How does cost affect access to care?


This collection of charts and a related brief explore trends in access to care in the U.S. The high cost of health care can be a barrier to access for both insured people (particularly those with high deductibles) and the uninsured, and costs can be particularly burdensome for people in worse health. 

About 1 in 10 adults report that they delayed or did not get care because of its cost


Most Americans do not report cost-related access barriers to health care. Still, a substantial portion of the population – about one in every ten adults (9%) – said that they either delayed or did not receive medical care due to cost in 2015.

Most adults are in better health and most have health insurance


In the U.S., most adults (89%) have health insurance and the majority (88% of adults) also report their health as at least good. Adults in worse health, those with low incomes, and the uninsured are much more likely than others to delay or forgo health services due to costs.

Adults who are in worse health have more difficulty accessing care due to cost


Nearly one in five adults in worse health (18%) said they delayed or did not receive medical care due to cost barriers, while 7% of respondents in better health reported the same. 

Uninsured adults are more likely to delay or go without care due to cost


More than 1 in 4 uninsured adults (28%) said they delayed or went without healthcare because of cost reasons. Meanwhile, 7% of adults who have health insurance reported encountering cost-related access barriers to care.

Low-income adults are more likely than others to have difficulty accessing medical care due to costs, but rates have declined in recent years


From 1998 – 2015, lower income adults have consistently reported more cost-related barriers to accessing medical care than higher income adults. Cost-related access problems generally rise during economic downturns. In 2015, rates of cost-related access barriers were lower than in any other year during this period for low-income people (11%, down from a recent high of 17% in the early years of the recent economic downturn and a low of 12% in 2002).

Adults in worse health are more likely than others to have difficulty accessing medical care due to costs, but rates have declined in recent years


Adults in worse health have long reported more cost-related access problems than those in better health. Cost-related access problems generally rise during economic downturns. Rates of cost-related access barriers are at their lowest in 2015 for those in worse health (18%, down from a recent high of 26% in 2009, and a low of 19% in 1998).

Uninsured adults experienced more difficulty accessing care due to cost


Uninsured adults have consistently experienced more difficulty accessing health care due to cost. Cost-related access problems generally rise during economic downturns. Note that the group of people who remain uninsured in 2014 and 2015 (after the Affordable Care Act’s coverage expansions) is likely different demographically from the people who were uninsured prior to 2014.

Adults are most likely to go without dental care and prescriptions because of cost reasons


Of the types of care that are delayed or forgone for cost reasons, dental care, prescription drugs, and eye glasses are at the top of the list, with at least 6 percent of adults reporting delaying or forgoing these types of care.

Adults in worse health report much higher rates of delayed or forgone medical care due to cost


Adults in worse health are much more likely to delay or forgo many types of health services.

More than a fourth of uninsured adults delayed or went without needed dental care because of the cost


Similarly, uninsured adults report significantly higher rates of cost-related access problems.

Uninsured adults and those in worse health are more worried about paying bills for routine medical care


Nearly two thirds (63%) of uninsured adults are very or moderately worried about paying for routine medical care. Adults in worse health care also more likely to report worries about paying for care, though the disparity is not as great as with insurance status.

Adults in worse health are less likely to worry about paying medical bills than in previous years


Adults in worse health have long reported more cost-related access problems than those in better health.

Uninsured adults and adults in worse health report more problems paying medical bills


About one in every three adults who reported being in worse health also reported problems paying bills for routine care as well as difficulty paying off medical bills over time (29% and 31% respectively). Uninsured adults had similar rates of medical bill problems.

Uninsured adults are less likely to have a usual source of care


Compared to those in better health people (10%) in worse health more often report not having a usual source of care (15%). The uninsured, in contrast, are much less likely to report not having a usual source of care (50%) than those with insurance (10%).

Uninsured adults who lack a usual source of care are also more likely to forgo preventive care


Of uninsured adults who did not report having a usual source of care, the majority (70%) also said they went without preventive health care services.