Return to the Public Policy Issues to Watch page
Updated September 29, 2008
Study: More than 57 Million Americans Had Medical Debt in 2007
More than 57 million Americans experienced problems paying their medical bills in 2007, and 42.5 million of them had insurance coverage, according to a study released Wednesday by the Center for Studying Health System Change (HSC).
The number of Americans in families who had difficulties paying medical bills increased to 19.4 percent last year, higher than the 15.1 percent of people who faced the same difficulty in 2003, the study found. The rate of problems with medical bills remained stable for elderly Americans, but non-elderly people who were insured and uninsured also faced such problems in 2007, according to the study, which was funded by The Commonwealth Fund.
The study found that approximately 2.2 million people with medical bill problems came from families that filed for bankruptcy as a result of their medical bills. A larger group said they experienced other financial consequences, such as problems paying for food and housing.
Sixty percent of people said family members' illnesses caused problems with medical bills, while 28.6 percent of bill problems were because of an accident or injury. About 8 percent of respondents said their medical bill problems were caused by the birth of a child, according to the study.
The study found that people with medical debt in 2003 and in 2007 had to make hard compromises in terms of paying for other necessities. Sixty-two percent said they were contacted by a collection agency, and more than half said they had to borrow money to pay medical bills, according to the study.
- from a Commonwealth Fund e-Alert for Sept. 29, 2008.
Senate Passes Student Insurance Bill
According to CQ, the Senate on Thursday passed (voice vote) Michelle’s Law (H.R. 2851) to extend health insurance coverage to students who leave school because of injury. Under the current law, students over 18 years of age are only eligible for coverage if they are full-time students or if their parents are willing to pay higher rates. As the House passed the bill in July, it now heads to the president for his signature. AAUW supports measures that assist students in continuing to pursue their higher education goals without barriers.
- from AAUW's Washington Update for Sept. 26, 2008.
House Passes Mental Health Parity Bill
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (H.R. 6983) passed (376-47) the House on Tuesday, ensuring that mental illness must be treated the same as physical illness by insurance companies. Following the vote, House Speaker Nancy Pelosi (D-CA) released a press statement noting that this long overdue legislation will help the many Americans suffering from mental illness to seek help.
AAUW’s member-adopted 2007-2009 Public Policy Program states, “AAUW promotes the economic, social, and physical well-being of all persons. Essential to that well-being are…quality affordable health care.”
- from AAUW's Washington Update for Sept. 26, 2008.
Healthy Families Act Gains Support, At The Cost of Ohio Bill
The Ohioans for Healthy Families coalition, which has been the champion behind the Ohio Healthy Families Act, has announced that they will pull the legislation from the November ballot in Ohio. The group has said that despite widespread support shown in the polls, the decision was made to avoid a divisive and shrill campaign filled with misinformation that could potentially harm the state of Ohio. Speaking for Ohioans for Healthy Families, Becky Williams stated that the coalition will instead shift its focus to the national stage in support of the federal Healthy Families Act (H.R. 1542/S. 910). The bill provides full-time employees with seven paid sick days a year to be used for their own medical needs or to tend to the medical needs of a child, spouse or parent. Part-time employees would receive a pro-rated share of paid sick days.
There has been widespread support of the legislation at the federal level, as well as by many Americans. The National Opinion Research Center in Chicago found that 77 percent of Americans said paid sick days were “very important” to them, and 86 percent said employers should be required by law to provide them.
ACTION: AAUW members have been very supportive of the Healthy Families Act in the past, and many of you have already contacted your representative and senators about this legislation. However, millions of Americans still do not have the option of taking a sick day to care for family members or themselves without putting their jobs, their healthcare benefits, or their family stability at risk. Contact your representative and your senators now to urge them to cosponsor the Healthy Families Act so that America's families don't have to choose between keeping a job and caring for themselves or a loved one. AAUW’s voter guides compare candidates’ positions on a number of issues, including paid sick days. Read more about family friendly workplaces.
- from AAUW's Washington Update for Sept. 26, 2008.
Health Care and the 2008 Presidential Election:
Comparing the Candidates’ Positions On Health Care
With health costs rocketing skyward and growing numbers of uninsured Americans, it’s no surprise that health care is among the top concerns of voters across the country.
Senator McCain and Senator Obama have responded by announcing competing plans to address America’s health care crisis and by making their proposals central to their campaigns. Their different plans present us, the voters, with an opportunity to see where they stand on health care and what they would do if elected President.
