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CDC Finds Fewer in US Skip Healthcare Over Cost Since ACA


The peak year for avoiding medical care for costs reasons was 2009-2010, just after the recession hit and before the ACA took effect.

As the percentage of uninsured Americans drops, so is the share of those who are bypassing medical care because they can’t afford it, according to data just released by the CDC.

The most recent numbers from the National Health Interview Survey (NHIS), which have been gathered since 1997, show that the percentage of people who failed to obtain healthcare sometime in the previous year fell to 4.4% in the spring of 2015, the lowest level since 1999 when it was 4.3%.

While the survey does not attempt to give reasons for the drop, it does coincide with a large decrease in the ranks of the uninsured, which has been documented in numerous surveys including this one: the NHIS found that the percentage of uninsured was 9.2% in March 2015. That represented a significant drop from 11.5% in March of 2014, which was itself a decline from 2013 and the peak uninsured rate of 16% in 2010.

The peak year when respondents said they failed to seek healthcare for costs reasons was also 2009 to 2010, when it was 6.9%. That was the year after the onset of the recession that began in the fall of 2008. The year 2010 marked the passage of the Affordable Care Act, and while many of its provisions did not take effect until January 1, 2014, an early provision to allow young adults to stay on their parents’ health plans until age 26 did keep many of them from becoming uninsured. In the past, this age group had been among the most likely to lack health coverage.

Starting in late 2013, government exchanges began selling coverage to Americans who had previously lacked insurance for reasons of cost or due to pre-existing conditions. Millions of low- or moderate-income individuals or families either qualified for subsidies to buy coverage or for Medicaid expansion in states that elected this option under the law.

Critics of the ACA have said its costs are exceeding expectations and note that some state regulators have had to allow double-digit rate increases for 2016. But others have said this reflects this years of pent-up medical needs among the uninsured, and that over time, as health needs are addressed and more Americans received preventive care, the health care law will prove its value in both human and financial measures.

The survey asks respondents about 15 measures, including health insurance coverage and type of coverage, having a usual place to go for medical care, obtaining needed medical care, receipt of influenza vaccination, receipt of a pneumonia vaccination, obesity, leisure-time physical activity, current cigarette smoking, alcohol consumption, human immunodeficiency virus (HIV) testing, general health status, personal care needs, serious psychological distress, diagnosed diabetes, and asthma episodes and current asthma.


Clarke TC, Ward BW, Freeman G, Schiller JS. Early release of selected estimates based on data from the January— March 2015 National Health Interview Survey. National Center for Health Statistics. September 2015. Available from: http://www.cdc.gov/nchs/nhis.htm.

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