The percentage of American adults who say they skipped medical care due to costs rose significantly last year, hitting 28 percent. That's up from 24 percent in 2021 and 23 percent in 2020, according to a survey out this week from the Federal Reserve titled Economic Well-Being of US Households in 2022.

The percentage of people skipping medical care due to money woes is now at the highest point since 2014, when the country was on a downward slide as the Affordable Care Act came into full effect, offering affordable health insurance options to all Americans. The percentage of Americans reporting skipped medical care due to costs in 2013 was 32 percent, then 31 percent in 2014, and down to 27 percent in 2015.

The Federal Reserve's survey reported that people without health insurance were significantly more likely to skip medical care due to costs than those with insurance in 2022—42 percent of uninsured said they missed care because they couldn't afford it, versus 26 percent of insured adults who said the same.

But the survey didn't find a significant change in the insurance rate between 2021 and 2022 that explained the jump in missed medical care. In both years, about 91 percent of adults said they had health insurance. Instead, the federal reserve suggested the four-percentage-point rise may, in part, be tied to high inflation. Overall, Americans' self-reported financial well-being was down last year, with only 75 percent saying they were doing "at least okay" financially, five percentage points below 2021.

Poor health

Medical care is one of those things Americans skimp on when money is tight, the Federal Reserve noted. Among the types of medical care Americans put off, dental care was the most skipped, with 21 percent of American adults saying they put off dentist visits last year. That was followed by 16 percent of adults saying they skipped seeing a doctor or specialist. Ten percent said they didn't fill prescription medication, 10 percent said they skipped follow-up care, and another 10 percent said they skipped mental health care.

The numbers may rise in the US as the COVID-19 emergency programs end and states have begun removing people from Medicaid. During the health crisis, Congress enacted federal legislation that would keep people continuously enrolled in Medicaid through the end of the COVID-19 public health emergency, which ended March 31. The Kaiser Family Foundation estimates that Medicaid/CHIP enrollment grew by 23.3 million to nearly 95 million between February 2020 and the end of March 2023, and between 5 million and 14 million could now lose coverage.

Already, the US spends more on health care than any other high-income country in the world but ranks at the bottom on many significant health metrics. For instance, compared to other high-income countries, the US has the shortest life expectancy at birth, the highest rate of avoidable deaths, the highest rate of newborn deaths, the highest rate of maternal deaths, the highest rate of adults with multiple chronic conditions, and the highest rate of obesity, according to an analysis published in January.