Out-of-Pocket Healthcare Costs Too High; Medical Debt Increasingly Rampant

August 6, 2022

Mountaineer News

Community Health

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WASHINGTON - Congress is considering a major legislative package that could affect not only investments in climate change but also the affordability of health care. Health-care advocates say it comes not a moment too soon.


One study found that from 1970 to 2020, the average American's health-care costs rose from $1,875 a year to more than $12,500.


Backers of a bill now in the U.S. Senate contended it will address rising health care costs and could provide Americans with some relief. Part of the Inflation Reduction Act would allow Medicare to negotiate directly on prescription drug prices in 2023, and cap out-of-pocket drug costs for Medicare patients at $2,000 a year. It comes a month after Gov. Ned Lamont expanded his state's Covered Connecticut program to adults without children. Jim Manley, board member of Consumers for Quality Care, noted rising out-of-pocket costs are a chief concern. "The issue comes down to caps on copays, rising deductibles and prescription drug copays," Manley explained. "Caps on copays are largely absent from the current health care bill that the Senate is going to take up this week. And so, that's been driving out-of-pocket costs higher and higher for more and more Americans." In the group's new survey, 45% of Americans said their out-of-pocket costs are far too high, and more than 70% feel health care costs are increasing "much more than other things they need." The Urban Institute said one in 10 people in Connecticut, and 13% of Americans overall, have past-due medical debt. Manley feels while the issue is important, it will not be a dominant factor in the November midterm elections. However, he believes a change is needed. In the survey, 60% of people said they skipped or delayed medical treatment because it is so expensive. "Health insurers have shifted costs onto patients through higher deductibles and out-of-pocket costs," Manley pointed out. "That's proven to be a real problem for the American consumer. It is leading them to either skip the care and/or go into medical debt. Medical debt is increasingly rampant throughout this country." For now, the Affordable Care Act outlines out-of-pocket caps, but Manley believes they should be updated. His group also is backing a cap on the price of insulin, which according to a 2020 study is much higher in the U.S. than in most countries.

References: Inflation Reduction Act Senate Democratic Caucus 07/27/2022 Covered Conn. expansion Office of the Governor 07/01/2022 Poll Consumers for Quality Care 2022 Debt data Urban Institute 03/21/2022 Insulin costs Rand Corp. 2020