Cost, medical debt, uninsured rate continue to be challenges

Uninsured rates have reached historic lows, says a national health care survey, but health care costs remain a major financial burden for many who cannot afford to use coverage which they have.

About 43% of working-age adults were “underinsured” in 2022, meaning they were uninsured, had insufficient coverage in the past year, or couldn’t afford care even with insurance, according to new research from the Commonwealth Fund, a health policy nonprofit.

» READ MORE: Inflation hits ACA health insurance plans in Pennsylvania

Those who struggled to pay for care routinely delayed needed appointments, skipped prescribed medications, and racked up medical debts they couldn’t repay.

“Having health insurance is not enough,” said Sara Collins, vice president of the Commonwealth Fund and lead author of the study, in a statement.

The biennial survey included a nationally representative sample of 8,022 adults contacted online and by phone between late March and early July.

Health care is harder to afford for people who don’t have insurance to help offset the cost. The national rate of uninsured persons has reached a historically low in early 2022, when about 8% of Americans were uninsured. Pennsylvania and New Jersey slightly better pricewith uninsured rates of 5.9% and 5.4%, respectively, in 2021, the most recent year for which local data is available, according to the Kaiser Family Foundation.

But the Commonwealth Fund survey found that a large proportion of people with health insurance also cannot afford the care they need.

Just under 30% of people with employer health insurance and an additional 44% with individual market coverage were underinsured in 2022. This means they had lifelong health insurance. year, but the out-of-pocket would have been so high, they could not afford treatment.

READ MORE: A bundle of joy, a stack of bills: Childbirth can cost thousands in out-of-pocket payments

High deductibles, expensive insurance premiums and rising health care costs have all strained people’s ability to maintain their health.

  • 49% of survey respondents said they would not be able to afford an unexpected medical bill of $1,000. (The average deductible for someone covered by an employer plan was $1,434 in 2021.)

  • 46% had skipped or delayed care due to cost.

  • 42% had difficulty repaying their medical debt.

People who didn’t postpone care — despite not being able to afford it — often faced tough decisions later about how to pay off the debt. Survey respondents said they emptied their savings, opened new credit cards, and put off career or educational plans to pay medical bills. Just over a quarter said they were unable to afford necessities, such as food, heat or rent due to medical debt.

“The fact that so many people in this country cannot afford needed healthcare – even with coverage at an all-time high – shows the importance of tackling healthcare costs,” said David Blumenthal , president of the organization, in a press release.

» LEARN MORE: What you need to know about how medical debt affects your credit score


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John A. Bogar