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High deductibles, copays drive more workers to put off health care

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As cost shifting among employer-sponsored health plans increases, a quarter of working adults with private health insurance can't afford their health care costs, a new analysis shows.

What's more, those with high deductibles or low incomes are putting off needed medical care and prescription drugs, according to a report released Friday by New York-based nonprofit the Commonwealth Fund.

Health care costs had the greatest impact on low and moderate income individuals and families. Thirty percent of people with moderate incomes and 53% with low incomes can't afford their health care costs, the report showed.

The Commonwealth Fund's new affordability index published in the report defines a moderate income as up to $46,680 for an individual or $95,400 for a family of four, and a low income as less than $23,340 for an individual and $47,700 for a family of four.

High deductibles, which the report characterizes as 5% or more of a person's income, are one culprit: According to the report, 43% of all adults surveyed said their deductible is difficult or impossible to afford. The percentage rose to 51% for low- and moderate-income individuals.

Those with high deductibles relative to their incomes are putting off needed care. Forty percent of people with high deductibles said they had not gone to the doctor when they were sick, had not gotten a preventive care test, skipped a recommended follow-up test, or had not gotten specialist care they needed because of their deductible, the report shows.

And 39% of low-income individuals put off care because of copayments or coinsurance.

“More Americans than ever have health insurance, but these findings show that too many people with all types of coverage aren't getting care because of high costs,” Commonwealth Fund President Dr. David Blumenthal said in a statement.

The analysis is based on the Commonwealth Fund's Health Care Affordability Tracking Survey conducted in July and August, and focuses on 1,687 adults, the majority of which were privately insured.