2003 Health Insurance Survey Summary and Chartpack

7/31/2019 2003 Health Insurance Survey Summary and Chartpack

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Summary and Chartpack

The Kaiser Family Foundation

Health Insurance Survey

October 2004


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Methodology

The Kaiser Family FoundationHealth Insurance Survey was designed and analyzed by researchers at the Kaiser Family

Foundation. Fieldwork was conducted by telephone by Princeton Survey Research Associates between April 30 and July 20,

2003, among a sample of 2,507 respondents ages 18 to 64 years. The sample includes 2,042 respondents who are covered by

health insurance (including 1,542 who are insured through an employer and 152 who purchase their own insurance), and 457

uninsured respondents. Results for all groups have been weighted to reflect the actual distribution in the nation.

The margin of sampling error for the survey is plus or minus 2 percentage points for total respondents; for respondents with

health insurance it is plus or minus 2 percentage points; for respondents insured through an employer it is plus or minus 3

percentage points; for respondents who purchase their own insurance it is plus or minus 9 percentage points; and for uninsured

respondents it is plus or minus 5 percentage points. For results based on subsets of respondents the margin of error is higher.

Note that sampling error is only one of many potential sources of error in this or any other public opinion poll.

Vol. indicates that a response was volunteered by respondent, not an explicitly offered choice. Percentages may not alwaysadd up to 100% due to rounding.

Full question wording and results are available separately at www.kff.org


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When asked what is the highest amount theyd be willing to pay for various aspects of health insurance, people give a variety

of responses.

When asked the highest amount they would accept for a monthly premium if they were shopping for health insurance,

about half (49%) name amounts of $200 or less, just over a quarter (28%) name amounts greater than $200, and another

quarter (24%) say they dont know. Those earning less than $30,000 a year, and those who are currently uninsured name

lower amounts, and are more likely to say they dont know (Chart 10).

When it comes to deductibles, about four in ten (42%) say they would accept amounts of $200 or lower, while three in

ten (30%) would accept higher amounts, and about one in five (18%) say they dont know. Again, the uninsured and

those with low incomes are more likely to name lower amounts, and to say they dont know (Chart 10).

More than half (56%) say that they would accept amounts of $20 or lower for a doctor visit co-pay, while a third ($33)

name amounts higher than $20, and about one in ten (11%) say they dont know. When it comes to prescription drug co-

pays, more than a third (35%) say they would pay amounts up to $10, three in ten (31%) name amounts between $10 and

$20, one in five (22%) name higher amounts, and 12% say they dont know. When it comes to co-pays, the uninsured

and those with lower incomes are somewhat more likely to name lower amounts (Chart 11).

3


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SECTION II. ATTITUDES TOWARD EMPLOYER-SPONSORED INSURANCE

People with employer-sponsored insurance (ESI) are sympathetic with their employers, and they prefer to get their insurance at

work rather than trying to buy it on their own. Those insured through an employer are somewhat divided on whether they view

health insurance coverage as part of, or separate from, their monetary compensation.

Nearly eight in ten (79%) of those insured through an employer say their employer is doing the best they can to provide

them with affordable health insurance coverage (Chart 12).

When given the option, more than half (55%) of those with ESI say they would rather have their employer pay for their

coverage at work, 7% say they would rather receive cash to buy insurance on their own, and 37% say it wouldnt make

much difference. Large majorities say purchasing their own coverage would make it more difficult for them to get a goodprice for insurance (81%), to find or keep insurance if they are sick (79%), to handle administrative issues (73%), and to

find a plan that matches their needs well (71%) (Chart 13).

Just over half (55%) of those with ESI say they consider having their health insurance paid for by their employer as part of

their wages, while about four in ten (39%) say they consider it separate from their wages. Those with employer coverage

are almost evenly divided about whether they would prefer to have a larger amount deducted from their paycheck for health

insurance (47%) or give up a future wage increase (41%). However, more than half (52%) say they would choose morecomprehensive benefits over higher wages, while 36% say they would choose higher wages, and 11% dont know (Chart

14). Interestingly, people with lower incomes and those with higher incomes give similar responses to all three of these

questions.

4


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SECTION III. ALTERNATIVE HEALTH INSURANCE OPTIONS

Flexible spending accounts (FSAs) are one alternative employer-based option that has been in use for some time. While about

four in ten of those with employer-sponsored insurance report that their employer offers an FSA, a much smaller share report

having contributed money to an FSA in the last year.

