Under the Affordable Care Act (ACA) the poor are accessing care, which the middle class increasingly postpone. Eighty percent of employer plans now have deductibles, which averaged $1,307 during 2014 in the Western states. Co-pays, co-insurance, and drug costs are additional. Free clinics note that seven percent of their patients have insurance through an employer. Employers have been cutting back on benefits for decades without a corresponding rise in wages. The American Academy of Pediatrics states high deductible plans are a less desirable way to lower health care costs. Laura Ungar and Jayne O'Donnell explore the trends and health consequences of high deductible policy in their article "Dilemma over deductibles: Costs crippling middle class" appeared in USA Today on 1-1-15. LEARN MORE.