Health care affordability improved under pandemic policies

The share of adults reporting difficulty paying medical bills decreased from 18.7% to 15% from 2019 to 2022, according to a new analysis from the Urban Institute, with funding from the Robert Wood Johnson Foundation. Racial disparities in healthcare affordability also narrowed over the same time period.

The report shows improvements in affordability after several policies were implemented in response to the COVID-19 pandemic that protected and expanded access to subsidized health coverage. This includes a requirement that Medicaid protect enrollees from losing their coverage and expansion of tax credits to pay for health insurance premiums for plans sold on the Affordable Care Act Marketplace.

The share of Black and Hispanic adults reporting difficulty paying medical bills and forgoing needed medical care due to its cost fell sharply, reaching rates closer to those of White adults by 2022 (see image below):

As a result of healthcare becoming more affordable, the analysis found that the share of adults who reported forgoing needed medical care due to cost in the past year declined by more than 4.5 percentage points (18.5% to 13.9%).

“Although the Public Health Emergency has ended, the need for high-quality healthcare that’s accessible to everyone will never expire,” said Gina R. Hijjawi, senior program officer at the Robert Wood Johnson Foundation. “Policymakers must identify pathways to coverage for the millions of people with modest incomes, in order to reduce the consequences of losing the protection that Medicaid provided.”

“The strong federal response to the COVID-19 pandemic may have contributed to the healthcare affordability gains observed during the last three years,” said Michael Karpman, Urban Institute principal research associate. “But the recent expiration of the Medicaid continuous coverage requirement could halt or reverse progress in healthcare affordability if people losing Medicaid are not able to find an alternative source of coverage.”

Read the full analysis “Healthcare Affordability Improved between 2019 and 2022 under Pandemic Health Coverage Policies.”