Only Half of Employer and ACA-Insured People Can Afford Their Emergency Care

In the case of emergencies, only half of respondents with employer-provided plans (46.7 percent) and respondents with ACA plans (47.8 percent) were able to afford emergency medical bills, according to a study by health insurance marketplace, HealthMarkets. The company’s survey analyzed healthcare costs under varying medical circumstances for insured and uninsured families. The survey highlighted healthcare costs under three cost conditions – monthly out-of-pocket costs, emergency medical costs, and costs related to pre-existing conditions.

Almost 40 percent of respondents with employer-provided plans needed six months or more to pay off emergency costs, and 14.2 percent could not afford any costs associated with emergency care, the survey says. 30.4 percent of respondents with ACA plans required six or more months to pay off and 21.7 percent of plan-users said that they could not afford an emergency at all. For respondents with Medicare or Medicaid, 23 percent who had emergencies needed six months or more to pay off the related costs and 37.9 percent who had emergencies could not afford the costs at all.

Nearly 30 percent of uninsured individuals needed six or more months to pay off emergency medical fees and more than half (51.6 percent) could not afford the costs associated with emergency medical care. For out-of-pocket costs, 10.8 percent of uninsured respondents had monthly out-of-pocket expenses totaling more than $1,000, while 87.1 percent of Medicare or Medicaid users paid less than $251.

For chronic or pre-existing conditions, 76.4 percent of respondents with employer-provided plans said their condition(s) are covered, while 19.5 percent said some of their conditions are covered. For respondents with ACA plans, 69 percent of them reported their condition(s) are covered, while 25 percent said some of their conditions are covered. For Medicare or Medicaid receiving respondents, 86.7 percent reported their condition(s) are covered, while 9.4 percent said some of their conditions are covered. All three groups of insured individuals have less than 6 percent of respondents reporting that they do not have coverage for their chronic or pre-existing conditions, according to the study. 

The survey showed that uninsured respondents face tougher situations with chronic and pre-existing conditions. More than half (51.7 percent) cannot afford the costs associated with their conditions, and nearly 7 percent can only sometimes afford it.