A Third of Americans Are Still Struggling to Find Affordable Healthcare

  • 34% of Americans had trouble finding affordable policies
  • Three in 10 covered adults skipped care due to cost in 2016

Uninsured rates in low-income families have fallen under the Affordable Care Act, yet more than a third of Americans continued to face difficulties paying their medical bills in 2016, a survey found.

Adults in poor families were among the greatest beneficiaries of the ACA, with uninsured rates falling as much as 17 percentage points since it became law in 2010, according to a study from the Commonwealth Fund, a private, New York-based research organization. Still, 34 percent of Americans said it’s difficult or impossible to find affordable health coverage.

Health insurance affordability was a major issue in the 2016 presidential campaign, particularly after premiums for mid-level Obamacare plans for 2017 jumped by an average of 25 percent in October. While 20 million people gained coverage since the law was passed, Republicans have criticized Obamacare for rising premiums and limited insurer options, pledging to repeal and replace it with a better program. President Donald Trump and GOP lawmakers still haven’t come to an agreement on a replacement plan.

One group who could feel the hurt of a repeal is low-income families, whose uninsured rates have dropped under Obamacare. In 2010, 36 percent of families with incomes less than $48,500 were uninsured; in 2016, that number was down to 19 percent. 

Young Adults

Young adults age 19 to 34 made the largest coverage gains of any age group. Rates of uninsurance fell to 15 percent from 27 percent in the first six years of the ACA.

Still, about three in 10 adults with coverage reported not seeking care due to costs, a sign that health care often remains unaffordable. While this could be because Obamacare subsidies are insufficient, it may also be because of how people perceive their plans, said Sara Collins, vice president of health-care coverage and access program at the Commonwealth Fund and the study’s lead author.

“People with marketplace plans tend to view them as less affordable than people in employer-based plans, even if they’re paying the same premium,” Collins said in a telephone interview. “They pay out of pocket every month for their premium, where you don’t do that in an employer-based plan.”

After Trump signed an executive order on his first day declaring that his administration would seek repeal of the law, Republicans missed a Jan. 27 deadline for budget committees to receive and act on recommendations for a repeal bill. Though the deadline carries no penalty, several congressional Republicans voiced frustration on Tuesday over the slow progress on dismantling Obamacare.

Collins cautioned that affordability and coverage issues will worsen without an adequate replacement.

“Weaknesses in coverage remain, including ongoing problems buying individual insurance and high rates of medical bill problems,” she said in a teleconference to discuss the study’s findings. “However, a repeal of the key provisions of the Affordable Care Act, like its subsidies, without an effective replacement would exacerbate these weaknesses.”