Nearly 46m Americans would be unable to afford quality healthcare in an emergency

2 min
March 31, 2021

By Jessica Glenza

March 31, 2021

An estimated 46 million Americans said they would be unable to afford quality healthcare if they needed it today, a new West Health-Gallup survey has found. The survey also found wide racial and economic disparities in who believes they can afford healthcare.

Nearly twice as many Black Americans as white Americans said they would not be able to pay for healthcare, at 29% versus 16% respectively. More than one in three low-income Americans, or 35%, said they were unable to pay for needed healthcare in the last 12 months during the Covid-19 pandemic.

One in eight Americans (12%) said they reduced food spending to pay for healthcare. Among people who earn less than $24,000 each year, one-quarter cut back on food to afford healthcare. Also among low-income households, 21% had to reduce spending on utilities to afford care.

“Unfortunately, it’s not surprising that millions of Americans can’t afford healthcare,” said Dr Vikas Saini, president of the Lown Institute, a thinktank whose advocacy work has examined how high prices on insulin have led to rationing and even death among diabetics. “It is, however, shocking and kind of outrageous, but not surprising.”

“Our system has been structured for many years on the basis of private health plans and very deep dysfunction politically and within the medical industry,” said Saini.

The US spends more on healthcare than any nation in the world, and more than twice as much as the average high-income country. At the same time, it has the lowest life expectancy and highest suicide rates among 11 developed nations in the Organization for Economic Cooperation and Development (OECD).

“The US has an uninsured problem and an underinsured problem,” said Sara Collins, vice-president for healthcare coverage and access at the Commonwealth Fund. “This just leaves people, even if they have health insurance, really exposed to costs.”

“If you have an unexpected trip to the emergency room, it’s very likely you’re not going to be able to cover an unexpected $1,000 bill,” she said. “We have … healthcare prices that are a lot higher than they are in other countries.”

Surveyors said the results show, even as the $1.9tn Covid-19 stimulus bill is expected to provide relief to many, Americans will face a growing unaffordability crisis. Further, many of the provisions in the relief bill are temporary, such as increased provisions to help Americans who lost their jobs afford private health insurance.