How Much Do Marketplace and Other Nongroup Enrollees Spend on Health Care Relative to Their Incomes?

Data show that some still face high financial burdens

New research examining household spending on health care shows that typical marketplace enrollees with incomes between 200 and 500 percent of the federal poverty level spend more than 10 percent of their income on insurance premiums and out-of-pocket costs. Those with high expenditures can spend more than 20 percent of their income on medical care. Those in “fair” or “poor” health, those over age 45, and those who earn less are more likely to spend a higher percentage of their income on insurance premiums and out-of-pockets. The researchers say policy-makers should explore ways to protect those most vulnerable to high costs relative to their income.     

The report, prepared by researchers at the Urban Institute with funding from the Robert Wood Johnson Foundation, follows an earlier Urban Institute analysis showing progress on affordability since the Affordable Care Act’s implementation—with the percentage of nonelderly adults having problems paying medical bills sharply declining.

“Although real progress has been made ensuring people can access the care they need, there is more work to be done in terms of affordability,” said Kathy Hempstead, who directs coverage issues at the Robert Wood Johnson Foundation. “For many, health care costs can still be a financial hardship that causes them to delay or forgo coverage, and ultimately, the care they need.”

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To speak with a researcher about the new survey data, please contact Bryan Fisher at 202-745-5102 or [email protected]

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