Within the past two years, high medical costs led nearly 3 in 4 (71%) American families with children under 18 to make a sacrifice or hard decision during the holidays. This is according to the 2019 Aflac Health Care Issues Survey released by Aflac, the leader in supplemental insurance sales at U.S. worksites.

The national online survey of 1,127 U.S. adults looked at how medical costs from the last two years have affected Americans during the holiday season and year-round, as well as the rate of hospital visits and regrets related to health care coverage decisions.

Among families who visited the hospital in the past two years, 73% faced medical expenses beyond copayments or deductibles. These out-of-pocket costs can be significant, with nearly half (47%) of those families reporting having spent $500 or more. According to the National Retail Federation, $500 is about half of what the average shopper plans to spend this holiday season: $1,047.83. 

"While national conversations highlight how U.S. families are increasingly shouldering rising health care costs, this survey confirms a significant area in which many are feeling the pinch," said Bob Ruff, senior vice president of Growth Solutions at Aflac. "Many families are facing a financially difficult holiday season due to health care costs, leading many to purchase fewer gifts for others, take on risky debt, or give up invaluable time with loved ones because they must cancel travel plans or pick up extra work to help make ends meet."

Families are facing holiday disruption in various forms due to medical cost concerns in the last two years, including:

Bowing out on holiday giving — Nearly 1 in 4 (24%) families say they had to spend less on holiday gifts, and fully 1 in 5 (20%) decided against purchasing a gift for a loved one altogether.

Debt, the gift that keeps on giving — Over 1 in 4 (26%) families say they had to rely on a credit card, nearly 1 in 5 (18%) borrowed money from a friend or family member, and 12% took out a loan during the holiday season as a result of medical cost concerns.

Skipping on season's greetings — Nearly 1 in 5 families (19%) canceled travel plans to see friends and family, and about the same number (18%) canceled holiday events. Further, wage earners in 17% of families picked up extra hours during the holidays to offset medical expenses, meaning less time spent with friends and family.

Regrets: The 'Ghost of Health Insurance Past'

Other findings from the Aflac survey indicate many U.S. families deal with health insurance remorse, with 42% of families saying they made health care coverage decisions they regretted within the past two years. Top reasons for regret include choosing a plan with limited benefits, going to an out-of-network provider, choosing too high a deductible and not sufficiently researching their benefits.

In addition, financial fears affect continued access to health care year-round, not just during the holidays, with 35% of families reporting that they have postponed their own medical appointments and 24% having postponed taking a family member to see a medical professional due to medical costs concerns.

"The annual benefits open enrollment season, which is underway at many U.S. workplaces right now, is an opportunity to address these regrets and help ensure individuals and families have adequate coverage," Ruff added. "Looking at everything an employer offers and applying for supplemental insurance like that offered by Aflac can help provide an extra layer of financial protection and help hard-working American families with expenses health insurance doesn't cover."

Survey findings on all individuals, not just those with children, are also available. Across all groups, the results held steady, with more than half (53%) of individuals reporting they had to make some type of sacrifice or hard decision during the holiday season because of medical costs. Specifically, 1 in 5 said they had to spend less on holiday gifts (21%) or rely on a credit card (20%) in the past two years due to medical cost concerns.