While policy makers and health leaders have appropriately focused on addressing the COVID-19 pandemic, underlying racial and ethnic disparities in health exposed by the pandemic, and expanded coverage for the uninsured, another deep and challenging problem has intensified with little public debate: the growing affordability problem faced by US residents with employer-sponsored insurance (ESI). Most working-age individuals, approximately 155 million people, obtain health insurance through an employer-sponsored plan.1 Out-of-pocket costs and financial risk (ie, the variability in out-of-pocket costs) for this group have increased substantially over the last decade despite reforms such as co-pay waivers for preventive care and the elimination of annual and lifetime benefit limits. This Viewpoint describes the problem, its causes, and possible solutions. Proposed policy remedies follow from the observation that the increasing financial burden of out-of-pocket costs among people with ESI is largely a product of changes in benefit design combined with increases in health care prices paid by private insurers.
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Rosenthal MB. The Growing Problem of Out-of-Pocket Costs and Affordability in Employer-Sponsored Insurance. JAMA. 2021;326(4):305–306. doi:10.1001/jama.2021.11166
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