The Commonwealth Fund report, Too High a Price: Out-of-Pocket Health Care Costs in the United States, is based on the Commonwealth Fund Health Care Affordability Tracking Survey, which was conducted among a nationally representative sample of 2,751 adults ages 19 to 64 between September and October. The majority of people surveyed had employer-sponsored health insurance, but people with federal marketplace plans, individual health insurance, Medicaid or other coverage were also included in the sample.
Findings from the report are shown below.
- Thirteen percent of survey respondents said they spent 10 percent or more of their incomes on healthcare costs (excluding premiums).
- Low-income adults are more likely to have high out-of-pocket healthcare costs: 41 percent of respondents with annual salaries of less than $11,490 spend 5 percent or more of their income on out-of-pocket costs, and 31 percent spend 10 percent or more.
- Privately insured people across all income groups reported having trouble affording deductibles: 43 percent of respondents reported their deductible was somewhat, very difficult or impossible to afford.
- Low and moderate income adults reported the highest level of difficulty affording deductibles, with 49 percent of respondents making $22,980 to $45,960 per year, 64 percent making $11,490 to $22,908 per year and 58 percent making less than $11,490 per year reporting it was somewhat, very difficult or impossible to afford their deductible.
- In comparison, 27 percent of respondents making more than $45,960 per year reported this level of difficulty in paying for their deductibles.
- Out-of-pocket costs associated with healthcare lead to people skipping needed care: 40 percent of people earning less than $22,980 reported at least one example of skipping necessary healthcare because of their plan’s copayments or coinsurance, and 40 percent of privately insured people whose deductibles represented 5 percent or more of their income reported at least one instance of skipping necessary healthcare.
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