A close look at Commonwealth Fund survey figures shows that Americans with incomes from 250 percent to 399 percent of the federal poverty level (FPL) are still having serious trouble with medical bills.
Patient Protection and Affordable Care Act (PPACA) coverage expansion programs, PPACA benefits mandates and changes in the economy have helped the highest-income residents and low-income residents get health coverage and pay their bills.
But people in 250 percent of FPL to 400 percent of FPL category were about as likely to be uninsured in 2014 as they were in 2012, and they were a little more likely to say they were having problems with medical bills.
The Commonwealth Fund, a health policy think tank, commissioned a telephone survey of 6,027 U.S. adults ages 19 and older who live in the United States. That survey took place from July 2014 through December 2014. The fund also commissioned a similar survey two years earlier.
The percentage of participants who reported being uninsured when they were surveyed dropped to 16 percent in 2014, from 19 percent in 2012. Sara Collins, a vice president at the Commonwealth Fund, and the other authors of a report on the results note that the total share of participants who reported having problems with medical bills fell to 23 percent, from 30 percent.
But the results varied by income level.
PPACA has created a new system of premium tax credit subsidies for people with incomes ranging from 133 percent of FPL to 400 percent of FPL, and “cost-sharing reduction” subsidies – subsidies that cut the amount a patient has to pay for deductibles, co-payments and coinsurance amounts – for people with incomes ranging from 133 percent of FPL to 249 percent of FPL. PPACA also created a Medicaid expansion program for very-low-income adults.
The premium subsidy tax credits are much more generous for people with incomes ranging from 133 percent of FPL to 250 percent of FPL.