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.
Telephone calls to a nationally representative sample of more than 4,000 U.S. adults were made from July through November 2010. 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. 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.
Half of the respondents said they were up to date on five recommended screening tests: blood pressure and cholesterol, mammograms, colon cancer, 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 at a press conference. She said the Affordable Care Act will address some of the problems highlighted in the survey by alleviating the cost burden on the lowest-income Americans. She cited the expansion of Medicaid 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 noted worsening national trends in insurance coverage and medical debt over the last decade. About 28% of adults were uninsured for part of 2010, up from 24% in 2001. Forty percent reported having problems paying medical bills in 2010, up from 34% in 2005. About 32% spent 10% or more of household income on out-of-pocket costs and premiums in 2010, up from 23% in 2005 and 21% in 2001.