Working-age Americans are struggling to pay for health care, even those with insurance, report finds (2024)

Americans struggling to pay for health care

For Americans, paying for health care is often a hardship even for those with health insurance, with many people saying they struggle to afford rising premiums, deductibles, copayments and other medical costs.

Just over half of working-age Americans say they sometimes can't afford health care, according to The Commonwealth Fund. About 4 in 10 workers with employer-sponsored insurance or who are on Medicaid say they have difficulty paying, while that rises to about 6 in 10 for people who buy coverage through the Affordable Care Act's marketplaces, the study found.

By comparison, three-quarters of people without insurance who report problems affording care, according to the advocacy group, which promotes fairness in health care.

Almost two in five, or 38%, of insured Americans reported delaying or skipping necessary treatment or medication because of high out-of-pocket costs for health care. Rising medical costs are also straining household budgets, with roughly 30% of working-age adults with health insurance saying these expenses make it difficult to afford essentials like food, utilities, car payments and loans.

"It's much better to have insurance. People who are uninsured report higher rates of problems with not getting care because of the cost," health care scholar and lead study author Sara Collins told CBS MoneyWatch. "But they also indicate insurance coverage frequently fails to provide affordable access to care for large segments of the population."

Collins also supports policies that expand coverage and rein in health care costs so that people can afford to stay healthy without piling on medical debt, a leading cause of personal bankruptcy in the U.S. That could include expanding subsidies for lower-income people so their deductible, copayment and co-insurance costs are less burdensome.

Efforts by insurance companies to expand their provider networks would also lower people's out-of-pocket costs, she said. As of 2022, more than 100 million Americans carried debt related to obtaining health care, according to theKaiser Family Foundation.

Commonwealth Fund President Joseph Betancourt, M.D., also suggested that high health care costs are linked to Americans having one of the highest rates of chronic disease in the world.

"This is unsustainable for our health care system, and our nation — we need major reforms to ensure people can get the care they need, when they need it most," he said in a statement.

Megan Cerullo

Megan Cerullo is a New York-based reporter for CBS MoneyWatch covering small business, workplace, health care, consumer spending and personal finance topics. She regularly appears on CBS News 24/7 to discuss her reporting.

Working-age Americans are struggling to pay for health care, even those with insurance, report finds (2024)

FAQs

Working-age Americans are struggling to pay for health care, even those with insurance, report finds? ›

About 4 in 10 workers with employer-sponsored insurance or who are on Medicaid say they have difficulty paying, while that rises to about 6 in 10 for people who buy coverage through the Affordable Care Act's marketplaces, the study found.

Do half working age Americans struggle to afford medical care? ›

Fifty-one percent of working-age Americans struggle to afford their health care and about one of three (32%) are saddled with medical debt, according to findings from a Commonwealth Fund survey released today.

How many Americans struggle to pay for health insurance? ›

About half of U.S. adults say it is difficult to afford health care costs, and one in four say they or a family member in their household had problems paying for health care in the past 12 months.

Why is healthcare so expensive even with insurance? ›

The complexity of the U.S. healthcare system can lead to administrative waste in the insurance and provider payment systems. The consolidation of hospitals can lead to a lack of competition or even a monopoly, granting providers the opportunity to increase prices.

How does age affect health insurance? ›

The average cost of health insurance is higher for older people since they typically need more medical services. But insurance companies have to follow state and federal laws about age-based rates. Someone who is 64 or older can't be charged more than three times what a 21-year-old pays, for example.

Who pays more than 55% of the health care costs in America? ›

While there are people with high spending at all ages, in 2021, people 55 and over accounted for 56% of total health spending despite making up only 31% of the population. In contrast, people under age 35 comprised 44% of the population but were responsible for only 21% of spending.

What happens if you can't afford healthcare in America? ›

In a worst-case scenario, you could be sued and have your wages garnished. You might even be forced into bankruptcy. The Commonwealth Fund's 2023 Health Care Affordability Survey found that 38% of people surveyed said they delayed or skipped needed healthcare or prescription drugs because they couldn't afford it.

Why do doctors charge so much more than insurance will pay? ›

Insurance companies usually have what they call a contracted amount they pay doctors, hospitals, clinics. It's always a lot lower than what the doctor would bill a patient that had no insurance. The doctor has to charge more so they can pay their office staff, rent and utilities before he pays himself.

Who is to blame for high healthcare costs? ›

Much of this blame is landing on physicians and insurance companies. While all facets of healthcare play a role in its cost, physicians and insurance companies aren't the main culprits. If Not Doctors, Then What? The truth is that there is not one single factor making healthcare more expensive.

Why is health insurance unaffordable? ›

Administrative Overhead: Health insurers often have substantial administrative overhead, including marketing, underwriting, and claims processing. These costs are passed on to consumers in the form of higher premiums, which can contribute to overall healthcare expenditure.

Why might it be even more expensive to not have health insurance coverage at all? ›

The Cost of Not Having Health Insurance Is Even Higher

Studies repeatedly demonstrate that uninsured people are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases. When they do seek care, uninsured people often face unaffordable medical bills.

What age is health insurance most expensive? ›

Average Cost of Health Insurance by Plan Type
Age of memberAverage monthly cost for EPOAverage monthly cost for PPO
Age 30$466$512
Age 40$524$576
Age 50$733$805
Age 60$1,109$1,224
2 more rows
Feb 23, 2024

Is there any correlation between insurance premium and age? ›

The younger. Similarly, the older your age is, the higher will be the health insurance premium.

Which age group has the highest healthcare utilization? ›

The oldest older adults (ages 85 and older) have the highest per capita utilization of health services, and that population is expected to increase from 5 million to 9 million between 2005 and 2030.

How does low income affect healthcare? ›

Those with low incomes are more likely than Californians with higher incomes to say their community does not have enough primary care doctors (41 percent versus 31 percent), specialists (42 percent versus 24 percent), and hospitals (34 percent versus 22 percent) (Figure 7).

What percentage of Americans struggle with medical debt? ›

And they polled more than 1,200 people across the country. And the survey found 41% of U.S. adults have health care debt. That is huge.

What age group is least likely to have health insurance? ›

Young Adults (Ages 18 Through 24 Years)

Almost three out of every ten young adults do not have health insurance. Members of this age group are nearly twice as likely to be uninsured compared to members of the general population under age 65.

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