Many skip doctor visits and prescriptions, new data shows Image By HPN Staff Key Points 36% of adults reported skipping or delaying care due to high costs, with women and the uninsured disproportionately affected. 21% of adults didn’t fill prescriptions because of cost, and some reported splitting pills or skipping doses to save money. Despite past reforms like the Affordable Care Act, affordability remains a flashpoint in Congress, with Democrats pushing to reinstate subsidies and Republicans focusing on PBM reform. More than a third of Americans are skipping or postponing doctor visits and other needed health care due to high cost, according to recent polling from the Kaiser Family Foundation (KFF). In a related trend, more than 20% of patients have not filled a drug prescription because they couldn’t afford it. The KFF findings follow more than a decade of federal moves to bring down the cost of health care and health coverage — in particular, the Affordable Care Act, which was signed into law in 2010 by former President Barack Obama, with most of its provisions taking effect in 2014. The continued struggles of American families to afford healthcare services and prescription drugs may build the political case for further legislation as a potential remedy before the 2026 midterm election. Why it matters Health care policy was a major flashpoint in the debate over the recently passed budget reconciliation bill. To reduce spending and prevent an increase in existing tax rates, Congressional Republicans reduced the rate of growth in federal health spending and allowed tax subsidies for private healthcare insurance to expire. In the wake of the passage of the budget reconciliation bill, Congressional Democrats are pushing to revisit the expiration of those health insurance tax subsidies, among other healthcare spending items. Meanwhile, Republicans are laying the groundwork for additional legislation later this year to tackle healthcare costs. There are “opportunities to do several bipartisan items in health care,” House Ways and Means Committee Chairman Jason Smith (R-MO) recently told POLITICO. In July, Smith introduced bipartisan legislation to reform the role of pharmaceutical benefit managers (PBMs). According to the Federal Trade Commission, the three biggest PBMs “are charging enormous markups on dozens of lifesaving drugs” and there is an “urgent need” for policymakers to intervene. The bigger picture Across the public and private sectors, the U.S. spends roughly twice as much per person on healthcare as other wealthy countries, according to the Peter G. Peterson Foundation. “However, despite higher healthcare spending, America’s health outcomes are not any better than those in other developed countries,” the Peterson Foundation says. “The United States actually performs worse in some common health metrics like life expectancy, infant mortality, unmanaged diabetes and safety during childbirth.” The American Medical Association (AMA) reports that U.S. healthcare spending per capita jumped by 7.5% in 2023 to more than $14,500 per capita. Excluding the COVID-19 pandemic, this was the largest annual jump in healthcare spending per capita since 2003, the AMA says. More detail According to KFF’s polling, 36% of adults reported skipping or delaying health care during the past 12 months because it was too expensive. There was a gender gap in the findings, with 38% of women skipping care, compared to 32% of men. Roughly three-quarters of uninsured adults reported skipping care. But having insurance was not a guarantee of affordability — 37% of insured adults reported skipping care due to high costs, according to KFF. Meanwhile, 21% of surveyed adults reported that they had left prescriptions unfilled due to high costs. Even those who filled their prescriptions reported cost pressures, with 15% of those surveyed saying they had cut pills in half or skipped doses altogether to limit their outlays on prescription medicine.
