Cost Still a Barrier Between Americans and Medical Care

WASHINGTON, D.C. -- One in three Americans say they have put off getting medical treatment that they or their family members need because of cost. Although this percentage is in line with the roughly 30% figures seen in recent years, it is among the highest readings in the 14-year history of Gallup asking the question.

Since 2001, Gallup has asked Americans each November if they have put off any sort of medical treatment for themselves or their families in the past 12 months. Last year, many hoped that the opening of the government healthcare exchanges and the resulting increase in the number of Americans with health insurance would enable more people to seek medical treatment. But, despite a drop in the uninsured rate, a slightly higher percentage of Americans than in previous years report having put off medical treatment, suggesting that the Affordable Care Act has not immediately affected this measure.

Among Americans with varying types of medical coverage (including no coverage), uninsured Americans are still the most likely to report having put off medical treatment because of cost. More than half of the uninsured (57%) have put off treatment, compared with 34% with private insurance and 22% with Medicare or Medicaid. However, the percentage of Americans with private health insurance who report putting off medical treatment because of cost has increased from 25% in 2013 to 34% in 2014.

Thirty-five percent of lower-income Americans -- those with annual household incomes under $30,000 -- report putting off medical treatment in the past 12 months, down from 43% in 2013. More upper-income Americans, on the other hand, report delaying treatment, with percentages rising from 17% in 2013 to 28% this year. The percentage of middle-income Americans who have put off medical treatment remains roughly the same as last year, at 38%.

Americans More Likely to Put Off Treatment for Serious Conditions

Those who indicate that they have put off medical treatment in the past 12 months are asked to rate the seriousness of the underlying condition or illness. This year, 22% of Americans say they have put off medical treatment for a "very" or "somewhat serious" condition. This is double the 11% who say they have put off treatment for a non-serious condition. Furthermore, the percentage who have put off treatment for a serious condition has increased slightly since 2013.

More Americans have put off treatments for serious conditions than for non-serious conditions every year except 2003, when similar percentages of Americans put off treatments for both types of conditions. The current 11-percentage-point gap between the two is one of the widest Gallup has found, second only to the 12-point gap found in 2010. On average, the gap has been less than 10 points.

Bottom Line

One of the goals of opening the government exchanges was to enable more Americans to get health insurance to help cover the costs of needed medical treatments. While many Americans have gained insurance, there has been no downturn in the percentage who say they have had to put off needed medical treatment because of cost. This may reflect high deductibles or copays that are part of the newly insured's plans, although separate research has shown that most of the newly insured in 2014 are satisfied with their health coverage.

Variation in the pricing for medical treatments, not to mention differences in how much insurance plans cover, could be confusing Americans or making them fear a needed treatment is too expensive. And while the costs of medical procedures aren't rising as rapidly as they once were, it is still too early to tell if that is an effect of the Affordable Care Act and how prices may change in the future.

Survey Methods

Results for this Gallup poll are based on telephone interviews conducted Nov. 6-9, 2014, with a random sample of 828 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia. For results based on the total sample of national adults, the margin of sampling error is ±4 percentage points at the 95% confidence level.

Each sample of national adults includes a minimum quota of 50% cellphone respondents and 50% landline respondents, with additional minimum quotas by time zone within region. Landline and cellular telephone numbers are selected using random-digit-dial methods.

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