Pandemic Funding Saved More Americans From Medical Debt

WEDNESDAY, Jan. 18, 2023 (HealthDay News) -- The number of Americans who had trouble paying their medical bills dropped precipitously between 2019 and 2021, and funds from the American Rescue Plan and other federal pandemic relief programs may have been a reason why, according to a study published online Jan. 18 in the National Health Statistics Reports, a publication from the U.S. Centers for Disease Control and Prevention.

Overall, 10.8 percent of Americans responding to a federal survey in 2021 said they had had problems covering medical bills that year, down from 14 percent in 2019, according to authors Robin Cohen, Ph.D., and Amy Cha, Ph.D., M.P.H., of the National Center for Health Statistics (NCHS). The latest stats follow "a significant trend downwards from 2011," following the 2010 passage of the Affordable Care Act, the authors noted, adding that in 2011, "nearly 20 percent of people were in families having problems paying medical bills."

Positive change during the past few years in medical bill coverage has been even more dramatic among adults too young to qualify for Medicare, the report showed. "Estimates from the Health Reform Monitoring Survey found that problems paying medical bills among adults aged 18 to 64 decreased from 23.6 percent in March 2019 to 16.8 percent in April 2021," according to the report.

The study was not designed to figure out why fewer people are overwhelmed by medical costs now. "However, the impact of the COVID-19 pandemic on problems paying medical bills cannot be discounted," Cohen and Cha wrote.

Specifically, three pieces of federal legislation enacted in 2021 -- the Coronavirus Aid, Relief, and Economic Security Act (CARES), the Consolidated Appropriations Act, and the American Rescue Plan Act -- "may have helped indirectly to mitigate the impact of the pandemic on people having problems paying medical bills," the report states. The legislation "provided direct monetary payments, flexibility with payments to creditors, additional unemployment assistance, subsidized payroll for affected small businesses, and improvements in paid sick leave."

The American Rescue Plan also expanded access to health insurance by expanding COBRA insurance premium coverage, while at the same time expanding access to Medicaid. According to the report, the percentage of people unable to pay for medical bills was smaller in states that had expanded access to Medicaid compared with people living in states without expanded access.

One other factor that might have influenced the number of Americans overwhelmed by medical bills: lower demand in 2021 for medical services, as COVID-19 fears had people cutting back on emergency department and outpatient hospital visits, as well as routine medical screenings.

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