Healthcare affordability improved between December 2019 and December 2022 as the results of policies put in place in the wake of the COVID-19 pandemic that protected and expanded access to subsidized health coverage, according to a June 12 report from the Urban Institute.
The report, funded by the Robert Wood Johnson Foundation, draws from the Urban Institute’s Well-Being and Basic Needs Survey, a nationally representative, internet-based survey of adults ages 18 to 64. The report draws from the surveys conducted between 2017 and 2022. Approximately 7,500 adults were surveyed each year.
Seven things to know:
1. Between December 2019 and December 2022, the share of adults reporting problems paying family medical bills in the past 12 months declined from 18.7 percent to 15 percent.
2. The share of adults who reported forgoing needed medical care because of costs in the past 12 months declined from 18.5 percent to 13.9 percent over that span.
3. Adults with family incomes between 100 percent and 200 percent of federal poverty level reported the largest reduction in problems paying family medical bills over that span (from 32.4 percent to 24.9 percent), the report said.
4. The Medicaid continuous coverage requirement during the COVID-19 pandemic eliminated the need for periodic renewals, allowing for millions of adults and children to remain enrolled even if they experience changes to their family income or other circumstances that would have made them previously ineligible. Eliminating the need for periodic renewals also prevented wrongful terminations for people who remain eligible but have trouble navigating the complex administrative processes.
5. The expansion of Marketplace premium tax credits likely contributed to rising Marketplace enrollment while reducing out-of-pocket premiums for current enrollees.
6. The Urban Institute estimated that 18 million people will lose Medicaid by 2024 because they are no longer eligible for the program or because administrative barriers will cause eligible people to lose coverage.
7. Other factors possibly bolstering healthcare affordability include federal relief programs such as expanded unemployment insurance benefits, COVID-19 economic impact payments, and the expanded child tax credit. The No Surprises Act also took effect in January 2022. Reductions in healthcare use because people delayed care or provider decisions to postpone services after the onset of the pandemic may also have been a factor, the report said.