Older Americans worry they can’t afford their own health care | CNN (2024)

Older Americans worry they can’t afford their own health care | CNN (1)

The rising cost of health care services is a top concern for many Americans over 50.

KFF Health News

What weighs most heavily on older adults’ minds when it comes to health care?

The cost of services and therapies, and their ability to pay.

“It’s on our minds a whole lot because of our age and because everything keeps getting more expensive,” said Connie Colyer, 68, of Pleasureville, Kentucky. She’s a retired forklift operator who has lung disease and high blood pressure. Her husband, James, 70, drives a dump truck and has a potentially dangerous irregular heart rhythm.

Tens of millions of seniors are similarly anxious about being able to afford health care because of its expense and rising costs for housing, food and other essentials.

A new wave of research highlights the reach of these anxieties. When the University of Michigan’s National Poll on Healthy Aging asked people 50 and older about 26 health-related issues, their top three areas of concern had to do with costs: of medical care in general, of long-term care, and of prescription drugs. More than half of 3,300 people surveyed in February and March reported being “very concerned” about these issues.

In fact, five of the top 10 issues identified as very concerning were cost-related. Beyond the top three, people cited the cost of health insurance and Medicare (52%), and the cost of dental care (45%). Financial scams and fraud came in fourth place (53% very concerned). Of much less concern were issues that receive considerable attention, including social isolation, obesity and age discrimination.

In an election year, “our poll sends a very clear message that older adults are worried about the cost of health care and will be looking to candidates to discuss what they have done or plan to do to contain those costs,” said John Ayanian, director of the University of Michigan’s Institute for Healthcare Policy and Innovation.

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Health care costs are impacting wallets

Older adults have good reason to worry. One in 10 seniors (about 6 million people) have incomes below the federal poverty level. About one in four rely exclusively on Social Security payments, which average $1,913 a month per person.

Even though inflation has moderated since its 2022 peak, prices haven’t come down, putting a strain on seniors living on fixed incomes.

Meanwhile, traditional Medicare doesn’t cover several services that millions of older adults need, such as dental care, vision care or help at home from aides. While private Medicare Advantage plans offer some coverage for these services, benefits are frequently limited.

All of this contributes to a health care affordability squeeze for older adults. Recently published research from the Commonwealth Fund’s 2023 Health Care Affordability Survey found that nearly a third of people 65 or older reported difficulty paying for health care expenses, including premiums for Medicare, medications, and expenses associated with receiving medical services.

One in seven older adults reported spending a quarter or more of their average monthly budget on health care; 44% spent between 10% and 24%. Seventeen percent said they or a family member had forgone needed care in the past year for financial reasons.

The Colyers in Pleasureville are among them. Both need new dentures and eyeglasses, but they can’t afford to pay thousands of dollars out-of-pocket, Connie said.

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“As the cost of living rises for basic necessities, it’s more difficult for lower-income and middle-income Medicare beneficiaries to afford the health care they need,” said Gretchen Jacobson, vice president of the Medicare program at the Commonwealth Fund. Similarly, “when health care costs rise, it’s more difficult to afford basic necessities.”

This is especially worrisome because older adults are more prone to illness and disability than younger adults, resulting in a greater need for care and higher expenses. In 2022, seniors on Medicare spent $7,000 on medical services, compared with $4,900 for people without Medicare.

Not included in this figure is the cost of assisted living or long-term stays in nursing homes, which Medicare also doesn’t cover. According to Genworth’s latest survey, the median annual cost of a semiprivate room in a nursing home was $104,000 in 2023, while assisted living came to $64,200, and a week’s worth of services from home-health aides averaged $75,500.

Many older adults simply can’t afford to pay for these long-term care options or other major medical expenses out-of-pocket.

“Seventeen million older adults have incomes below 200% of the federal poverty level,” said Tricia Neuman, executive director of the Program on Medicare Policy for KFF. (That’s $30,120 for a single-person household in 2024; $40,880 for a two-person household.) “For people living on that income, the risk of a major expense is very scary.”

Planning for the future is challenging

How to deal with unanticipated expenses in the future is a question that haunts Connie Colyer. Her monthly premiums for Medicare Parts B and D, and a Medigap supplemental policy come to nearly $468, or 42% of her $1,121 monthly income from Social Security.

With a home mortgage of $523 a month, and more than $150 in monthly copayments for her inhalers and her husband’s heart medications, “we wouldn’t make it if my husband wasn’t still working,” she told me. (James’ monthly Social Security payment is $1,378. His premiums are similar to Connie’s and his income fluctuates based on the weather. In the first five months of this year, it approached $10,000, Connie told me.)

The couple makes too much to qualify for programs that help older adults afford Medicare out-of-pocket costs. As many as 6 million people are eligible but not enrolled in these Medicare Savings Programs. Those with very low incomes may also qualify for dual coverage by Medicaid and Medicare or other types of assistance with household costs, such as food stamps.

Older adults can check their eligibility for these and other programs by contacting their local Area Agency on Agency, State Health Insurance Assistance Program or benefits enrollment center. Enter your ZIP code at the Eldercare Locator and these and other organizations helping seniors locally will come up.

Camille Tokerud Photography Inc./Stone RF/Getty Images/FILE Related article When older parents resist help or advice, use these tips to cope

Persuading older adults to step forward and ask for help often isn’t easy. Angela Zeek, health and government benefits manager at Legal Aid of the Bluegrass in Kentucky, said many seniors in her area don’t want to be considered poor or unable to pay their bills, a blow to their pride. “What we try to say is, ‘You’ve worked hard all your life, you’ve paid your taxes. You’ve given back to this government so there’s nothing wrong with the government helping you out a bit.’”

