It has long been said that many Americans have avoided seeking medical treatment because they were not insured or that they were specifically excluded from coverage for a pre-existing condition. The Affordable Care Act (aka, Obamacare) has insured about half those Americans who did not have insurance and eliminated the pre-existing condition exclusion.

But these things have come at a cost. No matter who provides the insurance now — your employer, yourself though private coverage or Obamacare — deductibles have increased as insurers struggle to keep monthly premiums down. The effect has been to change the reason for putting off treatment from no insurance to an unaffordable deductible.

In a recent survey commissioned by Insurance.com, researchers found that 64% of have delayed seeking care because of a high deductible. Most respondents said their deductibles settled in a range of $1,501 to $2,000, and another 20% said they paid more than $2,000, while 8% paid $1,500 or less.

Most people (45%) chose a high-deductible health plan (HDHP) because it was the most cost-efficient option. More than a third (37%) said it made the most sense for their situation, and 16% said that it was the only choice their employer gave them.

The survey report noted mixed results on the goal of better educating consumers about their health care choices:

We found HDHPs have mixed results. Most respondents said they are getting more information from their health insurer (63 percent) and doctors (61 percent) to make them better health care consumers. Sixty percent said they shop around for health care services, which is a positive response for HDHPs. However, only 41 percent of respondents said they now consider themselves better health care consumers.

Some consumers contribute to a health savings account (HSA) and use that pretax cash to help pay the higher deductibles. More than a third of Americans (38%) contribute from $1,001 to $2,000 to an HSA every year. Another 20% contribute $500 to $1,000, while 19% sock away more than $2,000. Some employers will contribute to an employee’s health savings account, with 64% of those surveyed saying they received between $500 and $2,000 from employer contributions. The other good news here is that most HSAs now allow individuals to rollover unused cash from one year to the next.

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