Almost 13 Million Fewer People Have Trouble Paying Medical Bills

The amount of Americans under age 65 in families having trouble paying medical bills has dropped significantly over the past 5 years, according to a survey report from the National Center for Health Statistics (NCHS). The percentage of children in families that struggle to pay healthcare bills has steadily declined, as well, although as of June 2016 it remained higher than the percentage of such adults.

The National Health Interview Survey (NHIS) administered by the NCHS defined “family” as “an individual or a group of 2 or more related persons living together in the same housing unit.” Therefore, the term could apply to a household of just 1 person, and included some cases of unrelated people sharing a household, such as an unmarried couple.

In 2011, 21.3% (56.5 million) of Americans under age 65 were in families that had had problems paying medical bills in the past 12 months, according to the survey. By June 2016, that number had dropped by 12.7 million to an amount of 43.8 million people, or 16.2%. The amount of people in families struggling to pay these bills decreased steadily every year, although the difference between the 44.2 million in 2015 and 43.8 million in June 2016 was not statistically significant.

Each year from 2011 to 2016, females were more likely than males to be in a family having trouble paying medical bills, though the percentages for each gender decreased each year. There was no statistically significant difference between genders by June 2016, when 16.7% of females and 15.7% of males were in struggling families.

Within each year, children aged 0 to 17 years were consistently more likely than adults to be in families that struggled to pay medical bills. The percentages of these children decreased from year to year, as well, but the decline from 2015 to the first 6 months of 2016 was not significant. By early 2016, 17.6% of children under age 18 were in families that had trouble paying medical bills, compared to 15.7% of adults.

The NHIS found that the percentage of people in families that struggled to pay medical bills varied by insurance type. In early 2016, 28.5% of uninsured people were in these families, compared with 21.1% of people with public insurance and 12.6% with private insurance. Within each insurance category, there was a significant linear decrease from 2011 to June 2016 in the proportion of people who were in families that had problems paying medical bills.

A similar decline over the 5 years was observed for people of all income levels, though the percentage of people in struggling families continued to vary by poverty status. Each year, people who were poor or near-poor were about twice as likely as not-poor people to be in families having problems paying medical bills. The group of near-poor people, defined as those with incomes of 100% to less than 200% of the poverty threshold, consistently had the highest rates of people in families struggling to afford medical bills compared to the other income categories. The percentage of near-poor people in such families dropped from 32.1% in 2011 to 24.9% in June 2016.

Finally, the survey also examined the effect of out-of-pocket expenses on a family’s ability to pay medical bills. In June 2016, 13.4% of respondents who had out-of-pocket medical expenses of $2000 or lower were in families that had that struggled or were unable to pay medical bills, and 25.1% of those expenses over $2000 were part of such families. These percentages had decreased from 17.9% and 32.7%, respectively, in 2011.