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Vital Signs Blog

Medical debt woes decline for families eligible for insurance subsidies

Families who qualified for the most financial aid also reported the biggest drop in trouble paying medical bills during the first six months of subsidized health insurance under the Affordable Care Act.

According to the results of the a survey by the Centers for Disease Control and Prevention, 28% of Americans younger than age 65 in near-poor families (those with incomes between 100% and 200% of federal poverty thresholds) reported their family struggled to pay medical bills during the prior year. That's down from 32.9% of those surveyed throughout 2013.

Under the Affordable Care Act, people with incomes between 100% and 400% of the poverty level were eligible beginning in January 2014 to receive subsidies to buy health plans. The lowest-income households received the most financial aid and additional help to lower the cost of deductibles and copayments. A legal challenge before the U.S. Supreme Court could jeopardize those subsidies in as many as 37 states.

The CDC survey found smaller shifts among poor families—with income below 100% of the poverty level—and those considered “not poor”—with income above 200% of the poverty level.

But not all low-income families have benefited from the broader Medicaid eligibility funded by the healthcare law. Twenty-two states, including Texas and Florida, have declined to expand their programs.

Nationally, 47.7 million respondents said their families struggled to pay medical bills, or 17.8%, compared with 51.8 million, or 19.4% in 2013.

Those with out-of-pocket expenses of $2,000 or more were more likely to report family trouble with medical bills, though the percentage in the first half of 2014 (27.4%) declined from 30.3% the prior year.

Women were more likely than men to report their family struggled with medical bills in the survey last year and in the previous three years.

Among the uninsured, 31.2% of those surveyed during the first half of last year reported difficulty with medical bills. The figure was 24.2% among the publicly insured and 12.4% among the privately insured. That's compared with 33.2%, 24.8% and 13.7% among the uninsured, publicly insured and those with private plans, respectively, in 2013.

Among Hispanics, 20.5% reported during the first six months of 2014 that their family had trouble with medical bills, compared with 22.6% in 2013. The percentage dropped to 16.3% from 17.8% among whites and to 23.8% from 26% among black families. Asians reported 8% of families had difficulty with medical bills in the first half of 2014 compared with 8.8% the year before.

Follow Melanie Evans on Twitter: @MHmevans






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