One-fifth of seniors with health problems miss emergency care because of cost: study – The Hill

History at a glance


  • Older Americans face an increased risk of economic insecurity.

  • A new study shows that a majority of people between the ages of 50 and 80 are at least somewhat concerned about the cost of an emergency medical visit.

  • In the past two years, 22 percent who might have needed emergency care did not seek it because of concerns about the cost.

Concerns about cost keep more than 20 percent of Americans between the ages of 50 and 80 from seeking emergency medical care, even when they think they might need it, according to a new study.

Of more than 2,000 older Americans surveyed, most reported concern about the cost of emergency room visits. Individuals in their 50s and early 60s, women, those without health insurance, people with household incomes under $30,000, and those who say their mental health is good or poor are the most likely to say , that they would miss emergency care because of the cost.

The new research is published in The American Journal of Managed Care.


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COVID-19 has strained the household finances of many Americans, the authors write, and data show that out-of-pocket health care spending in 2022 rose at the fastest rate recorded since 1985.

Respondents completed the survey in June 2020 and were prompted to look back on the previous two years and the first few months of the COVID-19 pandemic.

Four in five adults who did not have a medical emergency during that period said they were concerned about the cost of emergency care, with 45 percent saying they were very concerned about it. Eighteen percent said they were not confident they could afford an emergency room visit.

“As an emergency physician, I’ve seen patients come to the emergency room having put off their care. They often come in sicker than they would have been if they had received care earlier,” lead author Rachel Solnick of the Icahn School of Medicine at Mount Sinai Health System in New York said in a release.

“This scenario is what I find most troubling about the results of this study. Some groups who are medically vulnerable or have suffered worse outcomes from COVID-19 are more likely to report cost-related avoidance of [emergency room] than their counterparts. These findings underscore the importance of reducing the number of uninsured individuals and the need for insurers to clearly communicate coverage for emergency services.

Older Americans face a greater risk of economic insecurity, the authors write. Previous research has found that about half cannot afford basic expenses. These factors can make it more difficult for these Americans to absorb unexpected health care costs.

Additionally, as the number of older adults in the country increases, emergency room visits will also increase, placing greater demands on the already strained American health care system.

The study was conducted before the passage of the No Surprises Act, which aims to limit surprise billing for emergency care when a privately insured person receives care outside their network. However, the law does not address other sources of high health care costs, such as in-network deductibles, the authors noted.

In addition, older Americans may be covered by Medicare or Medicaid, which already prohibit the form of billing addressed in the No Surprises Act.

But “combined with increased cost concerns among those ages 50 to 64, we find that the financial impact of emergency care remains a major concern for older Americans who have not yet reached Medicare eligibility age and do not meet Medicaid income thresholds,” the researchers said.

Although only four percent of survey participants were uninsured, those people were 35 percent more likely to say they weren’t confident they could afford emergency care.

The researchers suggest that future policies help reduce out-of-pocket costs for this vulnerable population.

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