A trade group representing the nation's health insurers is questioning the accuracy of a mid-September report released by the Commonwealth Fund that contends American workers are finding healthcare coverage increasingly unaffordable or unavailable.
As proof, America's Health Insurance Plans (AHIP) said its August 2005 study showed that consumers seeking health insurance in the individual market have more choices, broader benefits and greater affordability than is widely known.
AHIP responded to the Commonwealth Fund study by saying its methodology was flawed.
It questioned the Common-wealth Fund's reliance on a telephone survey, which focused on 137 respondents who have individual market coverage. In contrast, AHIP said its survey includes 1.9 million policyholders and 3.2 million covered lives. "It is the most comprehensive study of the individual market to date," AHIP's September 14 press release stated.
The Commonwealth Fund's report, "Squeezed: Why Rising Exposure to Health Care Costs Threatens the Health and Financial Well-Being of American Families," used its biennial Health Insurance Survey of 2005 to explore the experiences of adults ages 19 to 64 in the individual insurance market, compared with adults who have employer-based coverage.
Compared to those with coverage through their jobs, adults who pay for their own health insurance give health plans lower ratings, pay more out-of-pocket for premiums, face higher deductibles and spend a greater percentage of income on premiums and healthcare expenses, the Commonwealth Fund survey found.
AHIP said its survey found that nearly nine out of 10 people who completed the application process for non-group insurance in states that let insurers consider an applicant's medical history were offered coverage.
According to AHIP's survey, nearly every plan in the market offered a prescription drug benefit, coverage for inpatient and outpatient mental health treatment, coverage for inpatient and outpatient substance abuse, annual visits to an obstetrician-gynecologist, well-baby care and care for pregnancy complications.
"The data could not be clearer: Coverage purchased in the individual market is accessible and affordable," said Karen Ignagni, AHIP president.