A new KFF poll finds that health care affordability is the public’s top economic anxiety. People who lack insurance, along with people who have insurance, struggle to pay for their health care. Roughly one in three Americans face medical debt.
The KFF poll studies the experiences of adults with complex conditions. Researchers surveyed more than 26,000 adults, nearly 17,000 of whom had at least one health condition, including cancer, diabetes, mental health issues, heart disease and lung disease.
KFF reports that one in four adults with three or more complex conditions faced denials and delays of care. That is common for people in Medicare Advantage plans, but KFF does not break out the data to distinguish the experiences of people in traditional Medicare from people in Medicare Advantage. Other data show that it is the people in Medicare Advantage with complex needs who most face challenges accessing care.
KFF further reports that roughly 20 percent of older adults with multiple complex conditions have gone without care or delayed care because of the cost or the challenge of getting an appointment. One in ten report deteriorating health as a consequence.
Thirty-six percent of adults under 65 with three or more health conditions reported struggling to pay their health care bills. Many of them went without care or delayed it because of the cost or did not fill prescriptions.
More than four in ten with mental health needs did not seek or postponed treatment because of the cost. More than one in three with heart disease struggled to pay their health care bills. More than one in four adults (27 percent) said their health deteriorated.
Just under half of adults with insurance (49 percent) managing three or more health conditions reported delays and denials of care by their health insurer in the last two years.
Uninsured Americans with three or more health conditions face even greater challenges getting and paying for health care. More than 70 percent of them have struggled to pay for their medical needs. Half have been forced to spend less on other basic necessities.
Among the uninsured with several health conditions, skipping care is fairly routine. More than two-thirds of them are going without care or delaying it and more than half cannot afford the medicines they have been prescribed.
Adults. with cancer are facing challenges getting their insurers to cover the care they need, with those 64 and under faring particularly poorly. More than four in ten adults with cancer 64 and under report denials and delays of care. More than two in ten adults with cancer 65 and older report denials and delays of care.
Again, KFF does not appear to identify different experiences for people in traditional Medicare and people in Medicare Advantage. But, many studies show that people in Medicare Advantage plans are at a particular disadvantage getting needed care without delay. KFF does explain that people in Medicare Advantage are far more likely to face prior authorization delays and denials of care than people in traditional Medicare, which rarely uses prior authorization.
Here’s more from Just Care:
- Medical debt plagues 100 million Americans
- Nearly one in three Americans struggle to pay their medical bills, Southerners fare the worst
- People in Medicare Advantage struggle to afford their care
- OIG finds widespread inappropriate care denials in Medicare Advantage
- Prior authorization in Medicare Advantage harms patients, sometimes severely
