More than half of U.S. citizens are struggling to meet their health care expenses even though many of them have insurance, with some even skipping out on essential health care services or medication due to high costs, according to a recent survey.
This difficulty in paying for health care persisted even among adults who were insured.
“Forty-three percent of people in employer plans, 57 percent enrolled in marketplace or individual-market plans, 45 percent with Medicaid, and 51 percent with Medicare said it was difficult to afford their health care.”
Among adults enrolled in employer insurance plans, low-income people suffered the most, with 56 percent of individuals with incomes under 200 percent of the federal poverty level—$29,160 for an individual and $60,000 for a family of four—reporting difficulty in paying for health care expenses.
The cost of health services forced 38 percent of working-age adults or their family members to delay or skip a needed service or prescription drug in the past year. Among this group, 57 percent said a health issue got worse because of the skipped care.
While some skipped health care due to cost worries, others who managed to get health care ended up in debt. In the survey, 32 percent said they had medical or dental debts which were being paid off over time.
“Insurance coverage failed to protect many people from incurring medical debt. Thirty percent of people in employer plans, 33 percent in marketplace or individual-market plans or in Medicare, and 21 percent in Medicaid said they had medical or dental care debt.”
The health care debt affected the quality of life, with 78 percent of the respondents saying they felt anxiety or worry about paying it off.
Thirty-nine percent of debt holders cut back on basic necessities like food, heat, or rent; 37 percent used up all or part of their savings; 36 percent received a lower credit rating; and 36 percent delayed or avoided a needed medical service or prescription drugs.
“Eighty-five percent of adults with medical or dental debt reported debt of $500 or more; half of those with debt said it was for expenses associated with treatment of an ongoing health condition,” the survey report stated.
While 42 percent of respondents said 10 percent of their monthly household budget went toward meeting health care expenses, 40 percent set aside 10 to 25 percent of their budgets, and 17 percent shelled out over 25 percent of their budget for such costs.
Rising Health Care and Insurance Costs
According to the Milliman Medical Index, which measures the total cost of health care for a four-member family covered by an average employer-sponsored preferred provider organization plan, health care costs are expected to grow by 5.6 percent in 2023 to hit $31,065.Costs “have increased by 4.8 percent annually since 2021, which is the sort of year-to-year increase we were seeing before the pandemic,” said Dave Liner, co-author of the Milliman Medical Index, in a May 30 statement.
Co-author Doug Norris pointed out that health care cost inflation “tends to trail general inflation by six to 12 months.”
“While there have been some encouraging numbers on the general inflation front recently, we have a while before healthcare cost inflation catches up,” he said.
Co-author Annie Man blamed macroeconomic factors for putting upward pressure on health care costs.
“It’s not just inflation—it’s the supply chain, labor shortages in healthcare, and a strong job market elsewhere” that are also contributing to a spike in prices, she said.
This is greater than the 5.2 percent rise in workers’ wages and the 5.8 percent inflation rate. Almost 153 million Americans depend on employer-sponsored health coverage.
Bringing Down Health Care Costs
According to Mike Gaal, another co-author of the Milliman Medical Index, health care costs for families and individuals may see downward pressure in the future as a result of stronger price transparency measures.“Hospitals and payers are now required to publish their negotiated reimbursement rates, a move that has the potential to create systemic change in the market dynamics—especially for employers that can harness the data to drive down costs,” he said in a statement.
One of the bills, “Transparency in Billing Act,” requires health insurers and group health plans to only pay claims submitted by hospitals that provide detailed and accurate billing.
“Dishonest billing, opaque rules, and shady industry practices have left patients paying higher costs for health care,” committee Chairwoman Virginia Foxx (R-N.C.) said at the time.
“Today’s passage of our bipartisan health care package makes great strides towards giving clarity to patients and building a health care system that is more transparent, affordable, and accessible.”