Health insurance costs far outpace inflation, resulting in more consumers shouldering thousands of dollars in out-of-pocket costs each year. Meanwhile, some insurance companies are rejecting nearly a fifth of claims. The double whammy leaves Americans paying more for insurance, but sometimes feeling like they’re getting less in return, experts say.
Frustration over denial and medical costs sparks massive revolt alum Hot on our heels, targeting health insurance companies murder UnitedHealthcare CEO Brian Thompson. Also last week, similar outcry led Anthem Blue Cross Blue Shield to reverse course Decide Limit anesthesia coverage during surgery.
This anger may stem from concerns that unexpected medical bills may cause financial harm, as well as concerns that insurance companies may deny basic care, putting the health and well-being of even those with health insurance at risk.
Some of these concerns are well-founded: The leading cause of bankruptcies in the United States is health care-related debt, highlighting the financial strain that high medical costs can cause.
In fact, a KFF survey earlier this year found that a majority of adults said they were worried about their ability to pay for health care services or unexpected medical bills, a sentiment shared by people regardless of whether they were doing well or struggling financially.
KFF data shows that in 2024, the average family health insurance premium will be $25,572 per year, while a single worker will pay an average of $8,951, an increase of 6% and 7% from the previous year. The health policy research firm found that since 2000, health insurance premiums have grown faster than inflation in all but a few years.
“Dissatisfaction with insurance companies stems from two things: ‘I’m sick, I’m in trouble,’ and the second is huge costs—‘I’m paying more than I was before, and I’m paying more than my salary. “A lot of people think they’re getting less coverage from their insurance company,” Andrews said.
While Americans have unfortunately suffered from other types of inflation in recent years— Sky-high grocery prices Thomas noted that they are credited with helping President-elect Donald Trump win last month — health insurance can take on a more personal edge.
“It’s not like, ‘How much am I going to spend on a lawn chair or a steak,'” Andrews points out. “People are sick or have some kind of health issue that they’re worried about.”
To be sure, people with employer-sponsored health insurance typically don’t pay full premiums because their employers bear most of the cost.
However, employees’ share of premiums is also rising, with employees with family coverage typically paying $5,700 in annual premiums in 2017, the latest year for the data, up from about $1,600 in 2000, KFF data shows. According to KFF, the average household deductible, or how much you pay out of pocket before coverage kicks in, has increased from $2,500 in 2013 to $3,700 in 2023.
A Gallup poll found that last year about 81% of Americans said they were dissatisfied with the cost of health care in the United States, a 16-year high.
“We’ve reached a point where health care is so inaccessible and unaffordable, and people are rightly frustrated,” Dr. Céline Gounder, CBS News medical contributor and KFF Health News public health guest editor, told CBS. Friday morning.
Health insurance denied
In addition to rising health insurance costs, Americans are angry about being denied coverage, with a KFF analysis of non-group qualified health plans in 2021 finding that the situation affected nearly 1 in 5 claims. However, their research found that denial rates varied widely among insurance companies, ranging from as low as 2% to as high as 49%.
“When you pay for something and they don’t give it to you and they keep raising the price, you’re going to be frustrated,” says Holden Karau, a software engineer who created A free service called “Fight Health Insurance”.
Kalaw said she came up with the app, which uses artificial intelligence to create appeal letters, based on her own experience with insurance and that of her dog. Her pet insurance company initially refused to cover the anesthesia costs for her dog’s root canal, and Kalaw, who is transgender, said she fielded numerous appeals to have her surgery and surgery covered by her insurance.
Increasingly, insurance companies are using artificial intelligence to review claims and deny them, which is not always obvious to consumers. Shift to AI-based reviews sparks lawsuits against insurance companies, including UnitedHealthcare sued last year The families of two deceased clients claim that insurance companies deliberately used faulty algorithms to deny elderly patients long-term care coverage that doctors deemed necessary.
“With AI tools on the insurance side, the negative impact of denials is minimal,” Kalaw added. “We’re seeing very high rates of AI-induced denials. And on the patient and provider side, they’re not A tool to fight back.”
Kalaw noted that most people may not know they have the right to appeal a denial. Most people who experience a denial or billing error don’t dispute it, a study shows established earlier this year. For those who do this, the first appeal will be handled by the insurance company, but if an internal appeal is also refused, you have the right to ask an independent reviewer to review your claims, according to the National Insurance Association.
“There are multiple levels of appeals, and based on my experience, I think appeals are important until you at least get an independent reviewer,” Kalaw said. “If you don’t appeal, you’re not going to get the care you need.”
