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More than half of working-age adults struggled to afford health care this year, according to a new Commonwealth Fund survey.

While the Commonwealth Fund, a private foundation that supports health care research, found that uninsured Americans struggled to pay for health care the most, even those with employee-sponsored insurance are having a tough time affording health care.

Out of the insured, 43 percent of Americans with employee-sponsored health insurance struggled to afford health care this year.

Meanwhile, 57 percent of those who purchased insurance on their own, such as on the Affordable Care Act marketplaces, found it difficult to pay for health care this year.

On top of that, 45 percent of Americans with Medicaid health insurance struggled to afford health care as well as 51 of older Americans with Medicare.

“While having health insurance is always better than not having it, the survey findings challenge the assumption that health insurance in the U.S. buys everyone affordable access to care,” said Sara Collins, the Commonwealth Fund’s vice president for health care coverage and tracking, and lead author of the study.

And the high cost of health care is forcing many Americans to forgo medical care.

Almost 40 percent of working-age adults reported skipping needed medical care or prescription drugs over the last year because they couldn’t afford it, according to the survey.

And almost 60 percent of those Americans who skipped or delayed care because of costs said their health worsened as a result, according to the survey.

Uninsured Americans were the most likely to put off addressing their health with 64 percent reporting they skipped or delayed needed health care or a prescription drug in the last year.

But 29 percent of working-age adults with employee-sponsored health care coverage admitted to skipping or delaying needed health care or a prescription this year.

Out of Americans who purchased their own insurance, 37 percent said they skipped or delayed health care while 39 percent of Medicaid health insurance holders and 42 percent of Medicare recipients said the same.

Almost a third of working-age Americans said they had medical or dental debt because of the high cost of care, the survey also found.

And 39 percent of people with medical or dental debt said it forced them to cut back on basic needs like food, heat or rent.

Commonwealth asked Americans whether inflation and other cost of living expenses made it harder to afford their health care, according to Collins.

“We found that insurance did not appear to protect many people sufficiently from the budget squeeze,” she said.

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