Medical debt a crippling problem for many Americans – InsuranceNewsNet

By Kathleen Stoll

Workers in West Virginia and across the country face significant financial challenges. The struggle to pay medical bills and the burden of medical debt are among the greatest of these challenges. Like many workers in West Virginia, I’m “underinsured.” That is, I pay private insurance premiums, but I remain at risk of incurring a large medical debt.

I joke that my only goal as a “rider” is to not fall off my horse. Not only is it embarrassing and possibly painful to hit the ground, but I also can’t afford to go to the hospital, even though I have private health insurance.

First, I have a high deductible – I have to spend $6,900 before my health insurance kicks in.

Second, it’s not like health care is free and the medical bill goes away once I spend that deductible. I still have out-of-pocket expenses for health care co-payments, capped at $6,900 per year. But not all medical bills count towards this co-pay cap. “Charges charged on the balance” and charges for uncovered health benefits do not count towards the disbursement limit. Even with health insurance, my medical bills can quickly add up to $15,000 or $20,000.

Why am I afraid of falling? Because I had bouts of vertigo. If I agree to a series of tests to explore the possible causes of my dizziness, the resulting medical bills could make my head spin much worse. I’m going to rack up $6,900, plus another $6,900 in medical bills, and probably more. So I have to keep my butt in the saddle until I keep some extra cash in the bank.

And my insurance plan is not the most expensive premium plan in the state market. Some plans may have higher deductibles and disbursement limits than my plan: a deductible of $7,700 and a disbursement limit of $8,700 for an individual and $17,400 for a family. It really is a head-turning change.

A new report from the Consumer Financial Protection Bureau found that an astonishing 30% of West Virginians have medical debt in collection. When healthcare providers turn medical debt over to collection agencies, it can mean low credit scores, garnished wages, and even bank account seizure.

Over the past five years, more than half of all American adults say they’ve gotten into debt because of medical or dental bills, according to a June poll by the Kaiser Family Foundation. An analysis of census data shows that 23 million people (nearly 1 in 10 adults) have significant medical debt. In total, Americans owe at least $195 billion in medical debt. Approximately 16 million adults in the United States have medical debt over $1,000 and 3 million adults have medical debt over $10,000.

Among those in debt, 1 in 5 say they never expect to be able to repay it. Even if it’s not in collection, this debt is likely charged to a credit card or other high-interest installment plan. It becomes a payment plan for the rest of your life that eliminates rungs on the upward economic mobility ladder for West Virginians – restricting a person’s ability to get a loan to buy a home, save for the kids’ tuition, set up a retirement plan or even just make ends meet from month to month.

This quote says it all.

“We have a healthcare system that is almost perfectly designed to create debt,” said Dr Rishi Manchanda, who works with low-income patients and served on the board of nonprofit RIP Medical. debt.

And while our healthcare system is perfectly designed to create debt, it does not create healthy consumer behavior. Many of us avoid necessary and proper care because we are trying to dodge debt. In the long term, this can mean that a health problem can become more serious and the medical intervention more expensive.

According to the Kaiser Family Foundation survey, about 1 in 7 people with debt said they had been denied access to a hospital, doctor or other provider because of unpaid bills. An even larger share – around two-thirds – have postponed the care they or a family member needs because of the cost.

The recent passage by Congress of the Inflation Reduction Act is helping to some extent. The law extends larger premium subsidies for people who buy insurance in the state market for the next three years. This extra assistance can help people afford a plan with a smaller deductible or lower copays. Even with this extra help, the bottom line is that private health insurance and health issues equate to high medical bills.

Medicaid – on the other hand – is affordable health insurance coverage with more comprehensive benefits, no deductibles, and very low co-payments.

OK, so get dizzy and sign me up for Medicaid. But to get Medicaid, I would have to work less or stop working all together. But I like my job. Medicaid low-income eligibility puts me and many West Virginians in the dilemma of wanting to work, but knowing that work can mean less affordable health insurance and health care. It’s no laziness when some West Virginians decide that Medicaid income eligibility creates a line they won’t cross by working more hours or accepting a promotion. But it doesn’t have to be that way.

I’m willing to bet a hospital stay copay that there are realistic and achievable ways for West Virginia to open the door to affordable health care for the hardest working (and hardiest) West Virginians. demanding). We don’t have to accept a threadbare blanket for our working families in West Virginia – a blanket that fits like a pony blanket on a workhorse; not really any protection at all.

It’s time to start the discussion about what a new, more affordable and comprehensive health insurance option might look like for workers in our state. We can rely on private insurance and Medicaid, and take advantage of federal money. There are good ideas from states like Colorado, Kentucky, Minnesota, and New York that can be adapted to West Virginia. Let’s not let the fear of medical debt continue to hold back the workers of our state.

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John A. Bogar