Families USA has conducted an extensive analysis of their plans, “Health Care and the 2008 Election: Comparing the Candidates’ Positions on Health Care.”
There is notable common ground shared by the two candidates. Senator McCain and Senator Obama both recognize the critical importance of controlling spiraling health care costs and their plans address this problem in some similar ways. Beyond this important similarity, the two candidates take profoundly different approaches:
Senator McCain offers a radical restructuring of America’s health care system. His proposal seeks to move Americans from the employer coverage they currently have through their jobs to an individual market where each person negotiates premiums and prices with their insurance company on their own. His plan does not support regulations – including some that already exist today – that prevent insurance companies from excluding people or increasing their premiums because of pre-existing conditions or family health histories.
Senator McCain’s plan, if enacted as he proposes, would produce the most dramatic overhaul of America’s health care system since many employers began routinely offering health benefits to attract workers decades ago.
Senator Obama offers an approach that builds on what works in our current system and strengthens the aspects of our system that need improvement.
His proposal allows workers to keep the group coverage they now have through their jobs, since groups have more clout in bargaining for lower premiums and better benefits. Today, employers help nearly 180 million workers and their dependents obtain coverage. He would establish a National Health Insurance Exchange to enable people and businesses to purchase health coverage like members of Congress and federal employees have today. And his plan regulates insurance companies so they can no longer cherry-pick only the young and healthy and deny coverage to people with pre-existing conditions.
- from a Families USA eAlert for August 13, 2008 info@
Student Insurance Bill Moves in House
On Wednesday, the House Energy and Commerce Committee approved (40-0) Michelle’s Law (H.R. 2851), according to CQ. Michelle’s Law extends medical benefits for up to 12 months to part-time students who are affected by disease or injury. Under the current law, students over 18 years of age are only eligible for coverage if they are full-time students or if their parents are willing to pay higher rates. The bill did hit one barrier as Rep. Michael Burgess (R-TX) attempted to introduce an amendment preventing insurance companies from denying coverage to individuals that incur injuries from high risk activities, but the amendment was dismissed as being non-germane to the underlying bill. AAUW supports measures that assist students in continuing to pursue their higher education goals without barriers.
- from AAUW's Washington Update for July 21, 2008.
New England Has Highest Rate of Health Insurance Coverage
New England has the highest rate of health insurance coverage in the United States, while the Southwest has the lowest coverage, according to a Centers for Disease Control and Prevention study.
Only 11 percent of non-elderly adults and 4 percent of children in New England are uninsured, compared with 30 percent of adults and 18 percent of children in the Southwest, the Associated Press reported.
Three regions -- the Great Plains, Great Lakes in the upper Midwest, and the Northeast -- had uninsured rates of 14 percent to 15 percent for adults and 6 percent to 7 percent for children. In the Southeast, almost 23 percent of adults were uninsured.
Overall, about 17 percent of people under age 65 were uninsured when the survey of 106,000 families was conducted from 2004 through 2006, the AP reported.
Health Day for June 26, 2008
House Approves Paid Parental Leave for Federal Employees
The House passed (278 - 146) Thursday the Federal Employees Paid Parental Leave Act (H.R. 5781). This important legislation will provide federal workers up to four weeks of paid leave for the birth or adoption of a child, and will be a significant step towards paid paternal leave for all Americans. It was introduced by Rep. Carolyn B. Maloney (D-NY) on April 14 with hopes of setting a national standard for this policy, which is common among all industrialized nations other than the U.S. Sen. Jim Webb (D-VA) introduced companion legislation (S. 3140) to the bill on June 16 that mirrors the standard set in the current National Defense Authorization Bill, which authorizes 21 days of paid paternity leave for the military. The White House has issued a statement threatening a presidential veto of the bill should it pass through Congress, favoring instead a short-term disability program as an alternative. Supporters of the bill oppose this option which treats the responsibilities of parenting a newborn as a circumstance to be insured against, rather than a positive life event.
ACTION: AAUW applauds the House for passing this important legislation. AAUW also supports the Healthy Families Act (S. 910/H.R. 1542), which would provide full-time employees with a minimum of seven paid sick days a year to be used for their own medical needs or to tend to the medical needs of a child, spouse or parent. For more information, read AAUW's position paper on family friendly workplaces and visit the new FMLA section of AAUW’s Legal Advocacy Fund Resource Library for information, frequently asked questions, statistics, and resources.
- from AAUW's Washington Update for June 20, 2008.
