There's growing concern that the value of a health insurance card is being eaten away by rising deductibles, the amount of actual medical costs that patients pay each year before coverage kicks in. Since virtually all U.S. residents are now required to have health insurance by President Barack Obama's health care law, McDermott said Democrats have a responsibility to make sure coverage translates to meaningful benefits. —A study by the advocacy group Families USA found that one-quarter of the people with individual health insurance policies went without care in 2014 because they could not afford the out-of-pocket costs. Deductibles can be a legitimate tool for employers and insurers to steer patients to doctors and hospitals providing high-quality care at a reasonable cost. The Commonwealth Fund, a private foundation that aims to improve the health care system, defines underinsurance as out-of-pocket costs that add up to 10 percent or more of household income, in most cases, or a deductible that amounts to 5 percent of income or higher. Democrats need an election-year health care narrative about how to improve Obama's law, said Robert Blendon, a professor at the Harvard T.H.
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