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 2017.
Most adults are in better health and most have health insurance
In the U.S., most adults (90%) 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 (19%) 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.
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 were at their lowest in 2015 for those in worse health (18%, down from a recent high of 26% in 2009).
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 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 forgone medical care due to cost
Adults in worse health are much more likely to forgo many types of health services.
More than a fourth of uninsured adults went without needed dental care because of the cost
Similarly, uninsured adults report significantly higher rates of cost-related access problems.
Adults trying to save money will seek substitutes and delay filling prescriptions
Over 6 in 10 adults report being prescribed a drug by a health care provider in 2017. However, nearly a fifth of them will ask for cheaper option because of cost saving concerns and some (8%) will delay filling a prescription in order to save money.
Uninsured adults and those in worse health are more worried about paying bills for medical care
Nearly 3 in 5 (59%) uninsured adults are very or moderately worried about paying for normal 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 individual or family problems paying bills for medical care as well as difficulty paying off medical bills over time (27% and 31% respectively). The uninsured had similar rates of medical bill problems.
Uninsured adults are less likely to have a usual source
Compared to those in better health (14%), people in worse health are less likely to report not having a usual source of care (8%). The uninsured, in contrast, are much less likely to report not having a usual source of care (46%) than those with insurance (9%).
Uninsured adults who lack a usual source of care are also more likely to not use preventive care
Of uninsured adults who did not report having a usual source of care, the majority (62%) also said they did not have any preventive health care services.