Avoided Care Due to Cost - Women in South Carolina

South Carolina

Many Americans experience challenges accessing and affording health care. The high cost of U.S. health care is one of the major factors in avoiding needed care. Approximately half of American women reported in 2022 that they have delayed necessary medical care, testing or treatment due to cost, a rate 1.5 times higher than men. In addition, about 57% of women could not pay an unexpected $500 medical bill in full without going into debt and 23% could not pay it at all. 

Other barriers include inadequate or nonexistent insurance coverage, transportation issues, negative interactions with providers and care teams, delayed access and issues with childcare or work schedules. Widespread lack of access to affordable, timely and high-quality primary care is associated with increased preventable hospitalizations, excess strain on emergency services and missed opportunities to prevent disease and manage chronic conditions, all of which can lead to worse and more expensive health outcomes. Meanwhile, the cost of U.S. health care is projected to continue increasing. Currently, the average American spends almost $13,000 a year on health care.

According to America’s Health Rankings data, the prevalence of avoiding care due to cost is higher among:

• Women ages 25-34 compared with those ages 35-44.
• Hispanic women compared with Asian women. 
• Women with less than a high school education compared with those with higher levels of education; college graduates have the lowest prevalence of avoiding care due to cost. 
• Women with an annual household income less than $25,000 compared with those with an income of $75,000 or higher.

Adults who are uninsured or underinsured are more likely to delay or entirely avoid care due to cost compared with adults who are adequately insured. A survey found that almost half of uninsured women received no or delayed care due to cost. Another study revealed that women with high-deductible health insurance plans are more likely to have delayed breast cancer screening.

Multidisciplinary interventions that increase the affordability of health care by reducing out-of-pocket costs and preventing disease may reduce the proportion of adults who avoid care due to cost. Patient-centered care has also reduced the cost of care by empowering and educating patients to choose cost-effective diagnostic tools and treatment options.

Policy-level interventions that may make health care more affordable include expanding Medicaid and other coverage options for those who do not qualify for Medicaid (e.g., immigrants and individuals that do not meet income requirements) and establishing affordability criteria for health insurance plans.

Healthy People 2030 has a goal to reduce the proportion of people who delay or forgo needed medical care. 

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Lowry, Elise, Annaliese Johnson, Amanda Hunt, and Tad Lee. “States Hold Keys To Health Care Affordability, But Are They Using Them?” Health Affairs Forefront, February 8, 2022. https://doi.org/10.1377/forefront.20220204.765285.

Ranji, Usha, Caroline Rosenzweig, and Alina Salganicoff. “Women’s Coverage, Access, and Affordability: Key Findings from the 2017 Kaiser Women’s Health Survey.” Issue Brief. Kaiser Family Foundation, March 2018. https://www.kff.org/womens-health-policy/issue-brief/womens-coverage-access-and-affordability-key-findings-from-the-2017-kaiser-womens-health-survey/.

Wharam, J. Frank, Fang Zhang, Jamie Wallace, Christine Lu, Craig Earle, Stephen B. Soumerai, Larissa Nekhlyudov, and Dennis Ross-Degnan. “Vulnerable And Less Vulnerable Women In High-Deductible Health Plans Experienced Delayed Breast Cancer Care.” Health Affairs 38, no. 3 (March 1, 2019): 408–15. https://doi.org/10.1377/hlthaff.2018.05026.

Yong, Pierre L., Robert S. Saunders, and LeighAnne Olsen, eds. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Institute of Medicine Roundtable on Evidence-Based Medicine. Washington, D.C.: National Academies Press, 2010. https://doi.org/10.17226/12750.