Increased cost-sharing, particularly high deductibles, lead patients to neglect necessary healthcare, according to a position paper from the American College of Physicians (ACP).
“The effects are particularly pronounced among those with low incomes and the very sick,” said Nitin S. Damle, M.D., president of the ACP in an announcement that accompanied the paper.
By exposing individuals to the full cost of certain expenses, cost-sharing undermines the primary function of insurance, says the ACP, noting that underinsurance may be a more challenging problem than lack of insurance.
More than 40 percent of marketplace plan enrollees and more than 20 percent of those insured through employers who report being in fair or poor health or having a chronic condition express confidence that they can afford necessary care, the paper says. But those with high-deductible plans have less confidence in their ability to afford a serious illness than those with low-deductible plans.
The ACP notes that rising premiums have led many employers to shift costs to employees in the form of higher average deductibles, which more than doubled between 2005 and 2015, even as wages remained largely flat.
HENRY KOTULA 
