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Health insurance fails to protect Americans from financial risk

Boston, MASickness or injury can leave people in serious financial jeopardy even when they have health insurance, according to a report released today by The Access Project and Brandeis University. The Illusion of Coverage: How Health Insurance Fails People When They Get Sick, reports findings based on in-depth interviews with dozens of insured Americans in seven states.

"Widespread debt and access problems among insured people represent major product failure in our private health insurance market," stated Carol Pryor, Senior Policy Analyst at The Access Project and co-author of the report. "Confusing and complex insurance policies, routine denial of claims that should be paid, and poor customer service plague the insurance industry. These problems call for the establishment of clearer rules and standards of accountability for health insurers."

"For too many Americans, health insurance fails to protect them from the costs of medical care," said Jeff Prottas, coauthor and professor at The Heller School for Social Policy and Management at Brandeis. "A large percentage of the insured find themselves with unmanageable burdens of medical debt. This study details the many ways in which health insurance can fail to provide the financial protection people believe they are paying for," said Prottas.

Key findings from The Illusion of Coverage include:

  • Shifting more costs of care onto patients through high deductibles, co-insurance, and less comprehensive coverage creates significant health access and financial consequences.

  • Confusing insurance company policies and procedures leave patients confused, in debt, reluctant to seek health care, and vulnerable to predatory scam products.

  • Affordability of health insurance must be judged on more than premiumsit is necessary to consider the costs that people will face should they get sick.

The findings in The Illusion of Coverage a
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Contact: Nancy Kohn
nkohn@accessproject.org
617-654-9911 x230
Brandeis University
22-Mar-2007


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