Landing | Percent of people with a high medical cost burden by Total (2017 to 2024) | State Health Access Data Assistance Center

Percent of people with a high medical cost burden

Measure Overview

A recent poll from Gallup found that Americans perceive cost of health care as the “most urgent health problem” facing the country. Reports from the Centers for Medicare and Medicaid Services (CMS) show that health care spending in the U.S. rose $5.3 trillion in 2024, with personal health care spending rising “by an average of 8.9 percent annually over the two-year period, marking the fastest pace of growth since 1991–1992.”

As health care costs continue to rise in the U.S., some Americans have seen out-of-pocket (OOP) spending on health care account for a growing share of their annual income. High OOP spending can expose those with low and moderate incomes to unmanageable health care costs. This can lead to medical debt, forgone care due to cost, inability to afford other necessities like food or housing, and more. Tracking rates of high medical care cost burden in the overall population and across different demographic groups helps us to understand trends and disparities in health care affordability.

High Medical Cost Burden by State, Race/Ethnicity, and More: Breakdowns and Data Source

State Health Compare provides annual, state-level estimates of high medical cost burden, defined as the percentage of individuals in families where OOP spending accounts for more than 10 percent of annual income. These estimates come from SHADAC analysis of data from the Current Population Survey’s Annual Social and Economic Supplements (CPS-ASEC).

Three breakdowns are available for this measure: Employer Coverage, Income, and Race/Ethnicity.

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Notes

Family defined as a Health Insurance Unit (HIU), based on individuals who would likely be considered a family unit in determining eligibility for either private or public coverage. Income measured as HIU family income in relation to HHS Federal Poverty Guidelines (FPG). The margin of error (MOE) represents the uncertainty of an estimate due to sampling variability; the calculated MOE is 95%. N/A indicates that data were not available or suppressed because the number of sample cases was too small.

Data collection for the 2020 CPS (2019 estimates) was impacted by the COVID-19 pandemic, which likely caused measurable non-response bias. Users should treat 2019 estimates with caution. More information is available in Census Working Paper SEHSD WP2020-10. Data collection for the 2021 CPS (2020 estimates) was also impacted by the COVID-19 pandemic, which likely caused measurable non-response bias. More information is available in a September 2021 Census blog post. Though data collection for the 2022 CPS (2021 estimates) was not impacted by the pandemic, response rates continued to be below pre-pandemic normal, which has resulted in small, but measurable nonresponse bias. More information is available in a September 2022 Census blog post. Users should treat 2019–2021 estimates with caution.

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