Many Aging Boomers Struggle With Insurance Concerns

Low- and moderate-income people must often forgo treatments, report finds

FRIDAY, Jan. 20, 2006 (HealthDay News) -- Many aging baby boomers not yet eligible for Medicare are suffering from debilitating chronic conditions, yet often lack the resources to pay for essential health care, a new report finds.

"This is basically a working group actively saving for retirement," said Sara Collins, a senior program officer with the Commonwealth Fund, and lead author of the study. "We wanted to see whether they had health coverage, where they got coverage, and what their out-of-pocket costs were like and what that meant for access to care."

"These findings are clearly consistent with findings elsewhere," added Carol Pryor, senior policy analyst with The Access Project in Boston. "They point to a common problem."

According to the study, growth in U.S. health care costs is far outpacing increases in workers' wages. Employees are also being required to assume a greater share of premium contributions, deductibles and co-payments. And that's if they have any coverage at all.

The report joins a veritable deluge of data assessing the state of health insurance in the United States.

The situation is taking a toll. An earlier report from the Commonwealth Fund found that an estimated 77 million Americans, or 2 in 5 working adults, had a medical debt problem in the previous year.

The new findings appear in a report titled New Evidence on Health Coverage for Aging Boomers, put out by the Commonwealth Fund. It was to be presented Friday at the annual conference of the National Academy of Social Insurance.

The report was based on a survey of 1,189 adults aged 50 to 64 who were not enrolled in Medicare, who were employed full-time or part-time or who had an employed spouse.

More than 60 percent of the adults surveyed had been diagnosed with at least one chronic condition such as arthritis, cancer, diabetes, heart disease, high cholesterol or high blood pressure.

At the same time, health coverage was often lacking, with one-fifth currently uninsured or remembering a time they were uninsured since they were 50.

About 6 percent of insured older adults were really "underinsured." About one-third of respondents reported medical bill problems or accrued medical debt. Nearly one-quarter said they had foregone needed medical care because of the cost.

People with moderate incomes, like those with low incomes, worried about the affordability of health insurance. More than half of those with incomes below $40,000 and 42 percent of those with incomes between $40,000 and $60,000 reported being very worried about this issue.

In addition, 54 percent of people sampled with incomes under $25,000 and one-third of those with incomes between $25,000 and $40,000 said they had at some point gone without health insurance.

"What's surprising is the instability of coverage across low and moderate incomes," Collins said. "There is a sense of some risk and some high cost burdens among both low- and moderate-income working households in this age group."

About half of respondents in households with incomes under $40,000 and 43 percent of those earning $40,000 to $60,000 spent 5 percent or more of their income on out-of-pocket costs and premiums, the survey found.

Tax credits for people with low incomes so they can buy private insurance aren't likely to help, the authors said.

Pryor said: "One thing that jumps out at me is the inadequacy of many of the insurance products being sold. For people purchasing insurance on the individual market, their medical bill problems are really similar to people who are uninsured. Having these insurance policies is offering no protection at all."

"There's a big push to consumer-driven policies that would shift more of the costs to the individual," she continued. "You have to start asking yourself whether having this type of insurance provides any protection to people. For years, we have talked about the problem in terms of the uninsured. But if we cover more people with inadequate policies, we're really talking about the underinsured who are in as much jeopardy as the uninsured."

Some solutions?

Seventy-two percent of those polled, including a sizable number with higher incomes, said they would be interested in receiving Medicare before they turn 65. This could occur through some type of buy-in.

Another possibility would be a Medicare savings account, which would start accumulating before a person retires.

"Obviously, this is an age where chronic conditions start popping up," Collins said. "This raises concerns about people's ability to maintain their health as they move toward retirement and toward Medicare."

More information

Visit the Commonwealth Fund to see more findings from the report.

SOURCES; Sara Collins, Ph.D., senior program officer, The Commonwealth Fund, New York City; Carol Pryor, senior policy analyst, The Access Project, Boston; New Evidence on Health Coverage for Aging Boomers, released Jan. 20, 2006, by The Commonwealth Fund
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