Measuring The Burden Of Health Care Costs For Working Families

Political debate over the Affordable Care Act has defined the health policy political landscape for nearly a decade.  The impassioned back and forth over whether to “repeal and replace” or strengthen and defend the law has been a focus of multiple election cycles and millions of dollars in political ad spending. Amidst this ongoing discourse, it is easy to overlook the law’s important reforms to employer-sponsored insurance (ESI), which covers the majority of nonelderly Americans. The escalating costs faced by individuals and families with ESI have received far less attention than costs on the individual market or in public programs, but affordability concerns for this group are no less important.

Anecdotes and surveys suggest that families with ESI face major challenges in paying for their health care. Late last year, Kaiser Health News profiled a family of three earning $100,000 a year who accumulated $12,000 in medical debt, despite having ESI, earning income from four jobs, and experiencing no major health issues. Unfortunately, this story is not a rarity for American families. In 2018, one quarter of U.S. adults reported that cost was the nation’s most pressing health care issue, and 61 percent noted that paying higher premiums or a greater portion of medical expenses was a “major concern.” Roughly half of U.S. adults worried that they would not have enough money to afford care.  The burden of health care costs is heavy, and growing.