Low- and middle-income households

Paths that fix these help them.

• Underinsurance: covered, but can't afford to use it: High deductibles and coinsurance lead them to avoid care.
• Medical debt affects about 100 million people: Medical debt leads them to skip care and face damaged credit and financial distress.
• Premiums are a large, flat, hidden tax on wages: A flat premium takes a large share of a modest paycheck.
• Executive pay and nonprofit status: Tax-exempt systems provide uneven community benefits.
• Health professional shortage areas: Clinician shortages limit primary and mental health care access.
• Worse outcomes than peer countries despite the highest spending: Poor health outcomes especially affect low-income and minority communities.
• Racial, income, and geographic disparities: Access and outcomes differ by race, income, and location.
• Dental, vision, and hearing are mostly uncovered: Coverage gaps and costs lead them to skip dental and other excluded care.
• Housing, food, and transportation drive health, but health care isn't designed for them: Health systems lack tools and funding to address social conditions shaping their health.
• Employer health taxes can lower wages at firms that never offered coverage: New employer health taxes tend to reduce wages at firms that previously offered no coverage.
• Copays keep billing systems alive and still deter poorer patients: Point-of-care charges deter care, especially for poorer patients.