The midlife health care cost crisis of insured employees
People aged 50 to 64 are skipping routine care and splitting pills as health care costs continue to rise.
Having employer-sponsored health insurance does not insulate midlife adults – those between the ages of 50 and 64 – from the burden of high health care costs. This cohort faces higher rates of chronic conditions and requires additional routine care as they age, but high costs drive many people to delay or avoid medical care because they can’t afford it, according to an AARP report.
About three-quarters of midlife adults have private health insurance, including group coverage through an employer or through an individual health insurance plan. However, midlife adults paid higher premium costs and those costs grew faster than those premiums paid by other adults, according to an AARP Public Policy Institute and NORC at the University of Chicago analysis of the Medical Expenditure Panel Survey (MEPS). Premiums have grown 38% for midlife adults with single coverage plans since 2011, compared with only 25% for younger adults.
In addition, AARP found midlife adults are paying more out-of-pocket costs for health care. Almost half of midlife adults with private health insurance have deductibles greater than $1,400 per year, and in 2021, one-fifth of midlife insured adults with single plans spent more than 10% of their gross income on health care costs. That compares with 13% of adults between the ages of 18 and 34 and 11% of adults aged 35 to 49.
A third of adults older than age 50 say they have had problems paying for health care in the past year and nearly half are concerned they will be unable to pay for needed health care services during the next year. This causes midlife adults to cut back on medical care, stretch out prescriptions by cutting pills in half, or make tradeoffs between health care and food, utilities and clothing. About half of respondents to a 2022 AARP survey reported delaying or forgoing care in the past year due to cost. One-third skipped dental care, one-fifth skipped vision care and 16% skipped primary care.
Related: Hidden crisis: Millions with employer insurance delay care due to high costs
In 2022, 7.2 million midlife adults, which is 11% of this population, had medical debt, and of those with debt, 20% carried a balance of more than $10,000.
As health care costs continue to rise, AARP advocates for policy changes to mitigate the burden on midlife and other adults. Its recommendations include enacting reforms that address incentives that lead to and result from consolidation, which results in higher prices; improving transparency to discourage anti-competitive behavior and allow consumers to make more informed decisions; developing strategies that enable improved coverage, access to preventive care and adequate support for disadvantaged populations; and leveraging new technology to create efficiencies, improve care delivery and administration, and help lower costs for consumers.