Hospital Co-payments Required of More Workers

AHRQ News and Numbers

Release date: July 11, 2006

The percentage of workers enrolled in employer-sponsored health plans that obligated them to pay a share of their hospital bill increased by more than 60 percent between 1999 and 2003—from 33.8 percent to 54.7 percent—according to the Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ).

Specifically, AHRQ's Medical Expenditure Panel Survey (MEPS) of private-sector employers found that:

• The percentage of enrolled workers whose plans did not require hospital co-payments fell by nearly a third between 1999 and 2003—from 66.3 percent to 45.3 percent.
• The percentage whose plans required co-payments ranging from $150 to $400 for hospital care doubled from 10.5 percent to 21 percent during the same period.
• The percentage of enrolled workers required to pay more than $400 for hospital care also doubled, from 6.4 percent to 13.1 percent.
• While the proportion of enrolled workers required to make a co-payment when they visit the doctor increased only slightly—from 92.4 percent to 95.3 percent—there were more dramatic shifts in the amounts they had to pay.
  • The percentage that had to pay more than $0 but less than $10 per physician visit shrank from 57 percent to 23.5 percent.
  • The proportion that had to pay more than $10 but less than $20 per physician visit almost doubled, rising from 33.4 percent to 60.8 percent between 1999 and 2003.
  • The 2 percent of enrolled workers who had to pay more than $20 per visit in 1999 ballooned to 11 percent in 2003.

For further details, go to Statistical Brief No. 127: Changes in Co-pays for Employer-Sponsored Health Insurance Plans, 1999-2003, available at http://www.meps.ahrq.gov/mepsweb/data_files/publications/st127/stat127.pdf (PDF Help).

For a related MEPS Statistical Brief, go to Statistical Brief No. 128: Changes in Out-of-Pocket Maximum Limits for Employer-Sponsored Health Insurance Plans, 1999-2003, available at http://www.meps.ahrq.gov/mepsweb/data_files/publications/st128/stat128.pdf (PDF Help).

For more information, or to arrange an interview with a MEPS researcher about the findings, please contact Bob Isquith at Bob.Isquith@ahrq.hhs.gov or call (301) 427-1539.

Internet Citation:

Hospital Co-payments Required of More Workers. AHRQ News and Numbers, July 11, 2006. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/nn/nn071106.htm