Affordability of Health Care for People with

Medicaid

 

The Commonwealth Fund 2023 Health Care Affordability Survey! asked a
nationally representative sample of working-age U.S. adults (ages 19-64) about
their ability to afford health insurance and health care and about the impact that
health costs have on their household budget. This fact sheet presents results for the
837 respondents who were insured for the full year and had Medicaid coverage at
the time of the survey.

An estimated 76 million people under age 65 have Medicaid in 2023, a little less
than half of whom are children.? Medicaid enrollees' difficulties affording health
care stem from patient cost sharing, which can be high for those with very low
income, as well as from uncovered services like dental and vision, costs incurred
prior to becoming eligible for coverage, high spending by people with disabilities
or health problems, and the complexity of Medicaid benefits, which can make
them difficult to use. Among survey respondents with Medicaid:

4 50/ said it was very or somewhat difficult
'} to afford their health care.

said health care
costs had made
it harder to
afford food.

said they or a family member had
delayed or skipped needed health
care or prescription drugs in the past
12 months because they couldn't
afford the cost.

39%

60% of people who reported delaying or forgoing care because
of cost said a health problem got worse as a resulit.

0 were paying off debt from medical o

said their health
31% of people with medical debt said it had led them or a family costs had made
member to delay or avoid getting needed health care or it harder for
filling prescriptions. them to pay
for common
household
expenses like
spent 10 percent or more of .
0 . electric or
their monthly household budget heating bills
on health care. - '
0%
16% spent 25 percent or more. =

1. Sara R. Collins, Shreya Roy, and Relebohile Masitha, Paying for It: How Health Care Costs and Medical Debt Are
Making Americans Sicker and Poorer (Commonwealth Fund, Oct. 2023).

2. Caroline Hanson et al., "Health Insurance for People Younger Than Age 65: Expiration of Temporary Policies
Projected to Reshuffle Coverage, 2023-33," Health Affairs 42, no. 6 (June 2023): 742-52.

Policy Options for Making
Health Care More Affordable

States and the federal
government could:

Eliminate or limit cost sharing
for high-value services.

Ensure full Medicaid coverage
through three-month
retroactive eligibility to reduce
uncovered medical costs.

Expand the scope of Medicaid
coverage by adding dental,
vision, and other currently
optional services.

Broaden Medicaid managed
care networks to increase
access to providers and
prevent uncovered costs.

Increase the amount of
personal income protected for
people using long-term care
services and supports to pay
for their living expenses.

Shorten the medically needy
spend-down period to help
lower costs for people with
serious health problems.

Protect consumers from
financial ruin caused by
medical debt.

The
Commonwealth
Fund