And the unfortunate truth is there’s very little, if any, help available for seniors who aren’t poor but have modest financial resources. While the need for new dental, vision and long-term care benefits for older adults is widely acknowledged, “the question is always how to pay for it,” said Neuman of KFF.

This will become an even bigger issue in the coming years because of the burgeoning aging population.

There is some relief on the horizon, however: Assistance with Medicare drug costs is available through the 2022 Inflation Reduction Act, although many older adults don’t realize it yet. The act allows Medicare to negotiate the price of prescription drugs for the first time. This year, out-of-pocket costs for medications will be limited to a maximum $3,800 for most beneficiaries. Next year, a $2,000 cap on out-of-pocket drug costs will take effect.

“We’re already seeing people who’ve had very high drug costs in the past save thousands of dollars this year,” said Frederic Riccardi, president of the Medicare Rights Center. “And next year, it’s going to get even better.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.

Older Americans worry they can’t afford their own health care | CNN (2024)


What happens in America if you can't afford healthcare? ›

Not having health insurance can lead to large debt, affect your health if you delay care and may even hurt you at tax time, depending on your state.

What is the biggest healthcare problem in America? ›

A 2023 survey found that over half of U.S. individuals indicated the cost of accessing treatment was the biggest problem facing the national healthcare system. This is much higher than the global average of 31 percent and is in line with the high cost of health care in the U.S. compared to other high-income countries.

What factors make it difficult to provide health care coverage to everyone in the US? ›

uninsurance has been attributed to a number of factors, including rising health care costs, the economic downturn, an erosion of employer-based insurance, and public program cutbacks. Developing effective strategies for reducing uninsurance requires understanding why people lack insurance coverage.

Why can't people afford healthcare? ›

In many households, health care costs take up so much of monthly budgets that they affect the ability of people to pay for other living expenses. And the reverse can also be true: when the cost of other living expenses rises, it can affect families' ability to pay for their health care.

Could America afford free healthcare? ›

The Urban Institute estimated that a single-payer health system would cost an additional $32 trillion over the next decade, in addition to what the country already pays for Medicare and Medicaid. Most other organizations estimated roughly the same; with cost numbers ranging from $2.4-$2.8 trillion per year.

Why is healthcare in America so expensive? ›

There are many possible reasons for that increase in healthcare prices: The introduction of new, innovative healthcare technology can lead to better, more expensive procedures and products. The complexity of the U.S. healthcare system can lead to administrative waste in the insurance and provider payment systems.

What country has the best healthcare? ›

The Best Healthcare Systems in the World in 2024

What country has the best healthcare, according to this assessment? Singapore comes in at No. 1!

What was the #1 leading health problem in the US? ›

Heart disease and stroke still the leading causes of death for both U.S. men and women.

Why is US healthcare so inefficient? ›

The underperforming healthcare system lacks some of the factors that fuel innovation in other industries and countries: Consumers have not been cost sensitive because their employers and health plans often cover a large share of their costs, and because they lack the information required to assess quality and cost.

How can America make healthcare more affordable? ›

By reforming existing laws and enacting new policies – to minimize inefficiency, enhance the consumer experience, better leverage innovations, lower administrative costs and eliminate the need for reliance on harmful health care taxes, which only make health care more unaffordable – the following solutions will make ...

Why are Americans still uninsured? ›

Why are people uninsured? Despite policy efforts to improve the affordability of coverage, many uninsured people cite the high cost of insurance as the main reason they lack coverage. In 2022, 64% of uninsured nonelderly adults said that they were uninsured because the cost of coverage was too high.

How many Americans can't afford healthcare? ›

Difficulty Affording Medical Costs

When asked specifically about problems paying for health care in the past year, one in four adults say they or a family member in their household had problems paying for care, including three in ten adults under age 50 and those with lower household incomes (under $40,000).

Which concerns Americans about the US health care system? ›

Lack of insurance coverage, high costs, and poor outcomes are well-documented problems in the US health care system, and policies to address them have been hotly debated for decades.

How do poor people pay for healthcare? ›

In all states, Medicaid provides coverage for some low-income people, families and children, pregnant people, the elderly, and people with disabilities. Some states expanded their Medicaid program to cover all adults below a certain income level.

Why isn t healthcare free for everyone? ›

In the United States, everyone selfidentifies as middle class. This leads to a very simple syllogism about why the United States has no universal health insurance: there is no self-identified working class—no labor party, no national health insurance. It is hard to disconfirm that syllogism.

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Households' health insurance premiums would be eliminated, and their out-of-pocket (OOP) health care costs would decline. Administrative expenses in the health care sector would decline, freeing up productive resources for other sectors and ultimately increasing economywide productivity.

Is it illegal to not have healthcare in the US? ›

There currently is no federal law that makes health insurance a legal requirement. However, a few states across the U.S. make it mandatory to have healthcare coverage. If you live in a state where having health insurance is the law, you will have to pay a tax penalty for not complying.

Is there free healthcare for poor people in America? ›

In all states, Medicaid provides coverage for some low-income people, families and children, pregnant people, the elderly, and people with disabilities. Some states expanded their Medicaid program to cover all adults below a certain income level.

Do US citizens have to pay for healthcare? ›

There is no universal healthcare. The U.S. government does not provide health benefits to citizens or visitors. Any time you get medical care, someone has to pay for it.

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