Relief measures aimed at stemming the financial burden of the COVID-19 pandemic may have been a key buffer for families facing medical bills, a new study indicates.
The share of people living in U.S. families that had problems over the previous 12 months paying their medical bills decreased from 14% in 2019 to 12.5% in 2020 and 10.8% in 2021, according to a new National Health Statistics report published Wednesday by the Centers for Disease Control and Prevention. The decline corresponds to 10.5 million fewer people in 2021 who were in families having problems paying medical bills than in 2019, when 45.5 million individuals faced such an issue.
A previous CDC analysis found that the percentage of people in families who had problems paying medical bills in the past 12 months fell from 19.7% in 2011 to 14.2% in 2018, and researchers in the new report said their findings may mark a continuation of “decreasing trends.” While urging caution when comparing figures from 2019 to those before and after due to methodological changes that year – the impacts of which had not yet been fully evaluated – they also nodded to a number of potential contributors to the recent slide.
The study acknowledges that “the impact of the COVID-19 pandemic on problems paying medical bills cannot be discounted.” Declines in people accessing health care services during the early months of the pandemic may have led to less opportunity for medical debt, while pandemic relief measures “may have helped indirectly to mitigate the impact of the pandemic on people having problems paying medical bills.”
Specific legislation included 2020’s $2.2 trillion Coronavirus Aid, Relief, and Economic Security Act; the $2.3 trillion Consolidated Appropriations Act funding package approved in late 2020 that included $900 billion in COVID-19 stimulus relief; and the $1.9 trillion American Rescue Plan Act of 2021.
“This legislation provided direct monetary payments, flexibility with payments to creditors, additional unemployment assistance, subsidized payroll for affected small businesses, and improvements in paid sick leave,” the study says.
Additionally, the report notes that provisions within the American Rescue Plan increased eligibility for premium subsidies for health plans sold through the Affordable Care Act’s health marketplaces and made changes to Medicaid aimed at boosting coverage and benefits. The legislation also offered premium assistance for COBRA coverage, through which individuals can maintain health insurance they were receiving from their employer even after their employment ends.
Despite the overall declines, the analysis shows that some populations were more likely to experience problems paying medical bills. Nearly 12% of women were in families having problems with paying medical bills in 2021, compared with nearly 10% of men.
At 15.8%, Black people were more likely to be in families with problems paying medical bills than Hispanic people (12.8%), whites (9.4%) and Asians (6.1%). And similar to the share for Black people, 15.1% of people of other and multiple races were in families who had problems paying medical bills over the previous 12 months.
Among children in 2021, the report found those 17 years old and younger who had Medicaid and Children’s Health Insurance Program coverage were as likely as those without health insurance to be in families recently facing problems paying medical bills. Both groups were more likely to be in families facing problems than kids who were covered through private insurance.
The analysis also found that 13.1% of individuals between 18 and 64 years of age who had health care coverage through Medicaid and CHIP were in families having problems paying medical bills in 2021, compared with 9% of those with private health insurance. More than 20% of the uninsured were in families facing such issues.
Among states in 2021, 9.3% of people living in places where Medicaid eligibility had been expanded were in families having problems with paying medical bills in the past 12 months, compared with 13.8% of individuals living in nonexpansion states.
Notably, the new report comes as separate Gallup polling data from 2022 found that 38% of Americans said they or a family member had postponed medical treatment within the past 12 months due to cost – the highest share on record and a 12-point increase from 2021.
“People who are in families with problems paying medical bills not only face financial consequences but also may forgo medical care and prescription drugs,” researchers wrote in the CDC report. “Despite the decreasing trend in the percentage of people with problems paying medical bills, the burden associated with unpaid medical bills remains a public health concern.”