Adults With Long COVID Have More Difficulty Getting and Paying for Health Care


This study of health care access and affordability found adults with long COVID reported more unmet health care needs in the past 12 months.

 This study of health care access and affordability found adults with long COVID reported more unmet health care needs in the past 12 months.

Post–COVID-19 condition (PCC), or long COVID, adds even more strain to the already precarious health care system. Though definitions of long COVID vary, PCC generally refers to new or ongoing signs and symptoms at least 4 weeks or 3 months after initial COVID-19 infection.

Anywhere from 5-20% of American adults are estimated to have long COVID, some with symptoms so debilitating that they disturb or inhibit everyday life. However, difficulty finding available clinicians, denial of health insurance claims, clinician attitudes toward long COVID, and high out-of-pocket cost may be barring these PCC patients from accessing necessary care.

A new survey study, published this week in JAMA Network Open, wanted to determine whether adults with PCC are more likely to experience health care access and affordability challenges.

“The consequences associated with unmet medical needs may include exacerbated risk of disability and reduced health-related quality of life,” the study authors wrote, explaining the importance of this research. “Access to timely and effective treatment may be especially important for maintaining employment.”

This probability-based internet survey was conducted from June 17-July 5, 2022 and included 9484 US adults aged 18-64 years. Utilizing data from the Health Reform Monitoring Survey, the investigators estimated the association of PCC with access and affordability challenges among US adults.

Adults with self-reported PCC and adults who had never been diagnosed with COVID-19 were compared by demographic, health, and geographic characteristics. The investigators determined the association between self-reported PCC with the following access and affordability measures:

  • having a usual place of care
  • unmet needs for care in the past year because of costs
  • difficulties finding a clinician or difficulties using health insurance
  • problems paying medical bills in the past year
  • past-due medical debt

Self-reported PCC was defined as experiencing symptoms more than 4 weeks after first diagnosis with acute COVID-19. The respondents were classified as those with current PCC, those who had contracted COVID-19 but did not report PCC, and those never diagnosed with COVID-19.

The 9484 respondents included in the final analytic sample were 50.6% female and averaged 41.0 years of age. Past COVID-19 infection was reported by 36.4% of respondents (n = 3382), and among them, 22.5% (n = 833) reported currently having post–COVID-19 condition.

After adjusting for differences in health, demographic, and geographic characteristics, adults with PCC reported more unmet health care needs in the past 12 months than both adults with past COVID-19 infection but no PCC and adults with no COVID-19 history.

Respondents’ reasons for unmet health care needs in the past 12 months

From this survey study, the investigators concluded that adults with long COVID (post–COVID-19 condition) were more likely than other adults to have difficulty getting and paying for health care. “To our knowledge,” wrote the study authors, “this is the first study examining health care access and affordability among working-age US adults with PCC.”

They recommended that policies intended to improve health access and affordability should focus on developing treatment and clinical guidelines, training clinicians, and addressing insurance-related cost barriers.

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