and the affordable healthcare they need.
For example, nearly 40% of insured Americans report putting off or skipping necessary treatments due to cost.
This shouldn’t come as a surprise. Inflation has run rampant in recent years, affecting everything from groceries to housing costs and transportation. Wages have not kept pace: Some 30% of Americans surveyed say they have difficulty affording essentials like food, utilities, and loan payments.
Today, more than 100 million Americans report carrying medical debt. And as many as 25% of all personal bankruptcies involve medical debt, along with other forms of debt.
This is a problem, because every medical debt that providers write off because consumers can’t pay has to be made up for somewhere—which ultimately increases medical costs on everybody else.
As the healthcare affordability crisis deepens, it is essential to understand the ripple effects of these cost-related challenges on individuals and their overall well-being.
More Reading: Healthcare Debt In The U.S.
The Cost of Healthcare Affordability Delays
Studies indicate that delays in care, whatever the cause, result in worsening health problems over time.
This, in turn, increases costs in the long run, driving up insurance premiums and causing an ever-more vicious cycle.
This underscores the urgent need for solutions that address both the financial barriers to care and the subsequent impact on individual health.
Compare Pricing on the Best Insurance Plans Available
What Can Be Done About Healthcare Affordability?
While there are no easy or cheap solutions to the healthcare affordability crisis, there are lots of things individuals and families can do to reduce the impact of catastrophic medical events.
Employers can also leverage employee benefits to reduce cost obstacles to employees seeking medical care, and make it much easier for workers to see their doctors and get the preventive care and interventions they need to avoid even bigger and more costly medical issues down the road.
Here are some options you can explore:
Health Sharing Programs
Traditional insurance models often come with hefty price tags, especially employers, and for those ineligible for ACA subsidies.
That’s why many families and employers are dropping overpriced, bloated traditional health insurance policies and switching to health sharing plans.
These are non-insurance alternatives to traditional insurance products that still offer potent risk reduction when it comes to major and catastrophic medical events—at a fraction of the cost of an unsubsidized health insurance policy.
For employers and individuals who don’t qualify for an Affordable Care Act subsidy, health sharing routinely saves 40 to 50% compared to the cost of a traditional insurance product.
For a family of four, this saves thousands of dollars per year.
Particularly appealing to small business owners and independent contractors, health sharing programs provide a community-driven approach to healthcare, offering a more personalized and cost-effective solution.
Direct Primary Care (DPC)
Access to primary care is a cornerstone of a healthy population, and direct primary care (DPC) models are transforming how employees engage with healthcare.
Direct primary care patients don’t use insurance to see their primary care doctors, and DPC practices don’t even accept it.
Instead, patients (or their employers) pay a low, affordable flat rate per month, like a gym membership fee.
In return, the patient gets as many appointments as they need with their primary care doctor. There are no additional fees or copays. And doctors’ offices have much lower administrative overhead.
Those who need to see their doctor frequently can save significant amounts of money.
They also have no cost obstacles to seeing their doctor, and getting the care they need. There’s no reason to put off care or go without. DPC solves the primary cost barrier for employees and their families.
That, in turn, reduces absenteeism, presenteeism, increases employee engagement and morale, reduces turnover, reduces injuries due to distracted or disengaged workers, and reduces long-term healthcare affordability utilization.
This model not only improves healthcare experiences but also contributes to cost savings and better health outcomes.
DPC plans pair very well with health sharing plans such as DPC DIRECT and HSA-compatible plans such as HSA SECURE.
Critical Illness Insurance
In the face of escalating healthcare costs, critical illness insurance emerges as a vital complement to traditional coverage.
This insurance type fills the gaps left by standard plans, providing individuals and small business owners with additional financial support when facing significant health challenges.
It provides a large lump sum immediately on diagnosis of a major illness, which can be used for any purpose—especially for things that major medical insurance doesn’t cover.
You or your employee can use it to help cover deductibles and coinsurance, replace lost wages from time off work, to pay caregivers, or pay for hotel and transportation expenses.
The ability of critical illness policies to offer a safety net in times of need makes them a crucial component in the pursuit of comprehensive coverage.
Hospital/Accident Insurance
Even a simple child’s broken ankle can generate thousands of dollars in medical costs.
Even with insurance, families can face thousands of dollars in out-of-pocket costs like deductibles and coinsurance—up to their health insurance policy’s maximum, which can be as high as $9,800 as of 2024.
Most middle class families can’t afford to stroke a check for even half of this amount. Up to 60% of workers are still living paycheck to paycheck, and don’t even have $1,000 they can pay for medical care without going into debt.
A hospital/accident insurance policy is affordable, and can be a godsend for low and middle-income families who have to go to the ER or a hospital.
For small business owners and individuals alike, hospital/accident policies offer a strategic way to manage out-of-pocket costs, ensuring that financial barriers do not hinder access to necessary healthcare.
Employers can offer critical illness and hospital/accident insurance, along with disability income insurance, as part of a Section 125 Cafeteria plan, which provides important tax advantages as well.
Questions? Speak with one of our experienced HSA for America Personal Benefits Managers for a free consultation and quote, or help designing and implementing your employee benefits package.
Compare Pricing on the Best HealthShare Plans Available
Healthcare Affordability Crisis Conclusion
The health insurance affordability crisis deepens, necessitating a reevaluation of traditional approaches.
To bridge the gap, individuals and small business owners must explore innovative and comprehensive coverage solutions. Critical illness insurance, hospital/accident policies, health sharing programs, and direct primary care present avenues that go beyond the constraints of conventional insurance models.
As we navigate the complexities of healthcare affordability costs, it is imperative to prioritize accessible and affordable solutions that empower individuals and small businesses in their pursuit of a healthier future.
Here are few more blogs for further reading: Thousands Are Switching from Traditional Health Insurance to Health Sharing | How Direct Primary Care is Transforming Healthcare | How to Combine a DPC Membership with a Health Sharing Plan | The Pros and Cons of Religious vs. Secular Health Sharing Plans
