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Chronic Illness a Prescription For Financial Distress

Insurance does not save Americans with chronic illness from harsh financial burdens.

Rising health care costs have hit particularly hard low-income, privately insured people who suffer from chronic illness, according to a report from the Center for Studying Health System Change (HSC) by Ha T. Tu.

Between 2001 and 2003, the proportion of low-income, chronically ill people with private insurance who spent more than 5 percent of their income on out-of-pocket health care costs grew from 28 percent to 42 percent. Low income was defined as family income below 200 percent of the federal poverty level, or $36,800 for a family of four in 2003.

A majority (68 percent) of the chronically ill working-age adults who reported high health care costs and access problems are covered by private insurance.

Overall, in 2003, more than 1 in 5, or 12.3 million, people with chronic conditions lived in families with problems paying medical bills. Chronic conditions, as defined by HSC, include depression and nine other conditions such as asthma, diabetes, and heart disease.

The financial burden is even more difficult for uninsured Americans with chronic illness. Forty-five percent of uninsured Americans with chronic conditions reported problems paying medical bills.

Not surprisingly, both insured and uninsured Americans with problems paying medical bills suffered from other financial consequences. Sixty-eight percent of families with problems paying medical bills because of chronic illness also reported problems paying for necessities such as food and shelter.

The HSC estimated that 57.3 million working-age Americans—33 percent of the working age population—have at least one chronic condition.

"Rising Health Costs, Medical Debt, and Chronic Conditions" is posted online at <www.hschange.org/CONTENT/706/>.

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