In 2020, Nearly 1 in 5 Americans Skipped Out on Medical Treatment Due to Cost

A new survey released this week suggests that more than 46 million American adults avoided getting the medical care they needed because they couldn’t afford it in 2020. Sadly, the results reflect a long-running problem in the U.S.

The survey was conducted by Gallup and West Health earlier this February. A nationally representative group of 3,753 people over the age of 18 were asked: “If you needed access to quality healthcare today, would you be able to afford it?” They were also asked if they or a family member, in the past 12 months, had a health problem that they avoided getting treatment for because of the cost.

Overall, 18%—just under one in five—responded that they couldn’t afford good healthcare today. 18% also said they or a family member had skipped seeing a doctor over financial difficulties last year. Unsurprisingly, that last problem was even worse for people with less money, with 35% of those with an annual household income under $24,000 saying they skipped care, while only 7% of people making over $180,000 said the same.

There were also clear differences in the ability to afford health care between different demographics. Black and Hispanic Americans (29% and 21% respectively) were more likely than white Americans (16%) to say they couldn’t afford good health care today. Age also seemed to play a role, with younger people being less likely to say they could afford their health care than older Americans. At age 65, Americans become eligible for Medicare, the country’s largest source of publicly funded health coverage. White Americans over 65 were the least likely to report cost-related problems with their health care, with 8% saying they couldn’t afford it today.

None of this is really new. While the Affordable Care Act did provide some important reforms in health coverage, the out-of-pocket costs of insurance and medical treatment in general continue to rise, and lots of people continue to suffer for it. In 2019, a survey by Gallup and West Health estimated that 34 million Americans knew someone who died without being able to afford health care. That same year, another Gallup survey found that 25% of families avoided getting treatment for a serious health condition due to cost.

Some financial relief has made its way to Americans during the pandemic, particularly for the millions of people who suddenly became unemployed. And the recently passed American Rescue Plan Act comes with provisions that will make coverage more affordable for people with private insurance or who recently lost their jobs. But these changes are only temporary, and it’s expected that the costs of insurance will continue to rise, if modestly, in 2021.

Advocates for universal health care have called for more sweeping and permanent fixes to our health care system, like lowering the age eligibility of Medicare from 65. Many proposals to make health care more affordable also enjoy plenty of popular support, according to the same Gallup poll. Over 80% of people in the poll supported setting caps on out-of-pocket costs from Medicare, for instance, while 60% supported making Medicare eligible for everyone.