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Millions Of People Are Having An Easier Time Paying Medical Bills

Juana Rivera, left, speaks with agent Fabrizzio Russi about buying insurance through the Affordable Care Act in Miami on Dec. 15, 2014.

The number of people who have trouble paying their medical bills has plummeted in the last five years as more people have gained health insurance through the Affordable Care Act and gotten jobs as the economy has improved.

A report from the National Center for Health Statistics released Wednesday shows that the number of people whose families are struggling to pay medical bills fell by 22 percent, or 13 million people, in the last five years.

And that's good news, according to consumer and health policy advocates.

"The effect on families is profound," says Lynn Quincy, director of the Healthcare Value Hub at the Consumers Union. "Health care costs are a top financial concern for families, far above other financial concerns."

Quincy says the number one determinant of whether people can pay medical bills is whether they have insurance.

"The fact that this report shows it's getting easier, it seems like we should lay a good part of this at the door of the ACA," she says.

The decline in families worrying about medical bills corresponds with a huge increase in the number of people who have health insurance. In 2011, 46.3 million in the U.S. were uninsured. In June of this year, that figure had fallen to 28.4 million people.

Much of that increase is due to the Affordable Care Act, whose insurance exchanges were launched in 2013 for coverage starting in 2014.

About 20 million people this year have health insurance because of the ACA, according to the Department of Health and Human Services. That includes about 10 million people who gained coverage through the expansion of Medicaid and another 10 million who buy insurance on the Obamacare exchanges or are young adults covered through their parents' insurance.

Kevin Lucia, a research professor at Georgetown's Health Policy Institute, says the insurance offered under Obamacare has more financial protections than pre-ACA policies.

"The coverage is more protective in many ways," he says. "It doesn't include annual limits [or] lifetime limits, and it includes a comprehensive benefit package. That may be contributing to the improved data."

Some of the relief could also come because more people have jobs, so they can more easily pay their bills.

The unemployment rate has fallen from 9.1 percent in January 2011 to just 4.9 percent in June, according to the Bureau of Labor Statistics.

The finding that people are having an easier time paying medical bills may seem surprising because of reports that insurance premiums and cost-sharing have been rising in recent years.

A report in September by the Kaiser Family Foundation shows that more and more companies are offering their employees health insurance plans that carry higher deductibles.

But Quincy says simply having coverage is the key.

"People speak loudest when they are faced with increasing deductibles and increase cost sharing," she says. "But nothing determines the affordability of care than that binary equation: Do you have coverage or do you not?"

The report comes just as President-elect Donald Trump is naming officials to his health policy team who are determined to dismantle the Affordable Care Act. Trump has pledged to repeal and replace the health law, and on Tuesday named Rep. Tom Price, R-Georgia, a vocal opponent of Obamacare, to lead the Department of Health and Human Services.

Repealing the law would hurt the people who are seeing relief from high medical bills as highlighted in this report, says Jay Angoff, a former Missouri insurance commissioner who helped implement the Affordable Care Act at HHS.

"There are millions of people who have coverage under Obamacare," Angoff says. "What are they going to tell those guys?"

Copyright 2016 NPR. To see more, visit http://www.npr.org/.

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