About 29 percent of adults with health insurance last year were underinsured, with high deductibles and out-of-pocket expenses relative to their income, according to the latest Biennial Health Insurance Survey by the Commonwealth Fund. That’s up from 22 percent in 2010, when the Affordable Care Act was enacted, with the largest increase among people with job-based health plans. However, people who bought individual market plans were the most likely to be underinsured, with 42 percent reporting inadequate coverage in 2018. According to the survey, the uninsured rate for adults has declined to 12.4 percent from 20 percent in 2010, but has not changed since 2016. “U.S. working-age adults are significantly more likely to have health insurance since the ACA became law in 2010,” the report notes. “But the improvement in uninsured rates has stalled. In addition, more people have health plans that fail to adequately protect them from health care costs, with the fastest deterioration in cost protection occurring in the employer market.”

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Few patient populations are more vulnerable to the shifting winds around health care today than Medicare beneficiaries who need specialized, high-acuity and…