More than people in any other wealthy country, Americans struggle to pay for their health care. The lack of guaranteed coverage for all in the US means that millions go uninsured. Legislation permitting insurers to sell incomplete coverage means that millions more go underinsured. And, in the end, all Americans pay for the fact that so many Americans don’t have the coverage they need.
People who think they have adequate coverage often do not. They end up with big bills. Or, they only realize when they need care how much they will have to pay out of pocket and opt to go without or delay care. People enrolled in Medicare Advantage plans do not appreciate that having the “same benefits” as peole in traditional Medicare is a far cry from being covered for the same services, without administrative hassle and delay or huge out-of-pocket costs.
Today, nearly one in three Americans under 65 are in medical debt, trying to pay it off. About 25 percent are paying a collection agency. For about 25 percent of people in medical debt, their debt has affected their credit rating.
The majority of debt comes from hospital care, but a significant portion (43 percent) comes from doctor’s visits and 38 percent from lab and other tests. These bills take an emotional as well as financial toll on families, leading to anxiety. Three in ten people put off getting care.
People in southern states fared the worst, with about 40 percent reporting medical debt as compared to 25 percent in other regions. While it’s not clear why, it is posited that people in the south are less likely to have Medicaid because many southern states did not expand Medicaid coverage, and that southerners have less good coverage and lower incomes than people in other parts of the country. In addition, people living in the south tend to live in states with fewer consumer protections against medical debt. Structural racism may also play a role.
