Understanding the Causes and Consequences of Delayed Medical Care

Delaying or skipping necessary healthcare has become an increasing concern in the United States, affecting millions of Americans across demographics. While policy initiatives like the Affordable Care Act (ACA) and Medicaid expansion have significantly improved access to insurance and reduced financial catastrophes from hospitalization, many Americans continue to postpone or forgo care for a variety of reasons.

Delaying care can have cascading effects: worsening chronic conditions, more complicated medical interventions, increased emergency room use, and higher healthcare costs. Understanding the prevalence, reasons, and impacts of these delays is crucial to shaping policy, improving health outcomes, and reducing overall system costs.

Prevalence of Delayed Healthcare

Delaying healthcare is widespread in the United States, affecting both insured and uninsured populations. According to the Kaiser Family Foundation (KFF) Health Tracking Poll (May 2025), 36% of U.S. adults reported skipping or postponing medical care in the past year due to cost, with 75% of uninsured adults reporting delays compared to 37% of insured adults (KFF, 2025).

Delays occur across age, income, and geographic groups. Rural residents face physician shortages and long travel distances, while urban residents encounter long wait times for appointments and limited availability of specialists. Historical trends show that external factors, such as the COVID-19 pandemic, temporarily increased delayed care, with nearly 38% of adults skipping or delaying care in 2020 due to virus exposure fears. While some recovery occurred by 2022–2023, cost-related delays, particularly in preventive screenings, dental care, mental health services, and prescriptions, persist.

The types of care Americans delay range from routine check-ups and preventive screenings to management of chronic conditions. Even insured individuals with coverage are not immune, highlighting that access alone does not fully prevent postponed care.

Reasons for Delaying Healthcare

Multiple factors drive delayed care, including financial pressures, insurance limitations, access challenges, and personal treatment choices.

Financial Barriers: High out-of-pocket expenses—including deductibles, co-pays, and coinsurance—remain the leading reason for delaying care. High-deductible health plans, which now cover roughly 30% of privately insured Americans, leave patients responsible for thousands of dollars before insurance benefits begin (KFF, 2024).

Insurance Limitations: Coverage does not guarantee timely access. Nearly 23% of working-age adults are underinsured, meaning their health plans provide inadequate financial protection against medical costs (SSRS, 2024). Narrow provider networks, particularly in ACA marketplace plans, further restrict access, with enrollees often able to see only 40% of local physicians in-network on average (RevCare, 2024). Administrative hurdles such as claim denials, confusing billing, and pre-authorization requirements also discourage patients from seeking timely care.

Access Challenges: Appointment availability is a major barrier. Studies show average wait times for new patients across multiple specialties can exceed 26 days (Health Journalism, 2024; BMC Health Services Research, 2024). A declining number of primary care physicians per capita in some regions worsens these delays.

Behavioral Factors: Many Americans attempt self-treatment for minor conditions, using home remedies or over-the-counter medications before seeking professional care. National surveys estimate 25–30% of adults take this approach for non-emergency conditions such as rashes, mild infections, or musculoskeletal pain (Relias Media, 2024; NCCIH, 2024). Similarly, adults frequently postpone care for minor symptoms like fatigue, mild pain, or skin issues, assuming the problem will resolve on its own (CDC, 2023).

Ultimately, delayed healthcare results from a combination of financial, systemic, and behavioral factors, underscoring the need for multifaceted solutions.

Impact of Delayed Healthcare

Delaying medical care can lead to significant health and financial consequences for individuals and the broader healthcare system.

Emergency Room Utilization: In 2022, there were approximately 155 million ER visits in the U.S., with about 20% of adults and 5% of children visiting the ER in the past year (CDC, 2023). Many visits were for conditions manageable in primary care, highlighting the downstream effects of delayed care.

Hospitalizations and Higher-Cost Treatments: Postponing care can result in the worsening of treatable conditions, leading to more intensive and costly interventions. A 2023 study found that 38% of insured Americans delayed care due to cost, and of those, 42% reported their condition worsened (Medical Economics, 2023). Untreated mental health conditions similarly increase the likelihood of hospitalization and intensive care needs (JAMA Health Forum, 2023).

Mortality Rates: Delays in healthcare can also increase mortality. Inadequate prenatal care contributes to higher infant mortality, exemplified by Mississippi, which reported 9.7 deaths per 1,000 live births, nearly double the national average (The Sun, 2023). Delayed treatment of other critical conditions, including mental health issues, can similarly increase mortality and long-term complications (CDC, 2023).

Mental Health Impact: Untreated physical or mental illnesses can profoundly affect psychological well-being. Chronic conditions and untreated mental illness contribute to persistent stress, anxiety, and depression, with social and economic consequences. An estimated 14.6 million adults in the U.S. experienced serious mental illness in 2023, many without treatment (GAO, 2023; Mind Remake Project, 2024).

Trends in Delaying Healthcare and Future Outlook

Looking ahead, multiple factors suggest that delays in healthcare may increase in the coming years. Rising insurance premiums and out-of-pocket costs are already influencing care-seeking behavior. Analysts project average ACA marketplace premiums could rise by 15–20% in 2025 (KFF, 2024). In addition, potential reductions in Medicaid coverage and changes to ACA subsidies could leave more Americans uninsured or underinsured, increasing the likelihood of delayed care.

Geographic and systemic access challenges may also continue to drive postponement of care. Narrow provider networks and ongoing shortages of primary care physicians and specialists limit appointment availability, particularly in urban and rural regions alike. The combination of financial pressures, limited provider access, and reliance on self-treatment strategies underscores the multifaceted nature of delayed healthcare.

Conclusion

Delaying healthcare continues to threaten health, increase costs, and worsen outcomes, including hospitalization, mortality, and mental health impacts.

CareSaver offers a practical solution, empowering patients to navigate insurance and provider networks, compare costs, and access timely care. By lowering financial and informational barriers, CareSaver helps prevent avoidable complications and improve health outcomes.

Addressing delayed care requires coordinated efforts across policy, health systems, and technology. Empowering patients with clear information and access is critical to ensuring Americans receive the right care at the right time.