Healthcare costs in the US have become a major talking point as of late, with more Americans finding it difficult to pay their bills due to high prices they face, even when they are insured.
According to a new survey from the Commonwealth Fund — a health-care-focused think tank — 1 in 4 adults with health coverage struggle with high out-of-pocket costs.
While the survey highlighted that most people have coverage through their employers, the policies they have don’t always provide timely or affordable access to care. Because of this, many Americans find themselves skipping ongoing care and forgoing prescription refills because they can’t afford them.
The survey found that 20% of respondents reported being uninsured during this year. Another 23% of those who had insurance reported being enrolled in plans with high out-of-pocket costs, making it difficult for them to afford care despite having coverage.
The high cost of care resulted in 57% deciding not to get needed care, according to the survey. Forty-four percent of respondents also reported being in medical debt.
While the numbers are stark, Dr. Joseph Betancourt, a primary care physician who is president of the Commonwealth Fund, said in a statement that this isn’t uncommon anymore.
“Millions of families across the US can’t afford the care they need, including many who are managing chronic conditions like diabetes and heart disease,” Dr. Betancourt said.
“I routinely see patients facing unexpected costs that prevent them from getting essential care to stay well and avoid illness,” he added.
The report also noted that a third of respondents with chronic conditions reported they skipped filling a prescription because they couldn’t afford the costs.
For those who were considered underinsured, 66% had health insurance plans through their employer, 14% had individual plans, and 11% had Medicaid.
The survey also found that many found themselves in poor financial situations because of their health, as half of all adults with debt incurred it because they received hospital treatment for ongoing medical issues.
The survey from the Commonwealth Fund only compounds findings from other reports about the recent rise in healthcare and insurance costs.
According to WTW, a consulting firm, the cost of health insurance is on the rise. Its report says that US employers estimate their healthcare costs will increase by 7.7% in 2025, compared with 6.9% in 2024 and 6.5% in 2023.
This increase will affect a wide swath of the country, as around 165 million Americans get health insurance through their work.
According to the KFF’s 2024 employer health survey, family premiums for employer-sponsored health insurance rose 7% this year, pricing subscribers at $25,572. While employers pick up the majority of that price point, employees are still responsible for more than $6,200 on average.
“With cost increases reaching a post-pandemic high, companies are concerned about the burden it’s putting on their workforces, especially since it affects decisions about insurance coverage and care,” Tim Stawicki, WTW’s chief actuary of health and benefits, said in a statement.
Betancourt appeared to agree, sharing in his study that the financial burden of healthcare is making the situation worse.
“At the end of the day, these financial barriers ripple through our health care system, driving up costs -- with preventable hospitalizations being just one of many costly consequences,” Dr. Betancourt said.
The survey from the Commonwealth Fund was conducted between March and June of this year, including answers from 8,201 18- to 64-year-old Americans.