Even as most Americans applaud the quality, cost, and coverage of their health care, 40% are dissatisfied with their individual health care costs. Americans who are covered by Medicare or Medicaid are the least dissatisfied (29%), while dissatisfaction is highest among the uninsured (62%), according to a new Gallup survey.

These figures are based on combined data from Gallup’s 2014, 2015, and 2016 “Health and Healthcare” polls, conducted each November. During this period, which coincides with the implementation of the individual mandate component of the Patient Protection and Affordable Care Act, an average 42% of U.S. adults reported being dissatisfied with their health care costs. That was up from an average of 38% from 2011 to 2013, although similar to satisfaction levels a decade ago.

Slightly more than a third (37%) of Americans in Gallup’s 2014–2016 health care polling reported being enrolled in a government health care plan, such as Medicaid or Medicare; 52% got their health care through private insurance; and 11% had no insurance.

Among these three groups, dissatisfaction has increased the most in recent years for those with private insurance, rising to 49% in 2016 from an average 40% during 2011–2013 and more broadly from 31% in 2001.

Satisfaction with health care costs among Americans with private health insurance did not appear to be related to their own income level, but was related to the degree to which they contributed to their own insurance premiums.

Among those whose employers paid the full amount, only 27% were dissatisfied. This rose to 46% among those who shared premium costs with their employers and to 60% among those who paid the full costs themselves.

Consumers’ dissatisfaction with health care costs is more than a mindset—it is rooted in difficult decisions, according to Gallup. Fifty percent of those who were dissatisfied with what they paid said that they or a family member delayed medical treatment during the past year because of the cost. This included 32% who said the delay was related to a serious medical condition. In contrast, among those who were satisfied with their costs, 18% delayed medical treatment.

Gallup’s “Health and Healthcare surveys” are conducted by telephone each November with a random sample of at least 800 adults (18 years of age and older) in all 50 states and the District of Columbia. The combined polling sample consisted of 2,868 national adults.

Source: Gallup; December 12, 2016.

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