Problems Paying Medical Bills Among Persons Under Age 65: Early Release of Estimates From the National Health Interview Survey, 2011-June 2017

Questions for Robin Cohen, Ph.D., Health Statistician and Lead Author on “Problems Paying Medical Bills Among Persons Under Age 65: Early Release of Estimates From the National Health Interview Survey, 2011-June 2017

Q: What made you decide to focus on this special topic of Americans having problems paying medical bills?

RC: This report is the seventh in a series of reports looking at Americans having problems paying medical bills, and presents updated estimates using data from the first 6 months of 2017. Financial burden for medical care may put the entire family’s ability to pay medical bills — and its overall financial well-being — at risk. This report serves to continue to monitor the financial burden of health care in the United States.


Q: What do you think is the most significant finding in this study?

RC: Most noteworthy in this new report is the finding that since 2011, 13.2 million fewer persons under age 65 are in families having problems paying medical bills in the past 12 months.


Q: What kind of data do you have for persons who are specifically having problems paying for health insurance premiums and high deductibles in insurance plans?

RC: While this report does not specifically look at the details of persons’ health insurance plans, a report titled “High-deductible Health Plans and Financial Barriers to Medical Care: Early Release of Estimates From the National Health Interview Survey, 2016” was published in June 2017, and that report did take a look at some insurance plan details. The June report found that among privately insured adults aged 18-64 with employment-based coverage, those enrolled in a high-deductible health plan (HDHP) were more likely than those enrolled in a traditional plan, to forgo or delay medical care and to be in a family having problems paying medical bills. However, among privately insured adults aged 18-64 with directly purchased coverage, the pattern of results was different: there was no significant difference in financial barriers to health care according to the type of directly purchased plan.


Q: What are the trends among race and ethnicity groups who are having problems paying medical bills this year and compared over time?

RC: All race and ethnicity groups studied in this report saw decreases in the percentage of persons under age 65 who were in families having problems paying medical bills between 2011 and the first 6 months of 2017. Within each year from 2011 through 2017, non-Hispanic Asian persons were the least likely to be in families having problems paying medical bills.


Q: What type of demographics do you examine in this report, and what are those trends for those having problems paying medical bills this year and compared over time?

RC: This report provides trends for persons under age 65 who were in families having problems paying medical bills in the past 12 months from 2011 through the first 6 months of 2017 disaggregated by sex, age, race and ethnicity, health insurance coverage status, poverty status, and out-of-pocket medical expenses. Generally for all measures examined in the report, there has been a decrease in the percentage of persons in families having problems paying medical in the past 12 months between 2011 and the first six months of 2017. For example, among adults aged 18-64, the percentage who were in families having problems paying medical bills decreased from 20.6% in 2011 to 15.6% in the first 6 months of 2017.


Q: What is the take-home message of your report?

RC: I think the take-home message from this research is that among persons under age 65, one in six was in a family having problems paying medical bills in the first 6 months of 2017.

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