Fewer Americans confident they can afford healthcare, survey finds
Meg Bryant | May 11, 2018
- Just two-thirds of U.S. adults are very or somewhat confident they could afford healthcare if they come down with a serious illness, down from 70% in 2015, according to a new survey by The Commonwealth Fund.
- That confidence drops to about half for people whose incomes fell below $30,150 — down from 60% three years ago and 20% fewer than adults with higher earnings.
- The latest findings from the Affordable Care Act Tracking Survey also note significant declines in confidence among younger adults, those age 50-64, women and people with existing health problems.
People with employer health plans feel the most secure, with 55% claiming to be very confident they could afford care if they become very sick. That compares with 31% of adults in the individual insurance market, 44% of Medicare beneficiaries and 41% of Medicaid enrollees.
About a fourth of adults overall and a third of those in the individual market believe healthcare is harder to afford than in the past. And just 46% say they would be able to pay a $1,000 medical bill within 30 days if they unexpectedly take ill or are hurt.
Out-of-pocket medical costs continue to be a major worry for many people. In this survey, 14% list healthcare as their No. 1 financial concern. Uncertainty about the Affordable Care Act, including the repeal of the individual mandate, has dampened the outlook.
“The proliferation and growth of high-deductible health plans in both the individual and employer insurance markets is leaving people with unaffordable health care costs,” the report says. It notes that about 41 million insured adults face deductibles and out-of-pocket costs high enough, vis à vis their incomes, that “they are effectively uninsured.”
Out-of-pocket healthcare costs rose 11% last year, with average fourth-quarter costs of $1,813, up from $1,630, according to a recent TransUnion Healthcare report. Nearly half of out-of-pocket costs were less than $500 per medical visit, but 12% exceeded $1,000.
A Kaiser Family Foundation analysis predicted out-of-pocket costs for older Americans will reach 50% of average per capita Social Security income by 2030, up from 41% today.
In the wake of rising deductibles and worries about medical debt, some providers are finding new ways to approach bill collection and help consumers deal with medical bills. For example, Geisinger Health System offers interest-free installment payment plans up to 36 months, with longer terms based on case reviews and executive approval. Geisinger couples the payment plans with patient education and outreach.
In another case study, North Kansas City Hospital teamed up with CarePayment to offer patients up to 24-month 0% interest payment programs. The effort also includes an outreach program focused on healthcare consumerism and patient financing. In the first six months, net collections rose 67%, bad debt dropped 27% and the hospital saw an increase in patient satisfaction and loyalty.
- The Commonwealth FundAmericans’ Confidence in Their Ability to Pay for Health Care Is Falling