Better Access to Health Insurance Coverage Boosted Healthcare Use

One in five Americans received regular healthcare during the COVID-19 pandemic due to increased access to health insurance coverage resulting from enhanced marketplace subsidies and Medicaid eligibility policies, according to a survey from HealthCare.com.

HealthCare.com’s 2022 Open Enrollment Period survey gathered responses from 1,005 adults on October 11, 2022.

Specifically, 22 percent of respondents reported receiving regular healthcare services during the pandemic, which they attributed to having better access to health insurance. Fewer Americans were uninsured this year, with the share of people without insurance dropping from 13 percent in 2020 to 8 percent in 2022.

In 2022, 8 percent of respondents received coverage through the Affordable Care Act (ACA) marketplace, compared to 5 percent in 2020. These coverage increases are likely due to the enhanced premium subsidies made available through the American Rescue Plan Act (ARPA).

Similarly, the share of people enrolled in Medicaid increased from 12 percent in 2020 to 19 percent in 2022. Congress required Medicaid to provide continuous coverage throughout the public health emergency and paused the program’s renewal and redetermination process, improving access to health insurance.

Additionally, the share of people who ranked health insurance as their largest expense declined from 39 percent in 2020 to 26 percent in 2022.

However, respondents still faced financial barriers when it came to healthcare. Half of the uninsured individuals said they couldn’t afford health insurance because it was too expensive.

In addition, 42 percent of respondents reported having medical debt. Among those with debt, 39 percent had debts over $1,000 and 6 percent had more than $10,000 of debt.

Millennials, Gen X, and Gen Z were more likely to report medical debt than the Silent Generation and Baby Boomers.

Surprise medical bills are one of the driving factors behind medical debt. According to the survey, 50 percent of respondents experienced surprise medical bills in the last year. A third of adults received surprise bills totaling between $500 and $2,000, while 10 percent received bills for $2,001 to $10,000. Seven percent of people received more than $10,000 in surprise medical bills.

Similar to medical debt, younger generations receive surprise bills more frequently than older generations.

More than one in four Americans reported having no savings to pay for emergency medical bills, while 15 percent said they have between $1 and $500 that could go toward medical bills. Around 30 percent said they did not know how they would pay for a severe illness that led to a significant amount in medical bills.

Americans have skipped out on recreational activities to afford healthcare, the survey found. Almost a quarter avoided travel or entertainment, and 18 percent stopped buying big-ticket items. Other respondents neglected necessities to afford healthcare, such as food (16 percent), home repair (14 percent), and rent (9 percent).

Despite better access to insurance leading to increased healthcare utilization for some, 53 percent of respondents forewent healthcare services in the last year. Respondents went without dental services (29 percent), vision care (21 percent), lab tests (17 percent), emergency care (15 percent), preventive services (12 percent), and elective healthcare procedures (10 percent).

Most people (32 percent) avoided healthcare because they did not feel sick enough to receive care. Around one in five said they couldn’t afford it, while 17 percent said they disliked going to the doctor. Almost 10 percent of Americans said they forewent healthcare due to a lack of health insurance.

While Gen Z and Millennials were the most likely groups to skip healthcare, they were also more likely to say they benefitted from the ARPA premium subsidies and Medicaid provisions during the pandemic. For example, 34 percent of Millennials and 24 percent of Gen Z reported receiving more regular healthcare due to improved health insurance access compared to 17 percent of Gen X and Baby Boomers.