![]() ![]() 4, 5 While the average cost increase in employer-sponsored benefits was lower in 2003 than in 2002 (10.1% vs 14.7%), employee contributions to premiums rose sharply, deductibles and out-of-pocket maximums increased, copayments increased, and many employers reduced covered services. One indication of potential difficulties paying for care may come from such changes to private insurance coverage: 68.6% of Americans were covered by private plans in 2003, with 60.4% covered by employer-sponsored plans, representing small but significant declines from 2001 levels of 70.9% and 62.6%, respectively. 3 Even the privately insured may face difficulties paying for care with rising premiums, deductibles, and copayments, and private plans that may not cover an adequate amount of their costs to ensure access to quality health care. 2 Those with Medicare face copayments and bear the rising costs of prescription medications. 1 For those with Medicaid coverage, state budget constraints may affect their eligibility for coverage, the services offered, or their ability to find a provider willing to accept the Medicaid fee schedule. Among the uninsured, finding a provider who offers affordable services is challenging at best, and the wait for an appointment with a provider offering free or reduced-price services can be considerable. In an era of rising health care costs and budget constraints, an increasing number of Americans have difficulty paying for needed health care services.
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