WASHINGTON — Denise Wall, a Fresno-area schoolteacher with more than $2,000 in medical bills, was outraged to hear she could get free care if she quit her job and enrolled her family in Medicaid.
Brenda Bartlett, a factory worker in Nebraska, was so angry about $2,500 in medical bills she ran up using the coverage she got at work that she dropped insurance altogether.
“They don’t give a rat’s butt about people like me,” she said.
Sue Andersen, burdened with nearly $10,000 in debt through her family’s high-deductible plan, had to change jobs to find better coverage after learning she and her husband earned too much for government help in Minnesota.
“We are super middle class,” she said. “How are we stuck with everything?”
Health insurance — never a standard protection in the U.S. as it is in other wealthy countries — has long divided Americans, providing generous benefits to some and slim-to-no protections to others.
But a steep run-up in deductibles, which have more than tripled in the last decade, has worsened inequality, fueling anger and resentment and adding to the country’s unsettled politics, a Los Angeles Times analysis shows.
Many wealthy Americans — already reaping most of the benefits of the last decade’s economic growth — have weathered the dramatic increase in deductibles in recent years in part by putting away money in tax-free Health Savings Accounts.
Very poor Americans, millions of whom gained coverage through the 2010 Affordable Care Act, can see a doctor or go to the hospital at virtually no cost, thanks to Medicaid, the half-century-old government safety-net program.
Squeezed in the middle are legions of working Americans who face stagnant wages, insurance premiums that take more and more of their paychecks and soaring deductibles that leave them with medical bills they can’t afford.
“The system increasingly doesn’t work for this group in the middle,” said Drew Altman, longtime head of the Kaiser Family Foundation, or KFF, a California nonprofit that researches the U.S. health system.
This middle-class squeeze and the class divisions it is exposing are among the corrosive effects of the high-deductible revolution, which The Times is exploring in a series of articles based on original research, academic studies and interviews with scores of American workers, doctors and experts.
Bill McInturff, a GOP pollster who has studied healthcare opinion for years, says frustration has turned into resentment for many working-class Americans struggling with high deductibles and healthcare costs.
“Among the most angry focus groups I have done in my career was (one) with working-class women in Maine talking about how much their healthcare and child care coverage was costing them compared to the women they knew on Medicaid,” he said.
Although a majority of workers remain content with their health benefits, a quarter now report feeling frustrated, according to a nationwide poll of Americans with job-based coverage conducted for this project in partnership with KFF.
One in seven is angry about their insurance.
The discontent is even more pronounced among workers with the highest deductibles: four in 10 report frustration, and nearly a quarter say they’re angry.
“I’m not hard-core political, but it kind of stings sometimes,” said Shawn Stevens, a 40-year-old father who’s rationed his own medical care to keep the family afloat and to ensure his daughter, who has autism, gets what she needs.
“You work and do what you’re supposed to, and you really pay the price,” said Stevens, whose family was on a high-deductible plan through his Home Depot job outside Detroit. They’re paying off nearly $1,500 in medical bills, and his wife, a hospital scheduler, took a second job bartending several nights a week.
Stevens, whose family makes about $48,000 a year, looked at enrolling his daughter in Michigan’s Children’s Health Insurance Program, a subsidized government plan for working families.
“They told me I made too much,” he recalled. “I thought, ‘I’m not poor enough? I feel pretty poor.’ “
Most workers blame drug companies and health insurers for high healthcare costs, The Times/KFF survey found.