40% of Americans are delaying healthcare visits despite having insurance

In the U.S., health insurance does not guarantee you can actually afford the care you need. But if employers want a healthy, engaged workforce, then they need to ensure their plans are the exception to the rule. 

Forty percent of Americans admit they have delayed care due to costs, while one in six say their work has suffered due to a health issue they couldn't afford to address, according to a survey from research company NonFiction and Paytient, a company that offers interest-free lines of credit for healthcare costs. Their research, gathered from 1,500 Americans in partnership with the independent research group Nonfiction, also estimates that 69 million employer-insured Americans were basically paying for their own care out of pocket because they hadn't reached their deductible in 2023. 

Employees pay an average of $8,435 per year out of their paycheck to cover their healthcare plans, according to KFF, yet where that money is going is a mystery to most workers. As such, Americans now have $220 billion worth of medical debt, and uncertainty around just how much their care will cost and whether it's worth it to seek care.  

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"When folks are uncertain about their ability to pay for care, it shapes behaviors and changes decisions," says Brian Whorley, founder and CEO of Paytient. "We wanted to understand how that uncertainty impacts their lives in the workplace and at home."

Of those who reported seeing an impact on their work because of delayed care, 69% admitted to feeling distracted by their pain, and 31% lied to their boss to cover up why they were taking certain actions like taking time off or missing deadlines. Notably, 17% have left their jobs for better healthcare benefits, according to Paytient. 

Whorley stresses how crucial it is for employers to invest in usable health plans. If the deductibles are too high and preventive care costs are neither cheap nor transparent, employees will avoid care and let their condition worsen.

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"The task before employers and benefit plan designers is how to ensure the plan comes with the certainty of affordability," says Whorley. "How do they make sure employees are secure to make good decisions and not harmful ones? There's a social contract here where you bring your best self 40 hours a week, and [your employer] takes care of you."

But as healthcare costs go up each year, it's only getting harder for employers to fulfill their end of the bargain. Whorley suggests employers learn how their employees interact with their existing plans and redesign said plans if necessary. Ultimately, employers will lose money in productivity loss and turnover if they don't figure out how to design benefits that encourage care. According to the Integrated Benefits Institute, poor employee health costs businesses $575 billion a year. 

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Whorley notes that year-over-year health cost increases are not likely to slow down, especially as new innovations in medicine add more expensive medications and treatments to the mix. Whorley believes the healthcare system is due for a reckoning, and employers will play a vital role in helping the U.S. decide who will take the bulk of the financial burden. Will it be businesses, employees or the government?

"The challenge is an economic and ethical dilemma of who shoulders the costs," says Whorley. "We need to figure that out as a society."