Writing for Axios, Drew Altman gives us the latest on who’s having trouble paying their medical bills. The answer, it turns out, is most of us.

Here is a chart he presents, based on survey data from the Kaiser Family Foundation:


Some of this, perhaps, is not all that shocking. After all, we do live in a world of trade-offs. If you have to put off a vacation to pay for a new car, isn’t it reasonable that you might do the same to pay for a new knee? Or dip into savings? Or work extra hours?

But some of the trade-offs seem more troublesome. For example, 59 percent of people reported that they didn’t just dip into savings, but used up all or most of their savings. For 26 percent, that meant taking money out of long-term savings, presumably retirement funds. If a quarter of the population has to choose between financial security in retirement or paying current medical bills, we might be justified in wondering if something is wrong with our social safety net. Much the same if people can pay their medical bills only by borrowing at the astronomical interest rates charged by payday lenders.

Wasn’t Obamacare supposed to fix all this? Yes, but, as Altman tells us,

The share of the public reporting problems paying their medical bills has not moved much in recent years. The Affordable Care Act has extended coverage and better financial protection to tens of millions, but it doesn’t have much of an impact on affordability beyond people covered by the Medicaid expansion and the marketplaces.

In the far larger employer-based health insurance sector, deductibles and other forms of cost sharing have been growing about five times faster than wages, and deductibles have been growing especially sharply for people who work for smaller employers.

Yes, something is definitely wrong with our social safety net.