Are deductibles and coinsurance keeping employees from accessing healthcare?

Both employers and employees in the U.S. know that health insurance doesn’t necessarily make care affordable. As healthcare prices continue to rise, benefit leaders may have to rethink their health plans and break from the status quo.

The Survey of Income and Program Participation estimates that Americans collectively owe at least $195 billion in medical debt, despite over 90% of the U.S. population having health insurance. In other words, accessing life-saving care can ruin one’s finances, and avoiding care can ruin one’s health. That means the average health plan places workers in a precarious position, says Dr. Eric Bricker, medical director of insurance company SimplePay Health.

“A lot of companies are still giving employees health plans that are not actually affordable for the employee,” says Dr. Bricker. “An employer’s deductible could be $2,500 and the employees are paid $15, $18 or even $25 an hour.”

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Dr. Bricker argues that if most workers in a company do not make enough to comfortably meet their deductibles, then that health plan isn’t truly a benefit. Moreover, that health plan is a prime example of inequity and exclusivity, two challenges most companies have voiced a commitment to overcoming.

“The existing health insurance plan for the majority of employers today is contrary to the ‘E’ in DEI,” says Dr. Bricker. “For an employer to take steps to correct that, it shows employees the company’s true commitment to DEI, in not just words but action.”

Not to mention, a lack of access to healthcare equates to employees developing more severe, chronic conditions, which drives overall health plan costs for employers and increases absenteeism and presenteeism. 

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Dr. Bricker encourages employers to speak with their benefits brokers, vendors and advisers and reshape their health plans. He is confident with the right guidance employers can build a health plan that works for all, and it starts with these five steps.