Health insurance plays a critical role in financial stability. Skipping preventative care or delaying procedures and treatments can have major financial and health implications. Your health also directly impacts your ability to work, ability to provide care to others, stress levels, and relationships.
Enrollment in Affordable Care Act (ACA) health insurance plans has grown rapidly in recent years, reaching over 21 million for the 2024 plan year. This has helped fuel an overall boost in the percentage of Americans with health insurance. According to recent data, 7.2% of Americans are uninsured – down from 16% in 2010. While the trend has been positive, there is still much work to be done. Medicaid redetermination has unfortunately caused many people to lose coverage, sometimes unknowingly. With inflation continuing to drive the cost of living upwards, many Americans must make difficult choices between healthcare and other priorities, like food and paying their bills.
In this deep dive into the data from our study on the financial wellness of American households, Financial Well-Being 2024, we take a look at the uninsured population. Among our sample of 5,000 adults, 479 lacked health insurance.
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Americans Without Health Insurance Lack Access to Necessary Care
Americans who do not have health insurance are more likely than those who are insured to skip care that they need – either by choice, or not. Barriers to care include:
- Cost: 70% say they skipped care last year due to the cost last year (compared to 44% of people with health insurance).
- Location: The uninsured are than two times as likely to say that they cannot access the medical care they need where they live, with 49% saying this compared to 22% of those with insurance.
- Lack of Transportation: This group is also least likely to have the means to drive themselves to a medical appointment. They are more likely than those with insurance to have to ask a family member or friend for a ride, use public transportation, walk, or bike.
- 6% of people without insurance would not be able to find transportation to a medical appointment on short notice – compared to only 1% of those with insurance.
Unfortunately, the need to pay for healthcare is inevitable for most Americans, whether they have insurance or not. Nearly three quarters of people without insurance (73%) say they had to pay an unexpected medical expense last year. This group is roughly two times as likely than those with insurance to have to borrow money from family and friends to cover the expense (25% vs. 13%). They are also more likely to work more hours and miss other bill payments than the insured.
If faced with an unexpected medical expense in the future, nearly one quarter (23%) of uninsured people would not be able to cover it. Of those who can pay an unexpected expense, 39% can only cover up to $500. With the average emergency room visit costing $2,200, this group is at significant risk of falling into medical debt – the leading cause of bankruptcy in the US.
Financial Challenges Are Magnified For Uninsured
People who do not have health insurance tend to face a myriad of financial challenges, which may prevent them from prioritizing paying for care or buying insurance in the future. The vast majority (86%) say they struggled to pay their bills last year, resorting to tactics including:
- 51% used a credit card (compared to 40% of those with insurance)
- 55% paid a bill late (compared to 36%)
- 41% skipped meals (compared to 22%)
- 33% sold possessions (compared to 22%)
- 34% overdrew their bank account (compared to 34%)
More than one in five (22%) say that they expect their finances to become less predictable over the next three years.
Uninsured Experience Stress, Loneliness, and Other Challenges
Things like stress levels, poor social support networks, and a poor diet can have significant health implications that are magnified for those who delay care due to a lack of insurance. These factors are often referred to as social determinants of health.
Uninsured Americans are nearly two times more likely to say they are very or extremely stressed daily (51% say this, compared to 28% of those with insurance). Additionally, they are much more likely to report that their social connections are fair to poor (50% vs. 34%). This group is also more likely to say they do not have easy access to healthy food (41% s. 23%).
The Path Forward
Going without health insurance can have serious implications for your financial future, as well as your health. Even if money is tight or your employer doesn’t offer insurance, you have options. If you are out of work or earn a low income, you and/or your children may be eligible for Medicaid. Check with your state’s Medicaid office about eligibility requirements.
If you are not eligible for Medicaid, you may be eligible for subsidies that help cover the cost of insurance under the ACA. In fact, 94% of Assurance IQ customers who enrolled in an ACA plan for 2024 were eligible for subsidies. A licensed health insurance agent can help you determine what is available to you and your family.
However, simply having insurance is not a magic bullet. A third of people with insurance tell us they feel they don’t have sufficient coverage. You need to have the right insurance that meets your unique healthcare needs. Make sure you consider any chronic conditions, prescriptions, and specialists that you need coverage for when shopping for a plan. Avoid selecting a plan based on the cost of monthly premiums alone – often, plans with low premiums come with higher out-of-pocket costs. A licensed agent can help you understand your needs and select a plan that’s right for you.
Having the proper insurance can serve as a safety net that keeps your family resilient when the unexpected happens, allowing you to build long-term financial stability.
Explore the Report
Read the full report: Dive deeper into the well-being challenges facing Americans. Download Financial Well-Being 2024: The Challenges & Sacrifices Facing American Households.
This survey was commissioned by Assurance IQ and conducted by Wakefield Research among 5,000 nationally representative US adults ages 18+, between December 7th and December 20th, 2023, using an email invitation and an online survey. Data has been weighted. Within the sample, 479 respondents self-identified as not having health insurance.
Results of any sample are subject to sampling variation. The magnitude of the variation is measurable and is affected by the number of interviews and the level of the percentages expressing the results. For the interviews conducted in this particular study, the chances are 95 in 100 that a survey result does not vary, plus or minus, by more than 1.4 percentage points from the result that would be obtained if interviews had been conducted with all persons in the universe represented by the sample.