New Report: States fail to protect against insurance company abuses
As the election season heats up, it is important to recognize how candidates are addressing health care reform – and how dangerous it can be to force individuals to fend for themselves in the private insurance market.
The stories are far too common of insurance companies unabashedly denying coverage to people with pre-existing conditions, refusing to pay for services needed to treat common ailments, and increasing premiums for people with family histories of health problems.
What are states doing to protect consumers against insurance company abuses? Very little.
Families USA released a 50-state survey of insurance commissioners that focuses on states’ regulatory oversight (and lack thereof) of the individual health insurance market.
Click here to view key findings and read the report. The individual market is increasingly important as employer-sponsored health insurance declines and some elected officials promote its deregulated expansion. Yet what this report highlights is that the individual private market does not well protect consumers.
Asking individuals to purchase insurance on their own without appropriate consumer protections is unfair and unethical since many states have done very little to regulate the business practices of the insurance industry.
Different states have different protections. In one state, consumers may be able to buy insurance that will cover their medical needs, but only at a very high price. Just across the state line, neighbors with similar medical conditions may find that although policies are cheaper, no insurer will sell to them or insurers will only sell them polices that exclude coverage of the very services that they most need.
View the report here, and other in-depth materials about how to improve state laws.
Insurance companies appear to have one goal in mind: to cherry-pick the healthiest individuals and leave others out on their own. This report shows that more needs to be done to protect consumers from such insurance company practices.
- from a Families USA e-Arlert for June 12, 2008.
New Study: 25 Million U.S. Adults Are Underinsured
The number of underinsured U.S. adults--people who have health coverage that does not adequately protect them from high medical expenses--has risen dramatically. A new Commonwealth Fund study published today as a Health Affairs Web Exclusive finds that as of 2007, there were an estimated 25 million underinsured adults in the U.S., 60 percent more than the 16 million underinsured in 2003.
Most of this growth came from rising uninsured rates among middle- and higher-income families, according to the article, How Many Are Underinsured? Trends Among U.S. Adults, 2003 and 2007 by the Fund's Cathy Schoen, Sara R. Collins, Jennifer L. Kriss, and Michelle M. Doty. While low-income people remain the most likely to be underinsured or uninsured, underinsured rates nearly tripled since 2003 for adults with incomes at or above 200 percent of the federal poverty level (annual family income of $40,000 or more).
Underinsured people, even though they have coverage all year, report access problems and financial stress at rates similar to those of the uninsured. For example, about half of both the underinsured and uninsured had difficulty paying medical care bills, were contacted by collection agencies for unpaid bills, or changed their way of life to pay medical bills.
The study was based on the Fund's 2007 Biennial Health Insurance Survey. Following the method used in the 2003 baseline study, adults ages 19 to 64 were classified as underinsured if they were insured all year yet spent 10 percent or more of their income (or 5 percent if low-income) on out-of-pocket medical expenses, or if they had per-person deductibles that equaled 5 percent or more of their income.
- from a Commonwealth Fund e-Arlert for June 10, 2008.
Young Adults Remain at Risk: 13.7 Million Lack Coverage The number of uninsured young adults in the United States rose to 13.7 million in 2006--an increase from 13.3 million in 2005--making the 19-to-29 age group one of the largest and fastest-growing segments of the population without health insurance. According to a newly updated report from The Commonwealth Fund, 38 percent of high school graduates who do not attend college and 34 percent of college graduates will spend some time uninsured in the year after graduation.
The latest survey data also show that working young adults are much less likely than older workers to have access to health insurance through their employers. Just over half (53%) of 19- to 29-year-olds were eligible for coverage offered by their employers, compared with about three-quarters (74%) of 30- to 64-year-olds. Young adults often lose coverage at age 19, as a result of being dropped from parents' policies or from public programs like Medicaid and the State Children's Health Insurance Program (SCHIP). Young adults from low-income households are most at risk. The report found that two-thirds of young adults who went through a period without insurance in the past year had also gone without needed health care because of the cost.
One-half reported that they had problems paying their medical bills or were paying off medical debt over time. In the face of these challenges, new efforts on both the state and federal level to cover young adults are gaining momentum. Twenty states have passed legislation requiring insurers to extend dependent coverage to young adults older than 18 or 19. The new age limits range from 24 in Delaware, Indiana, and South Dakota to 30 in New Jersey. Some congressional bills have proposed allowing states to extend eligibility for Medicaid and SCHIP beyond age 18.
- from a Commonwealth Fund e-Alert for May 30, 2008.