Lower-income individuals in general are more likely to benefit from the redistribution of funding by others toward healthcare services, with households in the three lowest income groups receiving more healthcare services than they pay for through any form of payment. Those who require long-term care, however, must often spend most of their savings in order to qualify for public benefits. The highest of the five income groups pay more than they receive as healthcare services.

Carmen says the findings indicate a more regressive system for healthcare funding than previously suggested by earlier studies, and hopes that the study here will open up greater dialogue for how to improve the distribution of funds for U.S. healthcare from households and individuals with different incomes and conditions that affect their economic status.

“Our paper documents the large burden placed on low-income households, and provides a jumping off point for discussions of policies that would change our health care financing system,” said Carman. “Before we can discuss policies that would reduce the burden on low-income households, we must first understand the burden they currently face.”

Researchers relied on information from the Survey of Income and Program Participation, the Medical Expenditure Panel Survey, the Kaiser Family Foundation/Health Research Education Trust Employer Health Benefits Survey, the American Community Survey and the National Health Expenditure Accounts. They considered taxes and employer contributions for all payments from households toward healthcare, in their estimates.

Support for the study was provided by the Robert Wood Johnson Foundation as part of its work to build a culture of health. Other authors of the study are Jodi Liu and Chapin White.

The findings were published in the journal, Health Services Research.

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