Incorrect Wording in a Table

care.In 2017, the average family premium for employersponsored insurance was $18 764.Families with an employersponsored preferred provider organization plan had a mean premium and deductible of $19 481 and $2503, respectively.For a family with a high-deductible health plan, premiums and deductibles were $17 581 and $4527, respectively.1 Thus, the mean total expected cost for a family-premiums plus deductibles-is approximately $22 000 across both types of plans.Mr Buxbaum and colleagues object that high deductibles induce people to forego essential health services, which is not captured in the Affordability Index. 2 First, the RAND Health Insurance Experiment demonstrated that, although people did forego necessary health care services as cost-sharing increased, adverse effects on health were minimal.3 Second, the Affordable Care Act requires insurers to cover 3 primary care visits and preventive services without a deductible.These safeguards minimize adverse effects of high-deductible health plans.Third, the extent to which deductibles are a financial burden is captured in the Comprehensive Affordability Index.Adverse effects on health outcomes should be captured by another measure.We share Buxbaum and colleagues' concern regarding selfreported financial hardship, but these are subjective measures of affordability that capture prevailing moods, whereas the Affordability Index is an objective measure of financial burden.These subjective data are valuable, especially given socioeconomic disparities in access to adequate health care and increasing cost shifting from employers to workers. 4