Paul Tillinghast—Getty Images
By Kara Brandeisky
December 2, 2014

The Affordable Care Act kicked into gear over a year ago. And more than 86% of Americans now have health insurance, up from 82% in mid-2013.

Even so, according to a new Gallup poll, a third of Americans say they aren’t getting the medical care they need because of cost.

In fact, more Americans are putting off medical care than ever before in the 14-year history of the poll.

Source: Gallup

Uninsured Americans aren’t the only ones delaying medical treatment. Some 34% of Americans with private health insurance say they’ve skipped out on care because it was too expensive, up from 25% last year. Additionally, 28% of households that earn $75,000 or more report that family members have delayed care, up from just 17% last year.

One likely culprit? Rising out-of-pocket costs. Americans who get healthcare coverage through their employers have seen deductibles more than double in the past eight years.

Source: Kaiser Family Foundation, Employer Health Benefits 2014 Annual Survey. Note: Data is for covered workers with a general annual health plan deductible for single coverage.

It’s part of a movement towards what’s come to be termed “consumer-driven health care.”

The thinking is, when patients are more aware of healthcare costs and more discerning about what care they really need, they will also be more discerning in their usage—which in theory would lower costs for everyone involved. Two-thirds of large employers think consumer-driven healthcare is one of the most effective tactics to reduce costs, according to the National Business Group on Health.

But Gallup found that more Americans are skimping on care that they think they really do need. According to the survey, 22% of Americans say they’ve put off treatment for a serious condition, vs. 19% last year. The percentage of Americans who say they put off care for a non-serious condition stayed flat at 11%.

Previous studies have found that when consumers are asked to share more of the costs, they put off both necessary and unnecessary care.

For example, one study found that people on high-deductible plans are less likely to buy expensive, brand-name drugs (which may be sensible), but they’re also less likely to buy generic drugs they need to treat chronic conditions (likely not sensible).

When forced to pay more out-of-pocket, men in particular are more likely to skip care for serious problems like irregular heartbeats and kidney stones.

What’s especially frightening about these findings is that delaying needed care to save money in the short term may result in more costly complications and more difficult-to- treat health issues in the longer term. Skipping the cholesterol screening now, for example, could mean racking up a $100,000 tab for a heart attack later.

Are you avoiding treatment you need because you’re afraid of the bill? Try these strategies to get the same healthcare for a quarter of the price. If you’re on a high-deductible plan, use your Health Savings Account to budget for your expected—and unexpected—costs.

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