The share of income a family can afford to spend on health care and coverage depends on many things, including total earnings, other household expenses, whether their health costs are one-time or recurring, and a wide range of other personal circumstances. There is no cut-and-dried level of medical spending that is just too much for all families to absorb. Yet an indicator of high health cost burden can be a helpful way to track the extent to which people feel the economic pinch of rising premiums and out-of-pocket costs.

This measure reports the share of Californians who reside in households that spend 10% or more of their income on health care services and insurance premiums. In 2011-12, 17% of Californians were in such households.

In addition to expanding coverage broadly, the ACA aims to ensure people can afford coverage and care. With effective implementation of the ACA, the share of people spending 10% or more of their income on health care costs should fall — particularly among the increasing number of Californians obtaining insurance through the individual market. Tracking this indicator in the months and years to come will show what progress is being made toward that goal.

Marian Mulkey

Marian Mulkey was chief learning officer at the foundation. From 2010 until 2014, she served as director of the foundation’s Health Reform and Public Programs Initiative, where she led CHCF’s work to analyze the Affordable Care Act and inform public and private stakeholders and the public on ways to implement the law that would improve and expand coverage. Read More

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In California Health Policy, What’s Past Is Prologue, Reflections on 17 Years in California Health Policy, The Organizational Learning at the Heart of CHCF’s Work