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Posted June 10, 2019


A quarter of American workers surveyed in our new consumer-directed health plans report said they regularly do without healthcare services because of the out-of-pocket expenses involved. Unsurprisingly, we found that poorer workers are significantly more likely to do without.

What we also found, and what we explore in depth in our new “Paying for Healthcare in America” report, is that escalating healthcare costs are having a devastating effect not only on Americans’ financial health and preparedness, but on their psyche and overall wellness.


Financial Health, Stress, and Productivity

Our findings indicate an urgent need for targeted messaging and tools that support the financial health and empowerment of low- to moderate- income Americans in particular:

  • More than a quarter of workers told us their anxiety about healthcare expenses has grown worse in the past year. Low-income respondents were particularly likely (43 percent) to report that their anxiety has gotten worse over the past year.
  • Though even high-income workers report significant financial health struggles, out-of-pocket expenses hit low-to-moderate-income households hardest and cause them more anxiety: 44 percent of those making less than $25,000 are “very worried” about out-of-pocket costs, compared with 17 percent of those making over $100,000.
  • 24 percent of workers report that doing without healthcare services has impacted their productivity or engagement at work, most commonly leading them to feel distracted or spaced out, or causing them to call in sick, do very little work during the workday or leave work early.

WEX went into this research knowing that healthcare costs in the U.S. are higher than anywhere else in the world—and that pressures are mounting right along with expenses. Healthcare spending now accounts for 18 percent of the nation’s gross domestic product, having reached $3.5 trillion in 2017—or $10,739 per person. According to the Kaiser Family Foundation’s analysis of National Health Expenditure data, most of the recent health spending growth is in private and public insurance programs. Out-of-pocket costs have also been rising, jumping from a few hundred dollars on average less than a decade ago to an average deductible today of $1,573 among covered workers with individual plans.

To inform the development of our report, we talked to as many Americans as we could about their healthcare plans, conducting both qualitative and quantitative research that included online surveys, focus groups and online anthropology. This included taking an unflinching look at their confusion about health savings accounts (HSAs), flexible spending accounts (FSAs), high-deductible health plans (HDHPs), and how they approach healthcare decisions. Our goal: To help Americans gain the confidence they need to make the best choice about healthcare benefits for themselves and their families. Today we are all the more resolute about finding a way to help the consumers that our Partners serve every day.

For actionable ways to help change the consumer story, download the “Paying for Healthcare in America: Challenges, Missed Opportunities & What We Can Do” report in full here.


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