The federal Centers for Disease Control and Prevention released new data this week showing that about one in five Americans have trouble paying their medical bills.
Micah Wilson, 27, of North Charleston, is among them.
She has no health insurance. Under state eligibility rules, Wilson’s three children qualify for Medicaid coverage, but she and her husband do not.
“Medical expenses have been a constant strain because my husband is a full-time contract employee for the state. They do not offer health benefits to these employees at this time,” Wilson said. “There are rumors they may offer insurance towards the end of this year (or) start of next, but unfortunately that will not help us now.”
In December, doctors found a small nodule on Wilson’s thyroid during an emergency-room visit. By spring it was the size of golf ball. A biopsy was inconclusive, and physicians have not determined if it is cancer.
Without health insurance, Wilson said Medical University Hospital told her she must pay $1,500 up front before the hospital will schedule an operation to remove the whole tumor.
“After raising $964 of it, I was told they would take no less than $1,500, and that if I was a person looking to get chemotherapy, I would need $7,500,” she said.
Her surgery date has not been set.
“I can’t sleep at night for the trouble I have breathing. I choke on water and it’s painful — not to mention we don’t know if it is cancer. The surgery has to happen,” she wrote in an email. The tumor makes it difficult for her to speak.
Wilson’s medical expenses may sound atypical, but they are not. The average family of four pays more than $9,000 in out-of-pocket health care costs, including insurance premiums, each year, according to the 2013 Milliman Medical Index. That’s more than the same family’s annual grocery bill, an estimated $8,388.
But the CDC report released this week has a silver lining. It shows that fewer people had difficulty paying their bills in 2012 than in 2011. During the first six months of 2012, an average of 20.3 percent of people under age 65 in families had trouble paying those bills, down from 21.7 percent during the first six months of 2011.
It’s no surprise that the percentage is higher among families such as Wilson’s, with no health insurance. Among the uninsured, 36.3 percent had trouble paying medical bills last year.
“Not having insurance has become, simply put, a nightmare,” she said.
Federal law requires hospitals to treat all patients presenting a medical emergency in an emergency room, regardless of that patient’s ability to pay for the care. The government reimburses hospitals billions of dollars a year for administering “charity care,” but some of that care still goes unfunded.
Steve Hargett, chief financial officer for the Medical University Hospital Authority’s MUHA finance and support services, said the hospital has a variety of ways to help patients pay their medical bills.
Discounted or charity care is determined based on family size and income level, he said. Patients without insurance automatically get a 50 percent discount for services at Medical University Hospital.
“We would not argue at all that people have trouble playing their medical bills,” Hargett said. “It’s just a fact of life of the health care industry. There are so many uninsured patients and it’s expensive.”
The CDC report included responses from 55,321 people. Medical expenses included in the report were defined as bills for doctors, dentists, hospitals, therapists, medication, equipment and nursing home or home care.
Reach Lauren Sausser at 937-5598.