Short Takes On News & Events

Fewer U.S. Families Report Having Difficulty Paying Medical Bills

By Judith Graham

June 4th, 2013, 6:00 AM

Fewer American families are having problems paying medical bills, according to a study released Tuesday by the National Center for Health Statistics. Still, nearly a fifth off families still struggle with that financial responsibility.

The report found that 20.3 percent of families headed by someone under the age of 65 — 54.2 million people — had difficulty covering medical expenses in the first half of 2012, compared with 21.7 percent of families — or 57.8 million people – in the same period in 2011.

The federal agency didn’t offer an explanation for its finding. Other experts said factors likely driving the decline include a more robust economy, declines in the use of health care services,  slower increases in health care costs and provisions in the Affordable Care Act that expand insurance coverage to young adults and eliminate lifetime caps on insurance benefits and phase out annual caps.

“Two things may be happening,” said David Newman, executive director of the Health Care Cost Institute in Washington, D.C.  “The financial situation of many families is improving, along with the economy.  And people appear to be consuming fewer health care services; as this happens, they have fewer bills to pay.”

The NCHS report is by far the largest study of its kind.  Results come from in-person interviews with 155,321 individuals conducted between January 2011 and June 2012.  Other research that has examined the burden of medical bills on families has been based on much smaller samples.

Individuals without insurance were the only group to experience more difficulties paying medical bills: 36.3 percent reported this concern in the first half of 2012, up from 35.7 percent a year earlier. By contrast, 14 percent of families with private insurance had similar problems in the first half of 2012, down from 15.7 percent the year before.

Among those with public insurance – Medicaid, military programs, Children’s Health Insurance Program coverage, Medicare, and other plans – 25.6 percent said it was hard to cover medical expenses in the first half of 2012, a drop from 28 percent a year ago.

Other research lends weight to the findings. In April, the Commonwealth Fund published a report that suggested there was a “leveling off” between 2010 and 2012 in what had previously been steady increases in the number of people who have trouble making payments on medical bills, said Sara Collins, a vice president at the Commonwealth Fund and an author of the report.

She credited the Affordable Care Act for helping change the trend line.  About 3.4 million young adults have gained insurance since the law let individuals up to age 26 be covered through their parents’ policies.   Meanwhile, caps on lifetime benefits have been eliminated, annual limits on benefits are being phased out, and a number of preventive services are now available without cost sharing under the law, Collins noted.

The new report’s findings are also “broadly consistent” with what the Center for Studying Health System Change found in a December 2011 report tracking families’ difficulty paying medical bills, according to Peter Cunningham, a senior fellow at the Washington, D.C., organization.

“Since 2010, we’ve seen very little change in the number,” he said, probably because of “the moderation in health care costs and because people have been pulling back on their healthcare utilization and spending.”

3 Responses to “Fewer U.S. Families Report Having Difficulty Paying Medical Bills”

  1. randy says:

    Maybe providers are getting scared? Maybe they see that the decades long party is now coming to a close? They have been gouging consumers for far too long. Maybe the recent convictions by the justice department have them worried? Maybe they are seeing a government crack down on fraud and abuse with Medicaid and Medicare and providers see that they could be serving time in prison if they keep working the scam? Highly paid doctors in mid career do not want to risk losing their license and being prosecuted so maybe they are cleaning up their act and charging a fair price for their services? Maybe they have quit bilking the system and are cleaning it up out of fear?

  2. Twenty percent of families struggling to pay medical costs still seems like a very high number. Many families I talk with have high-deductible insurance plans, and choose not to see a doctor for minor ailments because they fear the high cost of an office visit – $200+ for 5 minutes with a doctor is not unusual. As more insurance plans require increased cost sharing by the patient, I’m sure the use of health care services will continue to decline.

  3. Maggie says:

    It’s also getting increasingly difficult to get a doctors appointment. I just went to the ER this morning with my 85 year old dad who has excellent insurance, who was passing blood. They wanted him to get a follow-up with a urologist right away for a urinary tract infection because his course of antibiotics will be done in 10 days. Well, he can’t get in to see a doctor for a month, early July. So, if the antibiotics don’t knock this out, he could harbor this infection for 20 days with no follow-up.
    Right now, the local hospital, Carle Hospital/Health System, limits it Medicaid patients to 20% of their population so they turn people away. The Affordable Care Act will expand the Medicaid population in this county (Champaign county has a high poverty rate unbeknownst to most people) exponentially but the local hospitals won’t be required to see those people.
    It may not be that medical costs are really going down but that expenses are decreasing due to demand/desired usage decreasing through delay, thereby “morphing” the expense curve. It may just be that its being rationed due to a lack of doctors to meet the demand. When there’s a famine, food consumption goes down but not because of any bureaucratic success. There just isn’t enough food.