Takeaways
- Health care costs are forcing millions of Americans to make painful sacrifices. A recent survey found that one-third of U.S. adults — estimated to be over 82 million people — have cut back on daily expenses to pay for health care.
- The trade-offs include essential needs. People are rationing prescription drugs, skipping meals, driving less, and cutting back on utilities just to afford medical bills.
- Lower and middle-income families are hit the hardest, but the problem affects everyone. Even a significant percentage of high-earning households report making sacrifices.
- The crisis is especially difficult for older adults. Seniors often need more medical care but rely on fixed incomes that haven’t kept pace with rising costs, forcing them to spend a significant portion of their retirement funds on health expenses.
- To get help, older adults may be able to take steps such as reviewing Medicare coverage every year, exploring supplemental plans like Medigap, applying for the Extra Help program for prescriptions, and utilizing free community resources.
Imagine having to choose between eating dinner and filling a prescription. For tens of millions of Americans, that is no longer a hypothetical — it is a daily reality.
A survey recently released by the West Health-Gallup Center on Healthcare in America painted a stark picture of how deeply health care costs have burrowed into everyday life. Roughly one-third of respondents said that they have had to cut back on at least one daily expense to cover their health care bills, based on a survey of nearly 20,000 adults. Researchers estimate that this represents more than 82 million Americans.
The trade-offs people are making are deeply personal and often painful. The research revealed a list of sacrifices people make to afford health care, including:
- rationing prescriptions (about 15 percent of those surveyed)
- skipping a meal (11 percent)
- driving less (11 percent)
- cutting back on utilities (9 percent)
- borrowing money (15 percent)
Lower-income households are hit hardest. More than half of those earning less than $24,000 a year report cutting back on daily expenses to afford care.
But the financial squeeze isn’t limited to the poor; even those who live far above the poverty line are making sacrifices. A quarter of adults in the United States earning between $90,000 and $120,000 a year report cutting back on at least one daily expense to cover their health care costs. Even 11 percent of households earning $240,000 or more annually say the same.
A Crisis Bigger Than the Bills
The burden of health care costs extends well beyond monthly premiums. About half of middle-income households said they have delayed a major life event, such as buying a home or having children, because of health care spending.
Experts warn that skipping medical care doesn’t just hurt wallets; it can also take a toll on overall health. When people delay or skip care, existing medical issues and chronic health conditions can worsen, leading to higher costs and greater strain over time.
“When you look at these types of trade-offs, it increases people’s overall levels of anxieties or depression,” said Tim Lash, president of West Health.
Policy changes may add to the pressure. The Affordable Care Act’s enhanced premium tax credits expired at the beginning of the year, which could lead to higher premiums for some Americans. According to KFF, an independent health information organization, premium payments could more than double for certain enrollees without those enhanced tax subsidies.
Older Adults Feel It Most
Though the crisis of rising health care costs touches Americans of all ages, older adults face a particularly difficult set of challenges. They tend to need more medical care, yet many live on fixed incomes that haven’t kept pace with rising costs.
Recent research shows that health care costs can be a major financial burden for older adults. One estimate finds that a 65-year-old retiring in 2025 could spend an average of more than $172,000 on health expenditures during retirement – and that figure continues to rise over time.
About 10 percent of seniors live below the federal poverty level. More than one in four rely exclusively on Social Security payments, which average $2,071 a month per person. Meanwhile, traditional Medicare doesn’t cover several common needs, such as dental care, vision care, or in-home support.
In addition to Medicare not covering certain health care services, Medicare costs are climbing. Medicare Part B’s monthly premium has increased to $202.90, exceeding $200 for the first time, and the annual Part B deductible is now $283. The Part A deductible for inpatient hospital stays has increased to $1,736. For those living on fixed incomes, these increases can consume a sizable portion of any cost-of-living adjustment they receive.
What Older Adults Can Do
The problem is systemic, but there are practical steps older adults can take to protect their health and their finances:
- Review Medicare coverage options every year. For some, switching to a Medicare Advantage plan may make sense, but it’s important to compare premiums, coverage, networks, and out-of-pocket limits carefully. Open enrollment each fall is the key window for making changes.
- Explore supplemental coverage. A Medigap (Medicare Supplement) policy may cover costs that traditional Medicare does not, such as copayments, coinsurance, and deductibles, reducing the risk of a devastating surprise bill.
- Look into the Extra Help program for prescription drugs. The Extra Help program, which is part of Medicare and subsidized by the federal government, helps older adults with limited income and assets cover the cost of prescription drugs. For eligible individuals, it may include $0 premiums and limited out-of-pocket costs at the pharmacy under Medicare Part D.
- Use community and local resources. Older adults can check their eligibility for various assistance programs by contacting their local Area Agency on Aging, State Health Insurance Assistance Program, or benefits enrollment center. Entering a ZIP code at Eldercare Locator will also provide a list of local organizations offering help.
- Ask about generic drugs and patient assistance programs. Most major pharmaceutical companies offer patient assistance programs for those who can’t afford their medications. Also, asking a doctor or pharmacist about generic alternatives can help patients find more affordable alternatives.
- Use free budgeting tools. The National Council on Aging (NCOA) offers a free online resource, BenefitsCheckUp, that connects millions of older adults with benefits programs that can help pay for health care, food, and housing costs.
- Don’t delay preventive care. It may seem counterintuitive when money is tight, but skipping preventive screenings and check-ups often leads to more expensive treatments down the road. Many preventive services are covered at no cost under Medicare.
The Bigger Picture
Health care costs topped a list of Americans’ economic anxieties in a KFF poll, ranking above concerns about the prices of food and groceries, gas, and utilities. That finding underscores how central, and how painful, this issue has become for millions of families.
The solution will ultimately require action at the policy level, which may come in the form of stable insurance subsidies, expanded Medicaid, greater transparency in medical billing, and more robust protections for those on fixed incomes. But while those debates play out in Washington, millions of Americans, including older adults, are making difficult choices every day.
Additional Reading
For additional reading on topics related to health care for seniors, check out the following articles:
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