Half of working-age Americans have trouble paying for healthcare

Many Americans under 65 are struggling to pay healthcare bills, and the high costs are deterring some from pursuing treatment, according to a Commonwealth Fund report released Thursday.

It’s not just a challenge for the insured. A significant number of Americans with health insurance coverage from their employers say they are having trouble affording healthcare expenses, the report stated.

Many Americans are also struggling with medical debt, with some owing thousands of dollars in healthcare bills.

Half of working-age adults (51%) said they had difficulty paying healthcare costs, and 43% of those with insurance from their employers also said they had trouble wiith those expenses.

The report found that 38% of working-age adults said they delayed seeking care or simply skipped treatment or filling a prescription due to the costs, or they knew someone in their family who had made that choice. And 29% of those with insurance from their job deferred care because they couldn’t afford it.

Many of those who said they postponed care or didn’t get a prescription paid a price for it. More than half of those (57%) who said they delayed treatment also reported that a healthcare problem worsened as a result. And 54% of those with employer-provided insurance said a health issue worsened if they skipped or postponed care.

Nearly one-third (32%) of adults under the age of 65 said they have medical or dental debt, and the figures were fairly consistent among those who had insurance. The survey found 41% of those without insurance had some kind of healthcare debt.

The vast majority of those with some kind of medical debt (85%) said they owed at least $500, but some carried higher debts. The survey found 36% of those with medical debt owe between $500 and $2,000.

More than a quarter of those with medical debt said they had healthcare debts between $2,000 and $5,000. More than 1 in 5 (22%) of those with a healthcare debt said they owed more than $5,000.

More than half of those with some kind of medical debt (54%) say it’s related to hospital care, while 37% said the debt is due to a doctor’s office visit.

The Biden administration has been paying more attention to consumer debt tied to healthcare costs. “Too many families across the country are saddled with crushing medical debt,” Health and Human Services Secretary Xavier Becerra said in April 2022.

Last month, the Biden administration announced steps to ensure that unpaid medical debt doesn’t affect Americans’ credit scores. Federal officials said they plan to develop regulations next year, NPR reported.

Hospitals are gaining increasing scrutiny for their handling of medical debt. Senators sent a letter to the IRS asking to review if nonprofit hospitals are meeting their responsibilities that come with their tax-exempt status. U.S. Sen. Elizabeth Warren specifically pointed to some hospitals’ efforts to collect debts.

“It's alarming that some nonprofit hospitals are using predatory tactics to squeeze money from patients who should be receiving free care,” Warren said in a statement on X, formerly known as Twitter.

Hospitals say they provide billions of dollars in community benefit through uncompensated care, efforts to improve community health and training doctors and nurses. Hospitals also called on more federal support for health systems.

The Commonwealth Fund report reflects results from a survey of 6,121 American adults under the age of 65 from April 18 through July 31.