By W. Stephen Love, President/CEO of the DFW Hospital Council

We frequently discuss the uninsured population, but what about the “underinsured?” Perhaps you are asking, “Just what is the underinsured?” They are residents with healthcare coverage crippled by out-of-pocket health costs that are 10 percent or more of household income. That bar is lowered to 5 percent or more of household income for low-income families.

The consequences of being underinsured are serious. People with high deductibles tend to skimp on healthcare, oftentimes not visiting the doctor when they are ill or skipping a medical visit. The increase in the Texas underinsured will also cause “bad debt expense.” To healthcare providers, this refers to the loss a company experiences because it provided services not requiring immediate payment. The loss occurs when the customer does not pay the amount owed. The underinsured contributes to this further erosion of operating margins. Combine this with the past few years when physicians and hospitals have been subjected to a flood of reduced reimbursements, sequestrations, fiscal cliffs and budget cuts.

In a Commonwealth Fund 2014 survey just released, 14 million adults were shown to be underinsured. This represented an increase of 3 million residents since 2012. The report also stated another 24 million adults had deductibles below the 5 percent, but when co-insurance, co-payments, out-of-network providers plus uncovered medical care were included, the total out-of-pocket costs totaled 10 percent or more of income so they too were considered underinsured.

The Kaiser Family Foundation reported nearly two-thirds of workers with benefits had deductibles of at least $1,000. Such costs were causing these workers to skip physician appointments to lessen the out-of-pocket expense. Obviously, this is not in the best interest of the patient and becomes a barrier to their healthcare.

Hopefully we can work together for new plans addressing this increasing problem that provide coverage. We must also balance financial incentives so they are not barriers to clinical treatment and care.