One out of three lower-income employees skip or delay care that they need because they can't afford it—and that results in a nearly 70 percent increase in sick days. (Photo: Shutterstock)

Health care is expensive. But doing without it can be even more costly—and not just for the person who needs it. And that might make employers rethink their health plans.

According to a new study from the Integrated Benefits Institute, someone who skips care when he needs it is also costing his employer money that might better be spent elsewhere. The report says that one out of three lower-income employees skip or delay care that they need because they can't afford it—and that results in a nearly 70 percent increase in sick days.

Employees who didn't have that dollar-sign barrier between themselves and care, on the other hand, racked up far fewer sick days.

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The study, using 2007–2017 data from the Centers for Disease Control and Prevention, looked at employees with family incomes below $35,000 and found that a third of them had to forgo care because of money issues in the 12 months prior to the survey. In addition, more than half of uninsured employees were prevented by financial issues by accessing needed care, compared with just a fifth of insured employees.'

Oh, and high-deductible health plans aren't helping much. The report also finds that workers in HDHPs ($1,100 or higher for a single plan, $2,200 or higher for a family plan) were 75 percent more likely than employees in low-deductible plans to be unable to afford care. Health savings accounts didn't lower that risk for employees with high deductibles, but there was lower risk associated with flexible spending accounts and coverage for prescription medications.

And while the study focused on lower-income employees, even those who made more money but who still couldn't afford care ended up with a similar increase in sick days over employees who could afford their care.

“We were not surprised that a lot of people put off or did without medical care because they just couldn't afford it,” says Brian Gifford, Ph.D., IBI's research director and the study's lead author.

Gifford adds, “More and more studies show that even people who have jobs with health benefits cut back on necessary health care services due to the out-of-pocket costs of high deductibles, copayments, and coinsurance. The finding that unaffordable care was associated with almost two additional full days of absence, even after considering health status age, sex, and race, really drives home the point that productivity losses are eating away some of employers' savings from increased cost sharing.”

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