Employer-sponsored health insurance is not adequately covering all health services for many: report

Many Americans, especially women, struggle to pay for necessary medical services, especially dental and mental health care needs, despite having health insurance through their employer.

This is according to a recent report published in the Journal of the American Medical Association (JAMA).

“Many Americans get health insurance through their employers, but health insurance plans offered to workers offer lower benefits than they used to,” says NYU School Public Health Policy. and José A. Pagán, Professor and Chair of the Department of Administration. Global Public Health, he told Fox News Digital in an interview.

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He is co-author of a new paper published in JAMA.

“There’s an enormous amount of waste in the system, and those costs are passed on to the American worker every day,” said medical contributor for Fox News and health at Baltimore’s Johns Hopkins School of Public Health. Dr. Marty McCurry, Professor of Policy and Management, said. , Maryland.

About 61% of working-age Americans had health insurance through their employer in 2019, according to a new study published in JAMA, the study’s press release reveals.
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About 61% of working-age Americans had health insurance through their employer in 2019, according to the study’s press release.

Out-of-pocket medical costs continue to rise.

The Affordable Care Act helps uninsured young adults obtain coverage through their parents’ coverage, including maternity care coverage, and copayments and deductibles for preventive services. It has improved employer-sponsored insurance coverage by eliminating .

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However, out-of-pocket costs continue to rise.

More women skipped medical care

Researchers analyzed data from the National Health Interview Survey.

This is a nationally representative annual survey conducted by the Centers for Disease Control and Prevention (CDC), according to a press release.

A young pregnant woman visits the doctor. In the new study, researchers evaluated her more than 238,000 adults between the ages of 19 and 64 who obtained medical insurance through their employer or union from 2000 to 2020.
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Researchers evaluated more than 238,000 adults aged 19 to 64 who had health insurance through their employer or union from 2000 to 2020.

About 6% of U.S. women with employer-sponsored insurance skipped necessary medical care in the past year in 2020 due to costs, according to the study. This is double her 3% percentage in 2000.

A minority of men said they would skip necessary medical care because it was affordable. That number in 2020 was only 3%, compared to 2% in 2000.

Many Dental, Mental Health Services Are Not Affordable

Mental health and dental services have never been particularly affordable for some Americans, especially women.

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Researchers also found that the number of women without access to mental health care has tripled in recent years, from about 2% to more than 6%.

“From 2000 to 2020, the lack of access to dental services for both men and women was consistently the highest of all services,” the press release notes.

I am a working dentist. A new study found that “from 2000 to his 2020, the lack of access to dental services for both men and women remained the highest of all services each year.”
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“Women’s lower incomes and higher health care needs may have contributed to these differences in reported affordability,” said the NYU Global School of Public Health’s Public Health Policy and Lead author Avni Gupta, a doctoral student in the Faculty of Management, added: .

“Employer-sponsored insurance plans need to redesign their benefit packages to reduce gender-based disparities.”

“The main limitation of this study is that it does not include questions that delve deeper into the causes of rising health care costs,” Pagan told Fox News Digital.

“Employer-sponsored insurance plans need to redesign their benefit packages to reduce gender-based disparities.”

“Although the most recent data available is for 2020, the affordability trend may continue to increase as a result of the COVID-19 pandemic,” he said.

Why are healthcare services not affordable?

Pagan told Fox News Digital part of the reason many people are unable to access health care is the lack of health care providers.

“Finding a mental health care provider has been especially challenging since 2020, as it coincides with the year of the COVID-19 pandemic,” he added.

A woman in a clinic about to receive a vaccine. “The main limitation of [new] The survey does not include questions to dig deeper into the causes of rising health care costs,” Dr. José A. Pagán told Fox News Digital.
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“The bottom line is that many middlemen are getting rich at the expense of America’s everyday workers,” added Makari, who has written more about this in her latest book, The Price We Pay. .

He says pharmacy benefit plans are “the biggest area of ​​waste.”

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In New York state, health brokers receive 4% of every dollar spent on health insurance premiums, he noted.

At Makary’s co-owned business, “we pay $220 per person per month for health insurance through Sedera,” he said, adding, “That’s about half the cheapest Obamacare replacement option.”

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“Companies have been duped and do not have time to properly consider all options,” he added.