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 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.
Marian previously worked as senior program officer in the foundation’s Market and Policy Monitor program, where she led work to monitor California’s health insurance markets. Prior to joining CHCF, she worked as an independent health policy consultant and at Kaiser Foundation Health Plan, where her responsibilities included pricing, utilization data reporting, and policy development.
Marian received a master’s degrees in public policy and public health from the University of California, Berkeley, and a bachelor’s degree in biology and economics from Reed College in Portland, Oregon.