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The People Who Suffered Most During Pandemic Are Most Plagued by Medical Bills

Analysis  |  By Alexandra Wilson Pecci  
   July 16, 2021

People struggle with bills even as insurance coverage increases, showing "that health insurance in America is not protective enough," says a Commonwealth Fund researcher.

Medical bill problems are plaguing the people who have suffered the most during the COVID-19 pandemic, finds a new Commonwealth Fund survey.

The survey examined pandemic-related health insurance coverage losses, current uninsured rates, and medical bill struggles.

It found that Black and Latinx/Hispanic adults; people who lost their job-based health insurance coverage; or those who got sick with COVID-19 struggled the most financially and with their medical costs.  

For example, it found that 55% of Black and 44% of Latinx/Hispanic adults said they had medical bill problems and debt, compared 32% of white adults.

And although one-third of U.S. adults said their income fell during the pandemic, that number was higher for Black, Latinx/Hispanic, and low-income adults: 44% of Black adults, and 45% of Latinx/Hispanic adults reported a loss of income.

Also, although insurance coverage doesn't insulate people from medical bill struggles, those without coverage have a harder time.

The survey found that one-third of insured adults and half of uninsured adults said they had a medical bill problem or were paying off medical debt.

In addition, 34% of working-age adults with employer coverage reported medical bill or debt problems, as did nearly half 46% of adults with individual and marketplace coverage.

Even when the medical debt is resolved though, it leaves long-lasting problems. Thirty-five percent of respondents said they had used up most or all their savings to pay their bills, 43% received a lower credit rating because of their medical debt, and 27% were unable to pay for necessities such as food, heat, or rent.

The survey findings also suggest that more people have gained insurance than lost it since the pandemic began. In fact, CMS reported this week that more than 2 million people have signed up for health coverage during the Biden-Harris Administration's 2021 Special Enrollment Period, which opened on February 15 in response to the COVID-19 pandemic.

However, the improved insurance coverage during the pandemic coupled with people's ongoing struggles "shows that health insurance in America is not protective enough," Sara R. Collins, Ph.D., lead author of the study and Commonwealth Fund Vice President for Health Care Coverage, Access, and Tracking, said in a statement.

"The persistent coverage inadequacy and vulnerability among U.S. working-age adults is compromising their ability to get the care they need and leaving many with medical debt at a moment when they should be recovering after months of financial insecurity," she said.

Alexandra Wilson Pecci is an editor for HealthLeaders.

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