When read a description of an FSA (these accounts allow employees to contribute a certain amount of pre-tax dollars at the

beginning of the year that may be used throughout the year to pay for medical expenses not covered by their insurance),

about four in ten (42%) of those insured through an employer (26% of the total non-elderly population) say their employer

offers an FSA1

. About a third (34%) of those who say they are offered an FSA (14% of all employer-insured) reportcontributing money to such an account (Chart 15).

Among those who say they contribute money to an FSA, more than half (55%) report contributing less than $1,000, three in

ten (31%) say they contribute $1,000 or more, and the rest say they dont know how much they contribute (Chart 15).

1 Note: This finding is based on self-report by employees. According to the 2003 Kaiser Family Foundation/Health Research and Educational

TrustEmployer Benefits Survey, a survey of employers, 16% of firms (employing 66% of workers who were covered by employer-based health

insurance) offered an FSA in 2003.5


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Charts Section 1Public Expectations of

Health Insurance

Chart 1


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Chart 1

Most Important Reason to Have Insurance

Percent saying each of the following is the most important reason to havehealth insurance

61%

72%

73%

85%

76%

71%

34%

25%

20%

24%

14%

25%

78%

21%

To protect against highmedical bills

To pay for everydayhealth care expenses

Note: Dont know responses not shown

Total

Income less than $30K

Income $50K or more

Income $30K-$50K

Insured through employer

Uninsured

Purchase own insurance

Source: Kaiser Family Foundation Health Insurance Survey, 2003 (conducted April 30 July 20, 2003)

Chart 2


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Chart 2

Feelings of Vulnerability

If you had a plan that did not pay for (ITEM) but covered everything else, would you feel

Vulnerable to high medical bills Well-protected by your insurance

Hospitalization

Routine doctors visits andcheck-ups

Visits to medical specialists

Prescription drugs

56%

58%

76%

81%

88%

93%

40%

37%

31%

22%

17%

10%

63%

6%

Home health care

Pregnancy and maternitycare

Mental health



Chart 3


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Chart 3

Whats Important in a Health Plan

Percent saying each of the following is the most important factor to them andtheir family in a health insurance plan

44%

40%

45%

37%

33%

35%

26%

30%

34%

22%

27%

30%

23%

27%

29%

24%

30%

27%

27%

29%

33%

Total


Uninsured


Income $50K or more

Range of benefitsLow cost* Choice of doctors

Income $30K-$50K


* Low cost includes responses for low premium, low co-payments, and low deductible. Note: Dont know responses not shown


Chart 4


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C a t

Reasons for Choosing Current Plan

Among those insured through an employer who were offered a choice of plans,percent saying each of the following was the main reason they picked their plan

29%

28%

21%

20%

27%

25%

25%

30%

32%

42%

38%

6%

5%

13%

8%

19%

4%

4%

8%

7%

Total


Income $50K or more

Plan covered widerange of benefitsor a specific

benefit you need

Cost of theplan was lessthan other

options

You liked thechoice ofdoctors and

hospitals

Income $30K-$50K

Plan was easy tounderstand andrequired minimal

paperwork

Otherreason



Chart 5


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Health Plan Grades

Among those with health insurance, percent saying they would give their plan thefollowing grades

19%

26%

27%

32%

46%

45%

29%

21%

20%

8%

4%

4%

4%

2%

1%

Total

B forgood

A forexcellent

C foraverage



D forpoor

F forfailing



Chart 6


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Employer-insured Want to Keep What They Have

Among those insured through an employerMany employers are trying to find ways to deal with the rising cost of health insurance.If your employer gave you the following two options, which would you choose?

75%

80%

76%

29%

20%

16%

19%

5%

4%

5%

64% 6%

Continue to receive the samecoverage you have now, but youare required to pay a highermonthly premium

Total employer-insured

Dontknow

Switch to a plan that is morerestrictive and offers fewerbenefits, but continue to paywhat you pay now

Income lessthan $30K

Income $50K

or more

Income$30K-$50K


Chart 7


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Assessment of Current Plan

Which of the following three statements comes closest to your own view aboutyour current health insurance coverage?

