Got health insurance? You may still have trouble paying your medical bills

Thursday, January 14th, 2016
Kaiser Family Foundation, January 5, 2016

A new Kaiser Family Foundation and New York Times survey found that one in five (20%) working-age Americans with health insurance report problems paying their medical bills over the last year. The situation is worse among people without insurance: half (53%) face problems paying medical bills.

Just to be clear, this survey is broader than just surprise medical bills. It’s about all forms of medical bills that are difficult to pay, but a significant share of people who had problems paying medical bills say that the issue was charges for providers they did not know were out of network. The survey found that among the insured with problem medical bills, about a third say they received care from an out-of-network provider that their insurance wouldn’t cover, and a majority (69%) were unaware that the provider was not in their plan’s network when they received the care.

As a result, people end up suffering a wide range of financial and personal consequences:

  • Using up most or all of their savings
  • Difficulty paying other bills
  • Spending less on food, clothing and basic household items
  • Working more hours or taking an extra job
  • Skipping or putting off other healthcare services

We’ve heard from people who’ve faced financial troubles after receiving a surprise medical bill. One example is Steve from Bellingham, Washington, who was in a bike accident and had to be taken by an ambulance to the hospital. Steve was seen by multiple surgeons that were all in-network except for one. Steve received a $14,000 bill from the out-of-network surgeon, which he had to fight for four years! Eventually it ended in court. Steve won.

Even though health insurance can bring peace of mind, having it doesn’t mean that you won’t encounter medical billing problems, including surprise bills. Thanks to loopholes in the law, just because you go to an in-network hospital doesn’t guarantee that the doctor, assistants, or lab work will be in your plan’s network, leaving you stuck paying for out-of-network care from providers who you rightly thought were covered.

We’re pushing for state reforms that will protect you from unfair surprise medical bills. Texas, New York, Connecticut, and California have already taken steps to address the problem, and we will be pressing other states to follow suit. We have real momentum, and the more people who speak out, the better chance we have to end these bills. If you’ve been surprised by a medical bill share your story and help us fight for the rights we all deserve.

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