HEALTHCARE

Nonelderly Floridians paying more for healthcare

One in four nonelderly Floridians spend at least 10 percent of their income on healthcare.

BY JOHN DORSCHNER

jdorschner@MiamiHerald.com

Tracy Goldbach, 38, a North Lauderdale bartender, pays $341 a month for health insurance, but still has had to shell out more than $25,000 from her own pocket this year to pay for back surgery her health plan refused to approve.

She's an extreme example of the 3.9 million nonelderly Floridians -- about a quarter of the state's under-65 population -- who are expected to spend more than 10 percent of their income on healthcare in 2008, according to a report released Tuesday by Families USA.

That's a 62 percent increase over the 2.4 million who paid more than 10 percent of income in 2000.

Of those, a stunning 1.2 million are expected to spend more than a quarter of their income next year on medical treatments. That's a 71 percent increase in that category since 2000.

The announcement came two days before Gov. Charlie Crist is expected to reveal a new plan to help Floridians who lack health insurance. About a quarter of the state's population is uninsured, according to the Human Services Coalition.

The Families USA study showed, however, that the vast majority of those with high out-of-pocket costs are members of families that have some insurance, like Goldbach. Almost 80 percent of those who spend 10 percent were in families covered by health plans, as were 73 percent of those who are expected to spend more than a quarter of their income.

Coauthor Kim Bailey Tuesday attributed the ever-growing costs to higher premiums and higher co-pays for prescription drugs, hospitals and doctors.

In the case of Goldbach, the bartender said she has been bedridden and not able to work for a year with severe back pain. Her insurer sent her to two back specialists who told her surgery was unnecessary, but the pain persisted and she went to a nonnetwork doctor who told her that surgery was a must.

''We couldn't stand to see her suffer anymore,'' said her father, Ed Goldbach. They decided to go ahead with the surgery. The $25,000 in costs doesn't include bills that are still coming in from the surgeon, anesthesiologist and various labs.

Families USA, a nonprofit consumer healthcare group based in Washington, calculated that a family of four earning $60,000 a year in gross income has $2,990 in disposable income after paying for necessities such as housing, utilities, food, clothing, taxes and transportation. For that family, 10 percent spent on healthcare would be double their disposable income.

In Massachusetts, recent health reform included a calculation that a family of four earning 300 percent of the federal poverty level ($62,000 a year for the family of four there) could afford to spend about 4 percent of its income for healthcare. Those that earned more can afford higher percentages, state researchers concluded.

During the Families USA conference call, Rep. Kathy Anne Castor, D-Tampa, said one reason for the increased out-of-pocket expenses is that a growing number of employers are finding they can't afford to cover their workers' spouses and children.

''The Families USA report is a wake-up call,'' Castor said. ''We're often talking about the uninsured, but there are plenty of families out there with health insurance who are socked'' with higher costs.

Abigail Vladeck of the Human Services Coalition said another problem was that Florida has 500,000 children who qualify for state-backed plans like KidCare but are not enrolled.

Families USA hired the Lewin Group to do the study. Researchers analyzed data from the U.S. Department of Health and Human Services and the U.S. Census Bureau to arrive at their figures.

Florida's 25.3 percent of nonelderly persons paying more than 10 percent was slightly above the national average of 23.2 percent, Bailey said. South Dakota ranked highest, with 30.8 percent. New Jersey was lowest at 18.2.

The study cited Kaiser Family Foundation surveys that showed job-bassed family health coverage rose from $6,351 to $12,106 from 2000 to 2007. Workers' share of the premium increased from $1,656 to $3,281.

Miami Herald Staff writer Mary Ellen Klas contributed to this article.