45%

54%

43%

58%

57%

45%

40%

36%

46%

38%

38%

9%

5%

11%

62%

4%

3%

2%

Total insured



Income $50K or more

My health insurance isadequate, but I worrythat my family might

have health care needsthat it wont pay for

My health insurance isgood and I feel well-protected when it

comes to my familyshealth care needs

My health insurance isinadequate, and I feelvery worried about my

familys health careneeds not being paid for

Income $30K-$50K




Chart 8


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Cost Is Main Barrier for the Uninsured

Percent of the uninsured saying each of the following is the main reason they donthave insurance

11%

52%

7%

5%

3%

3%

You dont think you need insurance

Cant get it due to poor health, illness, or age

It is too expensive

Other family member has insurance, but itdoesnt cover you

You dont know how to get insurance

Employer offers plan, but you are not eligiblebecause of waiting periods or part-time work


Chart 9


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Perceptions of Insurance Cost Among the Uninsured

Among the uninsuredAbout how much do you think itwould cost per month to buy healthinsurance for just yourself?

About how much do you think it wouldcost to buy health insurance for yourfamily? (Asked of those with families)

16%

20%

16%

4%

44%

$0-$199

Dont know

$500-$999

$1,000+

18%

18%

19%

6%

40%

$0-$99

Dont know

$200-$399

$400+

$100-$199 $200-$499


Chart 10


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Willingness to Pay for Premiums and Deductibles

If you were shopping for a health insurance policy, what would be the highestdollar amount you would consider for each of the following?

30%

6%

8%

14%

21%

20%

28%

6%

5%

15%

20%

25%

24%

16%

11%

19%

16%

14%

Monthly premium


$0-$50

Dont know

$201-$300

$300+

$101-$200

Deductible

$51-$100

30%

16%

7%

11%

15%

22%

27%

13%

9%

11%

14%

26%

18%

28%

12%

11%

12%

19%

Total

Income


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Willingness to Pay for Doctor and Rx Co-pays

If you were shopping for a health insurance policy, what would be the highestdollar amount you would consider for each of the following?

19%

17%

11%

27%

25%

15%

17%

13%

29%

26%

11%

16%

17%

35%

21%

Doctor visit co-pay


$0-$10

Dont know

$30+

$21-$30

Prescription drug co-pay

$11-$20

17%

10%

6%

26%

15%

13%

8%

25%

12%

12%

10%

31%

35%

39%

40%

Total

Income


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Charts Section 2

Attitudes Towards

Employer-Sponsored Insurance

Chart 12


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Employer Is Doing the Best They Can

Among those insured through an employerWould you say that your employer is or is not doing the best they can to provideyou and your family with affordable health insurance coverage?

Employer is doingthe best they can

Employer is notdoing the bestthey can

3%

79%

19%

Dontknow


Chart 13


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Employees Prefer to Have Employers Purchase Insurance

Among those insured through an employer

What if your employer gave you the cash amountthey would have contributed to your insurance, andyou had to buy health insurance on your own. Doyou think purchasing your own coverage would

make it EASIER or HARDER for you to orwouldn't it make much difference?

Would you prefer to have your employerpay for all or part of your health insuranceat work, or would you rather buy healthinsurance yourself, with your employer

giving you the cash amount they wouldhave contributed or doesnt it makemuch difference to you?

71%

73%

79%

81%

17%

21%

15%

6%

4%

4%

9%

10%Get a good price

for insurance

Find a plan that

matches yourneeds well

Find or keepinsurance ifyou are sick

Handleadministrative

issues

7%

37%

1%

55%

Prefer

employer topay

Rather buypolicy with

cash

No differenceDont know


Easier Harder No difference

Chart 14

W B fi


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Wages vs. Benefits

Among those insured through an employer:

Do you consider having your health insurance paid for by your employer

55% 39% 6%

Part of your wages Separate from your wages Dont know

Employers are trying to find ways to deal with rising health care costs. Would you rather

47% 41% 11%

Give up a future wage increase Pay more for health insurance Dont know

Would you rather have

52% 36% 12%

More comprehensive healthbenefits and lower wages

Less comprehensive healthbenefits and higher wages

Dont know



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Charts Section 3

Alternative Health Insurance

Options

Chart 15


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Flexible Spending Accounts

Among those insured through an employerPercent who say their employer offers/theyparticipate in a flexible spending account

Among those who participate in an FSA,percent who say they contributed thefollowing amount last year

23%

8%

24%

18%

13%

13%

Less than $100

Dont know

$100 to $499

$2000+

27%

49%

9%14%

Employer offers

FSA, but dontparticipate

Employer

does notoffer FSA

Dont know if

employeroffers FSA

Participate in

employer-offered FSA

$500 to $999

$1000 to $1999


Chart 16


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Attitude Toward Tax Credits by Insurance Status

If the federal government provided you with a $3,000* tax credit that you coulduse to purchase health insurance for your family, how likely do you think youwould be to find a plan to meet your familys needs?

