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How many Americans are uninsured (& why it matters)

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6 mins

The ranks of those Americans without health insurance continue to grow.

Millions of Americans were able to hold onto their health insurance after they lost their jobs in 2020 due to the pandemic. Still, for many, their unemployment subsidies from the federal government have expired, and they’re now relying on state unemployment benefits and personal savings to pay for their health insurance. Unfortunately, it’s a bleak picture growing bleaker.

How many people are uninsured in the U.S.?

According to the United States Census Bureau, in 2019, eight percent of Americans (26.1 million people) didn’t have health insurance at any point during the entire year. And, the consensus is that due to the ranks of the unemployed swelling in 2020 because of the pandemic, that number could exceed 30 million people when the final numbers are calculated.

Even with the Affordable Care Act making coverage available to uninsured Americans, most of those without health insurance do so for financial reasons. According to a Kaiser Family Foundation study in 2017, 45% of the uninsured indicated they don’t have coverage because the price was too high for them.

The second most common reason for not having health insurance coverage was either a job loss or a change of employers, and as a result, they lost their employer-sponsored health insurance.

Other groups related that they weren’t insured because they lost their eligibility for Medicaid or lost coverage through their spouse, parent, or other status change.

[ Related read: Essential things to consider when changing jobs ]

What happens if you don't have health insurance?

As can be seen, the millions of Americans without health insurance coverage have a valid reason for doing so, with only 2% of those in the study indicating they didn’t need health insurance coverage. The 98% with a reason have at least two things in common: they’re at significant risk financially, and their health is in greater jeopardy by not having coverage.

Here are the main risks someone faces when going uninsured.

Steeper healthcare costs

Without health insurance, they’re sometimes charged more for care than a health insurance plan would have covered. Many doctors and hospitals offer pre-negotiated discounted rates to members of health insurance plans as a consideration for the volume of people they treat.

Difficulty paying off medical bills

With or without health insurance, medical costs continue to skyrocket. For example, a visit to an emergency room for a broken arm can easily exceed $5,000, an expense that most Americans don’t have ample savings to cover. In fact, people under age 35 have a median savings account balance of just $2,600.

State tax penalties

Though the individual responsibility penalty for not having health insurance coverage no longer exists on a federal level, some states have their own health insurance penalties. (Check if your state does here.)

Not seeking healthcare treatment

The Kaiser Family Foundation’s research also found that almost 25% of people without health insurance hesitate to seek needed healthcare due to the high cost of uninsured care. By hesitating to put their health first, the uninsured risk health issues worsening over time. Can their chronic cough mean a severe respiratory condition? Without health insurance, many people can’t find out the answer to that question.

Unable to afford the medication they need

Rising prescription drug prices in America have made many medicines unaffordable. Kaiser reports that about 20% of uninsured people will delay or not purchase drugs because of the cost. Again, this puts their overall health at greater risk than their insured counterparts.

What to do if you have no health insurance

Of the millions of Americans without health insurance, numerous live in constant fear of how they’ll pay for any medical treatment they or a loved one may need while they’re without coverage. Unfortunately, many may not have access to health insurance anytime soon, if ever.

So, what can they do when a trip to the doctor or hospital is unavoidable? These are some options available.

Shop around

Like any service provider, fees will vary from provider to provider. Healthcare is a competitive market, and finding a provider trying to grow their practice through discounted fees is possible. Some urgent care facilities charge less than doctors in their area do for office appointments. It’s advisable to shop around before services are needed.

Ask for a discount or pay in advance

Many doctors sympathize with the plight of the uninsured and will extend a discount to patients without coverage. For example, some obstetricians will discount their fees to patients that pay in advance and are paying in cash instead of waiting for payment after the delivery and post-op care. This option is often available for lab work, various medical tests, and elective surgeries.

Make installment payments

Hospitals are well-known for offering installment payments to the uninsured if it’s worked out upfront. Unfortunately, they’re also known for being quick to turn unpaid balances over to collection agencies that won’t negotiate and play hardball to collect the balance. Therefore, it’s imperative that the patient talk as soon as possible with the hospital’s billing department to make financial arrangements after they’ve received treatment.

Save on prescription drugs

Doctors are generally happy to provide free samples they’ve received from pharmaceutical companies to uninsured individuals. In addition, some retailers, like Walmart, have lists of prescriptions offered at discounted prices. Those lists should be obtained in advance of a doctor’s office visit and shown to the physician to see if one of the meds on the list would work for the patient.

Have a savings account for medical expenses

Everyone feels better with a bit of money set aside for an emergency. Those without health insurance can self-insure by putting aside a percentage of their income each month. Even $50 or $100 per month can add up quickly and pay for most office visit fees.

Get insurance

Even though someone doesn’t have a “traditional” health insurance plan with a lower deductible and 80/20 coverage, other options are available. For example, a high deductible health plan (HDHP) coupled with a health savings account (HSA) is an option many people have found reasonably affordable. Also, supplemental coverages are available, such as cancer insurance or critical care insurance, that are affordable and pay for major illnesses like cancer, heart attack, stroke, and more.

Get a free critical illness insurance quote online in seconds.

Final thoughts

Maintaining health insurance in the 21st century is an ongoing challenge for millions of people. While the solutions to this problem, and healthcare costs in general, are topics of much disagreement, it can be agreed upon that everyone should have access to quality healthcare, regardless of their insurance status.

Having grown up in upstate New York, Bob Phillips spent over 15 years in the financial services world and has been making freelance writing contributions to blogs and websites since 2007. He resides in North Texas with his wife and Doberman puppy.

The information and content provided herein is for educational purposes only, and should not be considered legal, tax, investment, or financial advice, recommendation, or endorsement. Breeze does not guarantee the accuracy, completeness, reliability or usefulness of any testimonials, opinions, advice, product or service offers, or other information provided here by third parties. Individuals are encouraged to seek advice from their own tax or legal counsel.

— Published September 2, 2021
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