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Two years after the Affordable Care Act went into effect, about 90 percent of the U.S. population has some sort of health insurance - Medicare, Medicaid, an individual policy or an employer-sponsored plan. But a new poll from NPR, the Robert Wood Johnson Foundation and Harvard's T.H. Chan School of Public Health shows that people are still struggling to pay medical bills. NPR's Alison Kodjak reports that sometimes insurance isn't enough.
ALISON KODJAK, BYLINE: Barbara Radley can only reminisce about the work she did for almost 30 years.
BARBARA RADLEY: I drove semi. I held furniture. Yeah, it was nothing for me to throw a couch on my back and carry it up a flight of stairs.
KODJAK: Now she's 58. She lives in Oshkosh, Wis., and is disabled. She says she's got five herniated discs in her back. And on top of that, she suffers from diabetes, scleroderma, and her kidneys are failing. She and her husband - he's also mover - were doing okay between his pay and her disability payments. They made about $30,000 a year. Then, two years ago, they were hit with a double whammy. His company changed insurance to a new plan that cost about $700 a month with a $5,000 deductible. Then her husband needed emergency surgery and missed a few months of work.
RADLEY: The medical bills were just piling up. We just couldn't handle it. We couldn't keep up.
KODJAK: They moved out of their family home and rented a place from her daughter-in-law. They never eat out except when they head to their church for a free meal. Still, they ended up in bankruptcy early last year. That helped them get rid of their old medical debt, but the health problems didn't go away. Barbara's cost are constant, and her husband had another surgery last fall. In the last 12 months, they've racked up another $10,000 in unpaid medical bills.
RADLEY: You know, everybody wants your money, and it's like, well, stand in line. You know, you ain't going to get none.
KODJAK: NPR's new poll shows Radley has plenty of company. A quarter of the people we surveyed say medical bills have caused them serious financial problems in the last two years. Seven percent of that group filed for bankruptcy. Bradley now has to make Faustian bargains on a regular basis.
RADLEY: There's times I checked my blood for my insulin. And I know I only have two pens left, and I really can't afford it for another week and a half. Well, then I take a lower dose of my insulin. Otherwise, I'll just skip it.
KODJAK: Just yesterday, she was thinking about taking out a payday loan or selling something on Craigslist to cover the $450 co-pay for her insulin. Radley's family is one of millions who's out-of-pocket medical costs are rising. A study last year by the Kaiser Family Foundation shows premiums and deductibles have been growing far faster than worker's wages. Linda Blumberg, a senior fellow at the Urban Institute, says that hurts people who are really sick, like Barbara Radley.
LINDA BLUMBERG: When we see higher deductibles, higher copayments, higher coinsurance, higher out-of-pocket maximums on these insurance plans, the people who are most affected are those that have the most need for medical care.
KODJAK: About 15 percent of those who answered our poll questions said they couldn't get the health care they needed at least once in the last two years. More than half of those said it's because they couldn't afford it. And separately, about 20 percent of poll respondents said they didn't fill a prescription for the same reason. Mary Lee Warden is one of them. The 78-year-old lives in Cleveland, Texas. She uses a wheelchair to get to the drug store around the corner and to her doctor down the road. She pays $147 a month for Medicare, the government health insurance for the over-65 set. That's out of the $1,400 she gets each month from Social Security. She says she doesn't qualify for extra help like Medicaid or food stamps.
MARY LEE WARDEN: All my money's gone by the time I pay my rent, my gas, my lights, my water and my co-pay for the doctor. Everything else is gone.
KODJAK: Just two weeks ago, Warden skipped an appointment for an echocardiogram because she couldn't afford the $100 co-pay. And she hesitates to fill her prescription to ease nerve pain in her leg caused by a serious car accident. The co-pay last time was about $150.
WARDEN: Right now, I'm afraid to even buy medicine. I can't afford them.
KODJAK: Medicare, like more and more other health plans, leaves a lot of expenses for patients to cover, says Drew Altman of the Kaiser Family Foundation.
DREW ALTMAN: The public perception may be that because Medicare is so popular, that it is gold-plated Cadillac coverage. But people on Medicare know those out-of-pocket costs can really bite.
KODJAK: Altman says Obamacare has given nearly everyone in the U.S. access to healthcare. But having insurance isn't always enough. The next big challenge, he says, is to try to stop people from going broke when they get sick. Alison Kodjak, NPR News.
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