Survey: What Does U.S. Health Insurance Look Like in 2023?
Key takeaways:
Consumers are generally satisfied with their insurance plans’ prescription drug benefits despite higher monthly out-of-pocket costs.
High-deductible health plans remain a popular option for younger Americans.
Only 55% of Americans are on health insurance plans that cover their dental and vision care.
Just over 3 years after the start of the COVID-19 pandemic in the U.S., the GoodRx Research Team wanted to examine the current state of health insurance. During the height of the pandemic, many Americans lost coverage due to unemployment and other changes.
In a survey of over 1,000 insured Americans, we found that many people are satisfied with their prescription drug coverage, despite higher costs compared to last year. Americans also continue to rely on high-deductible health plans (HDHPs) for insurance coverage.
Here’s what else we uncovered about the current health insurance landscape.
The uninsured rate among Americans is steady compared to prior years
In 2023, the uninsured rate continued to hover between 10% and 11%. This is similar to previous years. Since the passage of the Affordable Care Act in 2010, the uninsured rate has fluctuated between 10% and 17%.
While the rate this year is lower than in recent years, we may see it rise over the course of 2023, particularly as the automatic Medicaid renewals put in place during the pandemic begin to wind down this month. Millions of Americans are expected to lose coverage due to this change.
High-deductible health plans are still a popular insurance choice
This year, 38% of people with insurance reported being enrolled in a high-deductible health plan (HDHP). HDHPs refer to insurance plans with a deductible of at least $1,500 for an individual or $3,000 for a family. Because HDHP deductibles and out-of-pocket maximums are higher than other insurance plans, the monthly premiums are often much lower.
Similarly to what we’ve seen in past years, HDHP enrollees tend to be younger, with 44% of enrollees this year in the 18-to-34 age group.
While this may seem like an attractive option for people who don’t anticipate many healthcare costs over the course of a year, it can prove very expensive if a health issue does arise. Research from the Commonwealth Fund has shown that sick adults with HDHPs are far more likely to experience medical debt or medical billing problems.
Despite higher out-of-pocket medication costs, consumers are generally satisfied with their prescription drug benefits
For the most part, Americans are satisfied with the prescription drug benefits offered by their insurance plans. Nearly 70% report satisfaction or high satisfaction with these benefits, versus less than 20% who reported being slightly unsatisfied or very unsatisfied.
At the same time, many Americans reported increases in monthly expenses for non-covered prescription medications compared to last year.
The percentage of people spending under $50 on non-covered medications decreased nearly 10% compared to last year; meanwhile, the percentage of people spending between $51 and $100 and $101 to $300 monthly increased by 8% and 3%, respectively. We saw a 1% decrease in the percentage of people paying over $300 monthly, compared to last year.
Overall, 24% of this group spent over $100 a month, another 34% spent between $51 and $100 monthly, and 42% spent up to $50 on non-covered medications.
Nearly half of Americans’ insurance costs stayed the same compared to last year
And there was more good news for many Americans: This year, about half of people with health insurance reported that their coinsurance, deductibles, and premiums stayed the same compared to last year.
While this news is welcome for many, another large group (up to 39%) of Americans saw increases in these insurance-related costs since last year.
More than half of people who change plans do so to gain more coverage
We found that 17% of Americans with prescription medication coverage changed their plan. The most popular reason for changing plans was selecting a plan with different coverage. Over half (51%) switched to a higher-coverage plan, and 31% switched to a lower-coverage plan. Just 3% reported switching to an HDHP.
Many health insurance plans don’t include dental and vision coverage
Legislation in the U.S. allows for dental and vision insurance to be offered separately from health insurance. Just 55% of Americans with health insurance that we surveyed also had their vision and dental insurance covered by the same plan. Over one-fifth (22%) of this group had neither vision nor dental included, and another 20% had only one or the other covered.
Summing it all up
The health insurance landscape remains diverse, with varying levels of coverage and satisfaction. While many Americans are generally happy with their prescription drug benefits, there’s still room for improvement when it comes to comprehensive coverage for dental and vision care and limiting prescription medication costs.
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References
Davis, K. et al. (2005). How high is too high? Implications of high-deductible health plans. The Commonwealth Fund.
Tolbert, J. et al. (2022). Key facts about the uninsured population. Kaiser Family Foundation.
