The Commonwealth Fund has come out with data supporting what insurance producers have said all along: Many high-income Americans are living paycheck to paycheck and having trouble handling medical bills.
About 62 percent of U.S. adults with incomes over 400 percent of the federal poverty level (FPL) who participated in a survey organized by the think tank reported having serious problems paying medical bills in the past two years.
Survey participants in the top income category were only somewhat more likely than participants in the bottom category -- the category for participants with incomes under the 133 percent of the FPL -- to report having problems with medical bills: 70 percent of the participants in the bottom category had medical bill problems.
The sample included 4,432 adults ages 19 and older living in the continental United States. For a family of four, household income was $92,200 or higher for U.S. residents in the high-income category and under $30,657 for residents in the low-income category.
Analysts at the Commonwealth Fund, a health policy think tank generally viewed as supporting PPACA, found that 6 percent of the low-income participants had to declare bankruptcy because of medical bills, compared with 3 percent of the high-income participants.
Only 7 percent of the high-income participants said medical bill problems interfered with their ability to pay for basic necessities such as food or heat, compared with 33 percent of the low-income participants.
The high-income participants protected their physical standard of living by taking on debt.
About 47 percent of the high-income participants financed bills with credit card debt, mortgage loans and traditional loans; 21 percent of the low-income participants took on medical-related debt.
The Patient Protection and Affordable Care Act (PPACA) is supposed to provide new minimum health coverage benefits standards and individual health coverage purchase premium subsidies that should help families with incomes under 400 percent of the FPL, the analysts said.
High-income families who must buy their own health coverage will not get subsidies.
The Commonwealth Fund analysts predicted that the new PPACA coverage standands and limits on annual out-of-pocket spending maximums will give high-income families some relief.
PPACA restrictions on insurers' ability to use personal health information in pricing health coverage should also help high-income families, by reducing the number of high-income families that spend at least 10 percent of their income on health insurance premiums, the analysts said.