Employersponsored Health Insurance Is Not Adequately Covering All Health Services For Many: Report

Many Americans, especially women, find it difficult to pay for the health care they need — especially dental and mental health — even if they have health insurance through their employer.

This was noted in a recent report published in the Journal of the American Medical Association (JAMA).

"Many Americans have health insurance through their employers, but employer-provided health insurance plans provide fewer benefits than in the past," said Jose A. Pagan, professor and chair of the department of public health policy and management in the School of Global Public Health at NYU Cares , Fox News Digital said in an interview

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He co-authored a new article published in JAMA.

"There's a lot of waste in the system and the cost is passed on to the average American worker," said Dr. Marty McCurry, a Fox News medical officer and professor of health policy and management at the Johns Hopkins School of Public Health in Baltimore, Maryland.

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According to the study's press release, about 61% of working Americans had health insurance through their employer in 2019.

The Affordable Care Act expanded employer-sponsored insurance coverage by adding coverage for maternity care, helping uninsured youth get coverage through parental protection, and eliminating deductibles and co-payments for preventive care, the press release added.

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But out-of-pocket costs continue to rise.

The researchers analyzed data from the National Health Survey.

This is a representative annual survey conducted by the Centers for Disease Control and Prevention (CDC), according to a press release.

The researchers evaluated more than 238,000 adults aged 19 to 64 who had health insurance through their employer or union from 2000 to 2020.

The study found that in 2020, nearly 6% of American women missed out on essential health care in the past year because of costs, including company-sponsored insurance -- double the 3% rate in 2000.

Fewer men reported missing out on needed health care due to affordability, with just 3% in 2020 compared to 2% in 2000.

Mental health and dental services are extremely inaccessible to some Americans, especially women.

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The researchers also found that the number of women not seeking mental health care has increased from around 2% to over 6% in recent years.

"Men and women have the highest default rates for dental services each year from 2000 to 2020," the release said.

"Possibly lower income and higher health needs in women lead to these differences in reported availability," added Avani Gupta, a graduate student in the department of public health policy and management at NYU's School of Global Public Health, according to the press release. pers. . release

"Corporate-sponsored insurance plans should redesign their benefit packages to narrow the gender gap."

"The main limitation of this study is that the survey did not include questions to explore the reasons for the improved accessibility of health services," Pagan told Fox News Digital.

"The latest available data is from 2020, but the trend of unavailability may increase due to the COVID-19 pandemic," he said.

The shortage of providers is partly because many people can't afford the healthcare, Pagan told Fox News Digital.

"Since 2020, finding mental health providers has been very difficult, coinciding with the Covid-19 pandemic," he added.

"The bottom line is that many middlemen enrich themselves at the expense of the average American worker," added McCarey, who details the problem in his latest book, The Price We Pay.

He noted that pharmacy benefit plans are his "biggest area of ​​spending."

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In New York state, health brokers take 4% of every dollar spent on health insurance premiums, he said.

At the company that Macari co-owns, "we pay $220 a month for health insurance through Cederra," he said, "which is about half the cheapest Obamacare replacement option."

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"Companies are held back and don't have time to properly evaluate all options," he added.

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