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Low-income adults spending 5% or more on out-of-pocket expenses


A new Commonwealth Fund study finds that 21% of adults with health insurance spent 5% or more of their income on out-of pocket expenses and that 40% skipped medical treatment because of high deductibles.

A new Commonwealth Fund report finds that 21% of adults with health insurance spent 5% or more of their income on out-of pocket expenses, excluding premiums.

Another 13% spent 10% or more, and low-cost adults were the most likely to have high out-of-pocket costs.

In addition, 13% of people with private health insurance now have plans with a deductible that is equivalent to 5% or more of their income. 

The report, Too High a Price: Out-of-Pocket Health Care Costs in the United States, noted that rising deductibles and stagnant family income has led to underinsurance in some cases.

Results were based on a survey of 2,751 adults ages 19 to 64 about the costs of their health insurance.

Insured adults in fair or poor health or those who reported at least one chronic condition were more likely to spend a larger share of their income on medical expenses not covered by insurance.

Other findings:

  • 43% of respondents said their deductible was somewhat, very difficult, or impossible to afford;

  • 58% of adults with incomes under 100% of poverty and 64% of those with incomes between 100% and 199% of poverty reported it was difficult to afford their deductibles;

  • 40% of adults with deductibles of 5% or more of income reported that because of their deducible, they had not gone to the doctor when sick, did not get a preventive care test, skipped a recommended follow-up test, or did not get needed specialist care;

  • 46% of insured adults with incomes under 200% of the poverty level said that because of their copayments or coinsurance, they had either not filled a prescription, not gone to the doctor when they were sick, skipped a medical test or follow-up visit recommended by a doctor, or not seen a specialist when they or their doctor thought they needed one.
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