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79 Million Americans Struggle to Pay Medical Expenses

Even the insured have difficulty with bills, study finds

August 20, 2008
Regardless of whether they have some health insurance or not, a growing number of working Americans struggle to pay their medical expenses, according to a new study by the Commonwealth Fund.

Using data from four years of the Commonwealth Fund Biennial Health Insurance Survey, the report examines the status of health insurance for U.S. adults under age 65 and the implications for family finances and access to health care.

Insurance coverage deteriorated over the past six years, with declines in coverage most severe for moderate-income families, the researchers said. As result, more families are experiencing medical bill problems or cost-related delays in getting needed care.

In 2007, nearly two-thirds of U.S. adults, or an estimated 116 million people, struggled to pay medical bills, went without needed care because of cost, were uninsured for a time, or were underinsured.

Forty-one percent of working-age adults, or 72 million people, reported a problem paying their medical bills or had accrued medical debt, up from 34 percent, or 58 million, in 2005. An additional 7 million adults 65 and older also reported bill or debt problems.

The increase occurred across all income groups but families with low and moderate incomes were particularly hard hit: more than half of adults with incomes under $40,000 reported problems with their medical bills in 2007, the study found. Underinsured adults or those with gaps in their health insurance reported the highest rates.

Declining insurance coverage and rising health care costs are likely contributing to skimping on needed care, researchers said. The share of U.S. adults reporting that the costs of health care prevented them from getting needed care increased from 29 percent in 2001 to 45 percent in 2007. Reports of cost-related access problems rose across all income groups and among both insured and uninsured adults.

"A perfect storm of negative economic trends is battering working families across the United States," the authors concluded.

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