Many in U.S. worry about affording healthcare in retirement

(Reuters Health) - Nearly half of Americans aged 50 to 64 worry they won’t be able to afford healthcare when they retire, while more than two-thirds are concerned that federal policy changes will affect their current health insurance, a new survey finds.

Survey participants who worried about the cost of health insurance now or during retirement were nearly three times more likely to avoid medical care or filling a prescription than those with more confidence in their ability to pay for healthcare, researchers report in JAMA Network Open.

“Many individuals, 45% in their 50s and 60s, are not confident they can afford healthcare in retirement,” said lead author Dr. Renuka Tipirmeni of the University of Michigan in Ann Arbor. “They are also three times as likely to avoid healthcare services. This is huge compared to what we were expecting.”

Part of what inspired this study was seeing many patients struggling with the costs of prescriptions, Tipirmeni said. “This is concerning to me as a physician since getting regular medical care is so important, especially as people get into their 50s and 60s and beyond.”

To study healthcare concerns among people approaching retirement, Tipirmeni and colleagues turned to data from the National Poll on Healthy Aging, a nationally-representative survey of U.S. households conducted online two to three times a year among U.S. adults ages 50 to 80.

Tipirmeni and colleagues focused on the responses of 1,028 men and women aged 50 to 64 when they were surveyed in October 2018. Slightly over one quarter of participants, 27.4%, said they had little or no confidence in being able to afford health insurance over the next year, while nearly half, 44.9%, said they had little or no confidence in their ability to afford health insurance when they retire.

For 14.1%, fear of losing health insurance kept them from leaving a job, and for 11.4%, it led them to postpone retirement. Most participants, 67.7%, said they were very or somewhat concerned about the impact changes in federal policy might have on their health insurance.

In the past year, 13.2% had skipped getting medical care and 11.9% had avoided filling a prescription.

Tipirmeni advises people who are worried about being able to afford a prescription to talk to their doctors, since there are sometimes cheaper alternative medications.

The new findings are “troubling,” said Dr. Albert Wu, an internist and professor of health policy and management at the Johns Hopkins School of Public Health in Baltimore.

“They suggest that nearly half of workers in the prime years of their working life doubted their ability to afford or maintain health insurance,” Wu said in an email. “Many know from direct experience what they are talking about as a third had already retired or stopped working. Those who were most worried were also likely to report skimping on needed visits and medications.”

While the Affordable Care Act was supposed to give workers more flexibility in changing jobs, recent attacks on it may result in workers feeling they can’t leave the job they’ve got, Wu said.

“This should be a wakeup call to policymakers,” he said.

The concerns about healthcare costs after retirement are “realistic,” said Dr. John Rowe, a professor of health policy and management at Columbia University’s Mailman School of Public Health in New York City.

“While Medicare is a generous and affordable benefit, current estimates show that out-of-pocket healthcare costs - co-pays, deductibles, out-of-network fees, costs related to long term care - may outstrip the capacity of low-middle-income elders to pay,” Rowe said in an email.

SOURCE: JAMA Network Open, online February 7, 2020.