HEALTH CARE COSTS: A PRimER - The Henry J. Kaiser Family ...

Families also are paying more out-of-pocket for health care. Another way of
gauging the burden of rising health costs on households is to look at family medical
out-of-pocket payments. These payments include the medical expenses of the
uninsured and, for the insured, cost sharing (deductibles, coinsurance, and
copayments) for covered services and amounts not paid for by insurance, such as outof-network
balance billing expenses and payments for non-covered services. While
out-of-pocket spending as a share of total national health spending has declined over
time (Figure 9), the actual dollar amounts that families spend for medical services
continue to rise (the reason that the out-of-pocket share of total spending continues to
fall is that the amounts paid by private insurance and government programs have risen
faster than the amounts paid out-of-pocket by families). In 2009, the average
expenses paid out-of-pocket for medical services were $795, an increase of 73% over
the $459 spent in 1996 (Figure 18). Average out-of-pocket expenses were higher for
the elderly ($1,294 in 2009) and those who reported being in poor health ($1,663 in
2009). The nonelderly uninsured paid, on average, $862 out-of-pocket in 2009,
compared to $706 for those with private insurance. Those whose poverty status was
negative or poor (below the Federal poverty line, which was $22,050 in 2009 for a
family of 4) paid $638 of their medical expenses out-of-pocket in 2009; for the near
poor (over the poverty line through 125% of the poverty line), it was $840.
Figure 18: Average Out-of-Pocket Health Services
Expenses and Percent Increases, 1996 and 2009
Nonelderly
Uninsured
Nonelderly with
Private Insurance
Below the Federal
Poverty Line
Poverty Line Through
125% of Poverty
Age 65 and Older
Perceived Poor
Health Status
Total
Note: Percents are the percent increase from 1996 to 2009. Dollar amounts and percentages do not include health insurance premiums.
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, Table 1.1, Total Health Services Median and Mean Expenses
per Person with Expense and Mean Expenses by Source of Payment, 1996 and 2009,
http://meps.ahrq.gov/mepsweb/data_stats/quick_tables_results.jsp?component=1&subcomponent=0&tableSeries=1&year=-
1&SearchMethod=1&Action=Search.
66%
A recent survey found that more than one in five Americans (21%) were in families
reporting problems paying medical bills in 2010, an increase over the 15% in 2003. 18
The 2010 proportion (21%) was similar to the 19% in 2007, which the authors indicate
may be attributable to a decreased use of medical care by people who lost jobs and
health insurance during the 2007-2009 recession and those who reduced their medical
80%
HEALTH CARE COSTS: KEY INFORMATION ON HEALTH CARE COSTS AND THEIR IMPACT
102%
85%
73%
46%
61%
21