This report examines health care coverage among Americans earning between 200 and 400 percent of the federal poverty level (FPL), $44,000 to $88,000 for a family of four.  The report found that 11 million middle class Americans lack health insurance, nearly 75 percent of insured middle class Americans obtain their coverage through their employer, and that health care cost growth has outpaced wages affecting middle class access to care.

From the report:

The rising costs of health care services are taking a mounting toll on family budgets, the nation’s businesses, and the costs of private and public insurance. While the majority of non-elderly Americans receive health care coverage through their employer today, the availability and affordability of job-based coverage has been gradually eroding, putting more low- and middle-income working families at risk of being uninsured without any co verage for their health needs. For those with health insurance, the value of that coverage has also begun to erode as limits on the scope of coverage leave more of those with insurance to face increased out-of-pocket costs when they seek care. This report focuses on health insurance coverage among those with middle incomes—its availability, affordability, and stability. It also addresses the growing burden of health care costs for the middle class, the adequacy of today’s health insurance plans to protect them from large medical bills, and the difference both make as individuals and families make health care decisions for themselves.

Full report: Health Care and the Middle Class: More Costs and Less Leverage (PDF | 576.89 KB)

The Henry J. Kaiser Family Foundation Focus on Health Reform. (2009). Health care and the middle class: more costs and less leverage. Rowland, D., Hoffman, C. & McGinn-Shapiro, M.