Hidden crisis: Millions with employer insurance delay care due to high costs

Millions of Americans with employer-sponsored health insurance nevertheless are paying most health care expenses out of pocket – or delaying care altogether.

“Both my parents died in their 40s from heart attacks,” a 42 year old said in response to a survey by Paytient. “I had been having some chest pain and was ordered to have a stress test. I was told I would have to pay $250 up front. I still haven’t had the test.”

As many as 69 million workplace-insured Americans were primarily self-paying for care in 2023 because they had not exceeded their deductible, the study found. Forty percent of workplace-insured Americans reported delaying care because of cost, which negatively affected their mental health, workplace culture and productivity. One in six respondents reported that their work was affected by a health issue they couldn’t afford to treat, and 69% of this group admitted being distracted by pain at work. Among the other findings:

• Forty-five percent of employed Americans with insurance didn’t meet their single coverage deductibles in 2023. On average, they were $1,482 short of meeting their deductible.
• Of those who said their work was affected, 31% reported having a panic attack at work.
• Of those affected by delayed care, 19% have spent time working second jobs during work hours to earn money for health care, and 31% have lied to their boss about what they are doing while dealing with delayed care consequences.
• Seventeen percent of workplace-insured Americans have left their jobs to afford better health care.
• Eighteen percent of workplace-insured employees have been unable to pay a medical bill under $500.

Related: Despite employer insurance, Americans unprepared for medical bills, delay care

“The results of this study spotlight the invisible insecurity of insured Americans as health insurance alone no longer guarantees access to care,” said Brian Whorley, founder and CEO of Paytient. “Bringing this narrative into the national dialogue on health care highlights an opportunity for employers to affordably ensure employees have the security and certainty that they will be able to access and pay for care when they need it.”