The public holds massive medical debt despite high insurance rates

MMedical debt accumulated on more than 23 million people in 2019 despite high rates of insurance take-up, with the amount owed totaling at least $195 billion.

For many families in the United States, a medical debt of at least $250 represents a considerable financial burden, according to to the US Census Bureau survey of income and program participation. Corn 90% have insurance coverage through private and/or public plans, the Kaiser Family Foundation reported that approximately 16 million people in the United States, or 6% of adults, owe more than $1,000 in medical debt , and 3 million people, or 1% of adults, owe more than $10,000 in medical debt.


“Most Americans have private health insurance, which typically requires payment of a deductible, coinsurance, and co-payment for medical services and prescriptions,” according to the Kaiser Family Foundation. “Many Americans, even those with private health insurance, don’t have enough cash to respect deductibles or maximum disbursements.

People from all demographic groups are spending their savings to pay down debt. About 75% of insured people with medical debt were more likely than uninsured people, 62%, to reduce their spending on food, clothing or basic household items.

Meanwhile, three-quarters of policyholders said the amount they had to pay for their insurance copayments, deductibles or coinsurance was more than they could afford, especially those with high deductibles. Seventy-six percent of people with debt and very low insurance deductibles also reported difficulty paying their bills, which would be the case when paying out-of-network coinsurance or repeated co-payments.

The burden of medical debt, however, is not felt uniformly across the United States. People who report fair or poor health, have a disability, live in rural areas and southern states, and those who have not expanded Medicaid to cover poorer populations have a much higher likelihood than alternatives to having unmanageable medical debt.

To date, 12 states have neglected to expand Medicaid, the government insurance program for the very poor and disabled: Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin and Wyoming. Twelve percent of those states have medical debt compared to 8% in states that have expanded Medicaid to cover a wider range of people living below the poverty line, which in 2019 was $12,490 for someone living alone and $25,750 for a family of four.


It remains to be seen to what extent the pandemic’s effect of delaying elective or preventive health care has had on medical debts in 2020. The Centers for Disease Control and Prevention calculated the percentage of people who delayed care in 2020 at the end of June at 41%. Concerns over possible exposure to the virus also caused 32% of adults to postpone or avoid seeking routine health care during the period, hinting at a possible increase in overall illness and death rates in the future. national level associated with chronic and acute health problems.

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John A. Bogar