26%

32%

18%

20%

29%

18%

31%

30%

11%

15%

14%

5%

6%

15%

12%

31%

32%

20%

23%

9%

Employer-insured

Purchase owninsurance

Uninsured


* Amount shown was asked of those with families. Individuals were asked about a $1,000 tax credit.

** Total excludes those with public health insurance (Medicare or Medicaid)

Total**

Somewhat

likely

Very

likely

Not too

likely

Not at all

likely

Dont know

enough to say

Chart 17


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Attitude Toward Tax Credits by Income, Age, Health Status

If the federal government provided you with a $3,000* tax credit that you coulduse to purchase health insurance for your family, how likely do you think youwould be to find a plan to meet your familys needs?

20%

13%

15%

21%

26%

23%

20%

20%

32%

28%

26%

31%

32%

31%

35%

28%

19%

17%

14%

11%

11%

10%

16%

14%

19%

16%

12%

8%

8%

9%

16%

20%

21%

25%

22%

23%

26%

25%

20%

14%

Somewhatlikely

Verylikely

Not toolikely

Not at alllikely

Dont knowenough to say




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Tax Credits Options by Insurance Status

On average, the cost of insurance is around $8,000* a year for a family. If thefederal government provided you with a $3,000* tax credit, what would you bemost likely to do?

31%

20%

17%

20%

74%

72%

67%

18%

7%

9%

45%

2%


Employer-insured


Uninsured

* Amount shown was asked of those with families. Individuals were asked about a $1,000 tax credit, and an average cost of $3,000 a year for an individual.

** Total excludes those with public health insurance (Medicare or Medicaid)

Total**

Supplement the tax credit w/your own

money to get more comprehensive plan

Purchase whatever plan

you can find for $3,000*

Go without

insurance

Chart 19

Tax Credits Options by Income Age Health Status


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Tax Credits Options by Income, Age, Health Status

On average, the cost of insurance is around $8,000* a year for a family. If thefederal government provided you with a $3,000* tax credit, what would you bemost likely to do?

17%

15%

17%

19%

25%

32%

23%

14%

73%

72%

68%

69%

61%

47%

65%

77%

6%

10%

9%

8%

11%

15%

9%

6%


* Amount shown was asked of those with families. Individuals were asked about a $1,000 tax credit , and an average cost of $3,000 a year for an individual.


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Tax Credits Compared With Other OptionsFor the Uninsured

Which of the following three options would you prefer to give you (and your family)greater access to health care?

19%

40%

33%

7%

Publicly-sponsoredhealth insurance

coverage, such asthat offered throughMedicaid, is madeavailable to you andyour family for low orno cost

Dont know

The federal government

provides a $3,000* taxcredit that you can useto purchase health

insurance foryourself and your

family

A new public clinic isopened in your community

where you and your familycan receive basic medicalcare at little or no cost, but itdoes not offer hospital care



Chart 21

Catastrophic Plan Favorability by Insurance Status


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Catastrophic Plan Favorability by Insurance Status

There is a type of insurance plan that only starts paying once you and your family have paid$5,000* of medical expenses out of your pocket. After that, it would cover medical expenseslike traditional insurance, requiring you to pay some co-payments each time you useservices. The monthly premium for the plan would be less than half of what you would payfor a typical comprehensive health insurance policy. Is your opinion of this plan

5%

11%

5%

18%

17%

10%

13%

19%

21%

20%

21%

42%

62%

56%

8%

9%

4%

6%

3%

50%

Somewhatfavorable

Veryfavorable

Somewhatunfavorable

Veryunfavorable


*Amount shown was asked of those with families. Individuals were asked about a $2,000 deductible.

Dontknow

Employer-insured


Uninsured

Total

Chart 22

C hi Pl F bili b I A H l h S


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Catastrophic Plan Favorability by Income, Age, Health Status

[Catastrophic plan with $5,000* deductible**] What is your opinion of this type of plan?

Somewhatfavorable

Veryfavorable

Somewhatunfavorable

Veryunfavorable

Dontknow


*Amount shown was asked of those with families. Individuals were asked about a $2,000 deductible. **See Chart 21 for full question wording.

