ACA reduced number of Americans with 'catastrophic' health expenditures

Sept. 24 (UPI) -- Researchers have linked a nearly 20% decline in "catastrophic" healthcare expenditures during the last decade to changes made as a result of the Affordable Care Act, according to an analysis published Thursday by JAMA Network Open.

An estimated 11.2 million Americans experienced "catastrophic" healthcare expenditures in 2017, down from 13.6 million in 2010, researchers reported. The ACA was signed into law in 2010 and fully in effect by 2014.

The researchers defined catastrophic health expenditures as calendar year out-of-pocket costs plus premium spending that exceeds 40% of post-subsistence income -- or income minus typical food and housing expenditures.

While low-income households saw a 2.3% reduction in risk for catastrophic health expenditures between 2010 and 2017, the risk still was more than twice that of those with higher incomes, the researchers said.

"These findings help to explain why so many U.S. residents, including those with insurance, continue to worry about their ability to afford needed care," the researchers, from Stanford University, wrote.

The Affordable Care Act, also known as Obamacare, was designed to lower the cost of healthcare insurance and reduce the number of uninsured Americans.

One of the goals of the law was also to protect low-income households from health expenses that would severely limit their ability to cover subsistence costs such as food and housing.

For the analysis, researchers reviewed data from the Medical Expenditure Panel Survey, using income information from the U.S. Bureau of Labor Statistics.

The number of uninsured non-elderly adults declined to just under 28 million in 2017, from nearly 43 million in 2010, the data showed.

Over the same period, the population of those who received Medicaid coverage increased to just over 18 million from 11.0 million.

Although the number of Americans experiencing catastrophic health expenditures declined by about 20%, privately insured adults accounted for 54% of all cases of catastrophic health expenditures in 2017, up from 46% in 2010.

"Despite large coverage gains, 11 million U.S. adults, including 6 million with private insurance, continue to experience catastrophic health expenditures annually," researchers wrote.

"These figures are likely to increase as millions lose employment or require unexpected medical care because of [COVID-19]."