More than 40% of adults in the United States went without necessary medical care in 2010 due to cost, up from 29% a decade ago, according to the Commonwealth Fund’s Biennial Health Insurance Survey.
Skipping needed care such as prescription drugs, specialist visits, and follow-up treatment is even more common among moderate- and low-income groups. For example, 56% of Americans with household incomes under 200% of the federal poverty level went without necessary care last year, according to the survey, which was released on March 16.
The survey, which was conducted from July through November 2010, is based on phone interviews with a nationally representative sample of more than 4,000 U.S. adults aged 19 and older. The analysis is limited to the approximately 3,000 adults aged 19-64 years who responded to the survey.
Cost was an issue for those with and without health insurance. About two-thirds of adults who were uninsured during 2010 said they had trouble accessing care due to cost; 31% of insured respondents reported the same problem.
Preventive care also took a hit in 2010. Only half of adults surveyed reported that they were up to date on five recommended screening tests: blood pressure and cholesterol tests, mammograms, colon cancer screenings, and Pap tests. Those with lower incomes were less likely to get screened: While 65% of adults with a household income at or above 400% of the federal poverty level were up-to-date, only 36% of adults at less than 133% of the federal poverty level were.
"The survey findings paint a dire picture of the degree to which low- and moderate-income families are currently burdened by costs of care and the degree to which a severe economic crisis can affect the health security of working families," Sara R. Collins, Ph.D., vice president for Affordable Health Insurance at the Commonwealth Fund, said during a press conference to release the findings.
Dr. Collins said the controversial Affordable Care Act will help to address some of the problems highlighted in the survey by alleviating the cost burden on the lowest-income Americans. She cited the expansion of the Medicaid program and federal subsidies to purchase private health coverage, both of which begin in 2014, as ways to reduce out-of-pocket costs and improve access to care.
The Commonwealth Fund report also noted worsening trends in insurance coverage and medical debt over the last decade:
- About 28% of adults in the United States were uninsured for part of 2010, up from 24% in 2001.
- About 40% of adults reported that they had problems paying their medical bills in 2010, up from 34% in 2005.
- About 32% of Americans spent 10% or more of their household income on out-of-pocket costs and premiums in 2010. This is up from 23% in 2005 and 21% in 2001.