4%

4%

6%

6%

14%

11%

12%

11%

18%

15%

15%

11%

19%

19%

18%

27%

21%

22%

20%

54%

60%

58%

60%

45%

52%

55%

61%

6%

6%

7%

6%

5%

5%

4%

5%

3%

3%

21%

4%

4%


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Catastrophic Plan Vulnerability by Insurance Status

There is a type of insurance plan that only starts paying once you and your family have paid$5,000* of medical expenses out of your pocket. After that, it would cover medical expenseslike traditional insurance, requiring you to pay some co-payments each time you use services.The monthly premium for the plan would be less than half of what you would pay for a typicalcomprehensive health insurance policy. If you had this insurance, would you feel?

19%

30%

16%

74%

64%

84%

79%

7%

6%

5%

11% 4%


*Amount shown was asked of those with families. Individuals were asked about a $2,000 deductible.

Employer-insured


Uninsured

Total

Well protected by yourhealth insurance

Vulnerable to highmedical bills

Dontknow

Chart 24

Catastrophic Plan Vulnerability by Income Age Health Status


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Catastrophic Plan Vulnerability by Income, Age, Health Status

[Catastrophic plan with $5,000* deductible**] If you had this type of plan, would you feel?

16%

15%

14%

14%

21%

18%

13%

79%

80%

79%

80%

76%

74%

83%

82%

5%

6%

6%

7%

14%

4%

4%

3%

3%


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Views of Consumer Driven Health Plans

Among those insured through an employer

Suppose your employer pays for a health plan that only starts to pay after your family hasspent $4,000* in medical expenses. They also put $2,000* in an account you can use formedical costs. If your familys medical expenses are more than $2,000*, you have to paywith your own money until you hit the $4,000* limit.

18%

78%

5%5%

16%

21%

52%

6%

Veryfavorable

What is your opinion of this type of plan? If your employer switched to this type ofplan, would you feel?

Dont

know

Vulnerableto high

medical

bills

Dontknow

WellProtectedby your health

insurance

Somewhatfavorable

Somewhatunfavorable

Veryunfavorable

*Amounts shown were asked of those with families. Different amounts were used for individuals ($2,000 deductible, $1,000 account).


Defined Contribution Plan Favorability byChart 26


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Gender, Education, Party ID

[Defined contribution plan with $4,000* deductible and $2,000 account**] What is youropinion of this type of plan? (Asked of those insured through an employer)

Somewhatfavorable

Veryfavorable

Somewhatunfavorable

Veryunfavorable

Dontknow

9%

9%

5%

6%

19%

18%

12%

21%

14%

12%

13%

18%

23%

19%

22%

20%

22%

22%

21%

43%

51%

59%

43%

57%

56%

53%

50%

5%

5%

6%

6%

5%

3%

7%

24% 4%

4%

4%

4%

3%

College grad

HS or less

Some college

Republican

Democrat

Independent

*Amounts shown were asked of those with families. Different amounts were used for individuals ($2,000 deductible, $1,000 account).**See Chart 25 for full question wording.


Party ID

Education

Male

Female

Gender

Chart 27

Defined Contribution Plan Vulnerability by


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y yGender, Education, Party ID

[Defined contribution plan with $4,000* deductible and $2,000 account**] If you hadthis type of plan, would you feel? (Asked of those insured through an employer)

24%

22%

13%

15%

71%

82%

80%

72%

78%

82%

81%

74%

6%

4%

3%

6%

3%

5%

4%

5%

17%

18%

15%

21%

Well protected by yourhealth insurance

Vulnerable to highmedical bills

Dontknow

College grad

HS or less

Some college

Republican

Democrat

Independent

Party ID

Education

Male

Female

Gender

*Amounts shown were asked of those with families. Different amounts were used for individuals ($2,000 deductible, $1,000 account).**See Chart 25 for full question wording.



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The Henry J. Kaiser Family Foundation

2400 Sand Hill Road

Menlo Park, CA 94025

Phone: (650) 854-9400 Fax: (650) 854-4800

Washington Office:

1330 G Street, NW

Washington, DC 20005

Phone: (202) 347-5270 Fax: (202) 347-5274

www.kff.org

Additional copies of this publication (#7203) are available on

the Kaiser Family Foundation's website at www.kff.org.

Harvard School of Public Health is dedicated to advancing the public's health through learning, discovery, and communication. More than 300

faculty members are engaged in teaching and training the 800-plus student body in a broad spectrum of disciplines crucial to the health and well

being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the

epidemiology of cancer; from risk analysis to violence prevention; from maternal and children's health to quality of care measurement; fromhealth care management to international health and human rights.

The Kaiser Family Foundation is an independent, national health philanthropy dedicated to providing information and analysis on health issues to

policymakers, the media, and the general public. The Foundation is not associated with Kaiser Permanente or Kaiser Industries

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