Affordable Care Act seeks to place cap on out-of-pocket expense

Despite its strong political opponents, the Affordable Care Act offers some valuable benefits to the American health care consumer revealed Families USA, a voice for quality and affordable health care since 1982.

On Wednesday, the foundation released a report on how the Affordable Care Act will keep out-of-pocket medical expenses from surging to unmanageable heights for families and individuals.

In a teleconference, Executive Director of Families USA Ron Pollack told reporters that the foundation was releasing a report entitled "Worry Less Spend Less: Out-of Pocket Spending Caps Protect America's Families." Commissioned by The Lewin Group, the report is an analysis of health care spending and how it applies to people in each state.

Throughout February and March state-specific reports will be released for public reference. Reports for Washington, Oregon, Virginia and New Jersey are already available by visiting

The reports examine the number of people who will this year pay more than the out-of-pocket spending cap expected to go into effect in 2014 if the Affordable Care Act stays in place.

With rising insurance costs, high premiums have caused many American families to drop health care or pay for less coverage, said Pollack. Businesses who struggle to maintain insurance for their employees either drop benefits or pass the high costs onto their employers.

The result is a growing number of Americans who are uninsured or underinsured.

Under the current legislation, a cap would be set in place in 2014 on the amount of out-of-pocket spending families or individuals can expect to pay should the worst happen. That means that a family would not have to pay more than $11,900 a year for medical expenses not covered by their insurance. Individuals would not have to pay more than $5,950 a year.

The report released by Families USA details the number of people in the state of Washington who are expected to pay more than the 2014 spending cap this year on out-of-pocket medical expenses.

The report found that more than 290,000 Washingtonians will exceed the cap limit this year. The amount of money to exceed that cap from these people would total $541 million.

The findings went on to explain that more than 71 percent of those people will come from working families. Seven percent would come from the unemployed force and 21 percent will come from those people not in the labor force.

The study also states more than two in five Washingtonians paying medical expenses in excess of the cap this year will come from households where the main source of income is employed by a small business of 100 employees or less.

Washington state Congressman Jim McDermott said that many of those nearly 300,000 people have purchased insurance but when they need to use it they discover how inadequate their coverage is.

McDermott said, "You're looking at a huge threat for most middle class families...any one of us could tomorrow have an automobile accident or some kind of major...heart attack or a stroke or something and suddenly wind up with a bill that's way beyond our coverage in our insurance."

McDermott went on to say that the Affordable Care Act has lots of important policies that are aimed at aiding the middle class like the out-of-pocket spending cap.

"It is one of the reasons why people like Bill Frist, who was the Republican leader in the House, said to the Republicans, 'Why are you repealing this bill? If you don't like something in it, fix it because there are lots of good things in it.' And this just happens to be one of them."


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