The anticipated spike in out-of-pocket health care expenses under the Patient Protection and Affordable Care Act has not materialized.

The average patient spent 3.5 percent more over the past year, according to a new study by the Robert Wood Johnson Foundation. This translates into about $1 per visit, including copayments and deductibles.

However, deductibles increased by an average of $8 for every type of physician visit. The deductible for a primary care visit increased from $14 to $20, while orthopedics increased from about $27 to $35. Researchers warned that rising out-of-pocket costs could cause some patients to forego care, although the study shows that co-pays and deductibles did not increase as sharply as some critics had predicted.

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