Chartbook on Care Affordability

High health care costs can prevent some patients from receiving the care that they need.

• People under age 65 whose family’s health insurance premiums and out-of-pocket medical expenses were more than 10% of total family income.
• People without a usual source of care who indicate a financial or insurance reason for not having a source of care.
• People unable to get or delayed in getting needed medical care, dental care, or prescription medicines who indicate a financial or insurance reason for the problem.

High Burden of Insurance Premiums and Out-of-Pocket Expenses

People under age 65 whose family's health insurance premiums and out-of-pocket medical expenses were more than 10% of total family income, by chronic conditions and family income, 2006-2012

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Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2006-2012.
Denominator: Civilian noninstitutionalized population under age 65.
Note: For this measure, lower rates are better. Total financial burden includes premiums and out-of-pocket costs for health care services.

• Importance: Health care expenses that exceed 10% of family income are a marker of financial burden for families.
• Overall Percentage: In 2012, 17.9% of people under age 65 had health insurance premium and out-of-pocket medical expenses that were more than 10% of total family income.
• Trends:
  • From 2006 to 2012, there were no statistically significant changes in the overall percentage.
  • Among  people with 4 or more chronic conditions and poor people, the percentage improved.
• Groups With Disparities: In 2012, the percentage of people under age 65 whose family’s health insurance premium and out-of-pocket medical expenses were more than 10% of total family income was about 3 times as high for poor individuals and low-income individuals and more than twice as high for middle-income individuals compared with high-income individuals.

People Without a Usual Source of Care for Financial or Insurance Reasons

People without a usual source of care who indicate a financial or insurance reason for not having a source of care, by insurance and race/ethnicity, 2002-2012

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Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2012.
Denominator: Civilian noninstitutionalizedpopulation without a usual source of care.
Note: For this measure, lower rates are better.

• Importance:  High-quality health care is facilitated by having a regular provider, but some Americans may not be able to afford one.
• Overall Percentage: In 2012, 20.2% of people without a usual source of care indicated a financial or insurance reason for not having a source of care.
• Trends:
  • The overall percentage worsened from 2002 to 2010 and then leveled off.
  • The percentage worsened among uninsured people and among Blacks and Hispanics.
• Groups With Disparities: In 2012, the percentage of people without a usual source of care who indicated a financial or insurance reason for not having a source of care was higher:
  • Among uninsured people and people with public insurance compared with people with any private insurance.
  • Among Hispanics and Blacks compared with Whites.

People Unable To Get or Delayed in Getting Needed Care

People unable to get or delayed in getting needed medical care, dental care, or prescription medicines who indicate a financial or insurance reason, by insurance and family income, 2002-2012

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Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2012.
Denominator: Civilian noninstitutionalized population who were unable to get or delayed in getting needed medical care, dental care, or prescription medicines.
Note: For this measure, lower rates are better.

• Importance: Some Americans cannot afford all the care they need.
• Overall Percentage: In 2012, of people unable to get or delayed in getting needed medical care, dental care, or prescription medicines, 69.3% indicated a financial or insurance reason for the problem.
• Trends:
  • The overall percentage worsened from 2002 to 2010 and then leveled off.
  • The percentage worsened among people with any private insurance and among people from middle- and high-income families.
• Groups With Disparities: In 2012, the percentage of people unable to get or delayed in getting needed medical care, dental care, or prescription medicines who indicated a financial or insurance reason for the problem was higher:
  • Among uninsured people and people with public insurance compared with people with any private insurance.
  • Among  poor, low-income, and middle-income people compared with high-income people.

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