Americans’ Personal Burden for Healthcare Costs Stable

PRINCETON, NJ -- More than 8 out of 10 Americans with private health insurance say they pay at least some of the cost themselves, and 72% of those say the amount they pay has gone up at least a little over the previous year. These percentages are little changed from previous years, suggesting that the proportion of Americans facing rising out-of-pocket health insurance costs has stabilized.

"Despite the economic crisis and the high-intensity focus on rising healthcare costs, Americans, on average, remain no more likely this year than last to say they are paying more for their families' health insurance."

These results are from Gallup's Nov. 5-8 Healthcare update. The question about out-of-pocket costs for health insurance was asked of Americans who have private health insurance and say they pay all or part of the cost, a group constituting 48% of the adult population. The rest don't have health insurance of any kind, have health insurance through a government plan such as Medicare or Medicaid, or have private health insurance in which the employer pays all of the costs.

Among those with private insurance who pay at least some of the cost personally, the percentage since 2003 reporting cost increases has been fairly consistent. This in turn suggests a continuing pattern of health insurance "price creep" over the years -- at least according to the perceptions of Americans who have private health insurance.

At the same time, the proportion of Americans perceiving an increase has apparently not changed over the last year. Despite the economic crisis and the high-intensity focus on rising healthcare costs, Americans, on average, remain no more likely this year than last to say they are paying more for their families' health insurance. If anything, the percentage saying such costs have risen has been slightly lower over the last three years (2007 to 2009) than in the four previous years (2003 to 2006).

Other findings from the November Gallup health update underscore the conclusion that Americans' perceptions of healthcare this year are no more negative, and in some instances are slightly more positive, than in years past.

Health Insurance Basics

More than 8 out of 10 Americans with private health insurance say they are required to pay at least a portion of the cost themselves, and one out of four pays the entire cost personally.

Having one's employer pay the entire tab for health insurance has become largely a thing of the past. The current 12% who continue to enjoy this state of affairs is a few points lower than last year, and well below the 24% and 19% who reported this situation in 2001 and 2002, respectively. Concomitantly, the 25% of Americans with private health insurance who say they pay the entire tab themselves is the highest of the decade. The trend on this measure has fluctuated; the previous high point -- 23% -- was in 2003.

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Survey Methods

Results are based on telephone interviews with 1,008 national adults, aged 18 and older, conducted Nov. 5-8, 2009. For results based on the total sample of national adults, one can say with 95% confidence that the maximum margin of sampling error is ±4 percentage points.

The results for those who have private health insurance and pay all or part of their health premiums are based on a sample of 456 national adults, with a maximum margin of sampling error of ±5 percentage points.

Interviews are conducted with respondents on land-line telephones (for respondents with a land-line telephone) and cellular phones (for respondents who are cell-phone only).

In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.