Medical debt is leading millions of Americans, many of whom are insured, to borrow money. (© spyrakot - stock.adobe.com)
My mailbox fills up with material concerned with the business of health care as well as the science of health care. Last month included news of consumers sharing their greatest health care concerns. Not surprisingly, paying for health care was the top concern.
Consumers wanted to know what could happen to insurance premiums when Affordable Care Act subsidies expire. They are concerned about what Medicare Advantage retirees are likely to spend on their care and what happens when Americans can’t afford the services they need.
It was surprising, but also encouraging, that teens’ mental health is among Americans’ top concerns. Let’s examine the current state of the U.S. healthcare system, based on what’s worrying most Americans right now.
Affordable Care Act marketplace premiums
The subsidies now in place have reduced enrollees’ premiums by an average of 44%. A KFF analysis in July projected that Affordable Care Act marketplace health plan enrollees could see their annual premiums double if existing subsidies under the Inflation Reduction Act are not renewed. Wyoming, Alaska, and West Virginia members would experience the greatest cost increases. This year’s election results could determine whether enhanced subsidies get renewed after 2025.
An updated KFF analysis in early August showed that insurers are eyeing an average premium jump of 7% for next year, attributing increasing hospital care costs and increasing demand for expensive weight loss medications and other specialty drugs as substantial factors in the rising prices.
Medical costs for new retirees this year
A Milliman Retiree Health Cost Index report found that an average 65-year-old couple reaching retirement in 2024 will need about $395,000 in savings to pay for certain levels of Medicare coverage. A healthy 65-year-old woman will need about $147,000 to cover costs for the remainder of her life. A man with comparable coverage will require $128,000. The difference is due to women usually living longer. Costs are expected to continue rising. Higher prices of prescription drugs, especially those for weight loss, diabetes, heart failure, and autoimmune conditions, are substantial drivers of cost increases.
The research also found that Americans’ expected costs tended to fall far short of reality.
More Americans struggling to afford care
A West Health-Gallup Healthcare Affordability Index report indicated that the number of American adults struggling with medical bills is on the rise. The proportion of all adults who can easily afford care fell 6 percentage points to 55% over the last two years. There were even sharper drops among people in the 50-to-64 and 65-plus age ranges. Timothy Lash of West Health said that while U.S. healthcare affordability improved in 2022, costs are rising again. Many people are skipping medical treatment and not filling prescriptions due to cost.
Lawmakers are working to implement Inflation Reduction Act measures to slow healthcare cost increases. The results of recent Medicare drug price negotiations will go into effect in early 2026. High prices are one of the biggest hurdles to the population maintaining good health as its individuals age.
Teens and mental health care
Mental health care access for young people is increasing. Nearly a third of U.S. adolescents received therapy last year, a Substance Abuse and Mental Health Services Administration analysis found. The 31.9% figure represents an increase over 2022, when 29.8% received services. More adults accessed therapy over the period as well.
The trend continues. Schools are using $285 million of federal funding to recruit and train thousands of on-staff mental health professionals. Centers for Disease Control and Prevention (CDC) research released in August shows progress, with fewer teens, especially girls, reporting feelings of hopelessness and sadness.
Mentally healthier teens will become healthier adults, taking on the economy, health care, and culture. That’s reason for optimism for us all.
