About three in ten of all Americans forgo getting medical treatment due to the high costs of U.S. health care, according to a new survey by Gallup. Unsurprisingly, the issue is even worse among people who don’t have access to health insurance. Three in five uninsured Americans skip out on care over cost concerns.
Americans pay significantly more out of their own pockets for medical care than residents of all other affluent nations, and correspondingly put off treatment at much higher rates than people in other wealthy countries.
Gallup’s new results are similar to those from its 2012 survey on the subject, and represent significantly higher numbers compared to a decade ago, when about 25 percent of Americans skipped on treatment. Gallup researchers speculate that even insured Americans must at times put off care due to the growing popularity of health care plans that push costs onto policy holders.
“One possible explanation for the higher numbers since then is the increase in the number of high-deductible plans,” wrote the authors. “Americans with serious conditions who have insurance may be putting off treatment to avoid high out-of-pocket costs.”
Employers — the main providers of health insurance in America — have increasingly been relying on high-deductible health plans (HDHPs) that force workers to pay more out of pocket as a way of cutting their own expenses — a trend that’s expected to continue for the foreseeable future. In fact, the average workers’ contribution to his or her health care increased by 102 percent between 2002 and 2012, even though the cost of employer-sponsored plans grew by just 97 percent over the same time period:
CREDIT: Kaiser Family Foundation
Out of pocket costs for many plans in the pre-Obamacare individual insurance market were even worse. These policies could come with deceptively low monthly premiums and annual deductibles as high as $10,000. Premiums were subject to change based on a person’s health status, and sick people could see their coverage dropped or be denied insurance in the first place. Many of the plans didn’t even give consumers essential financial protection by covering things like hospital visits and prescription drugs, or have maximum caps on how much Americans had to pay out of pocket each year. That system may have worked for healthy or wealthy Americans — but only at the expense of the sick and poor.
As Gallup notes, however, “[i]If the Affordable Care Act — which is designed to ensure that all Americans have affordable health coverage — works as intended, fewer Americans should need to put off getting necessary medical treatment because of cost.”
That’s because a series of Obamacare provisions will help the uninsured afford health coverage for the first time, and shore up the individual insurance market to provide far more comprehensive coverage while limiting Americans’ out of pocket costs.
For instance, 1.5 million low-income Americans gained public health insurance through Medicaid and the Children’s Health Insurance Program in October (the first month of Obamacare enrollment) alone, largely thanks to the health law’s optional Medicaid expansion. Other uninsured Americans, as well as people who used to rely on shoddy individual health plans, have been enrolling for private health insurance through Obamacare’s statewide marketplaces, where those making between 100 percent and 400 percent of the Federal Poverty Level (FPL) will get government subsidies to help them pay for their monthly premiums.
Plans on the Obamacare marketplaces have to offer a wide range of benefits, including maternity care, mental health care, and prescription drug coverage. This ensures that an unexpected illness — physical or otherwise — won’t bankrupt the policy holder. The health law also limits annual out of pocket costs to $6,350 for individuals and $12,700 for families, and poorer people who make up to 2.5 times the poverty level and get a mid-level “Silver” plan will get additional “cost-sharing” subsidies that can limit deductibles and other out of pocket costs even more. That’s especially helpful to the very Americans who are putting off treating a serious illness over affordability, since their exposure to costs that may have previously bankrupted them are kept in check by Obamacare.