Facts and Myths

Myth: Compared with Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, and the United Kingdom, the United States ranks last overall in access to care, administrative efficiency, equity, and health care outcomes.

Fact: 2023 data showed that just under half of Americans (49%) got health insurance through their employers. 36% received coverage through a government-provided plan such as Medicare or Medicaid. An additional 6% had non-group, or individual, coverage, which includes coverage through the Marketplace, known as kynect in Kentucky.

In Kentucky in 2023, 46% had employer-provided insurance, 45% had a government-provided plan, and 4% had non-group, or individual, coverage, including those who had coverage through kynect.

Learn More about Employer-Provided Insurance

Learn More about Medicare and Medicare Advantage

Learn More about Medicaid

Learn More about the Marketplace (kynect in Kentucky)

Myth: Employers can impose a 30- to 90-day waiting period before becoming eligible for health insurance. When changing jobs, it’s important to check with your employer to find out the waiting period for health insurance benefits. Medicare and Medicare Advantage also have non-immediate effective dates. For example, if you sign up for Medicare during Medicare open enrollment (October 15 through December 7), coverage begins on January 1 of the following year.)

Myth: A 2025 report found that 27.2 million Americans did not have health insurance. A quarter of working-age adults were underinsured in 2023, with 57% avoiding necessary care due to cost. The U.S. spends significantly more on health care per capita ($14,885 in 2024) than other high-income countries. On average, other large, wealthy nations spend about half that amount per person and produce better health outcomes. Universal health care could reduce total health care spending in the U.S. by an estimated 13%, or $450 billion a year, while saving 68,000 lives.

Myth: A 2025 report found that 27.2 million Americans did not have health insurance. A quarter of working-age adults were underinsured in 2023, with 57% avoiding necessary care due to cost. The U.S. spends significantly more on health care per capita ($14,885 in 2024) than other high-income countries. On average, other large, wealthy nations spend about half that amount per person and produce better health outcomes. Universal health care could reduce total health care spending in the U.S. by an estimated 13%, or $450 billion a year, while saving 68,000 lives.

Fact and Myth: Some types of health insurance plans, such as Health Maintenance Organizations (HMOs), only cover care by providers in their network. If you receive non-emergent care outside of the network, you must pay the full price. Other barriers to care include physicians who do not accept patients with specific types of coverage, such as Medicaid or Medicare, physicians who do not accept new patients, transportation difficulties, or a lack of childcare.  There can also be a lack of provider availability, especially in rural areas where many people must travel further and longer than those who live in urban settings to receive the care they need.

Myth: Not necessarily. Although your doctor can recommend that you have a procedure, diagnostic test, or surgery, your insurance plan may still need to approve it. If denied, you are responsible for the full cost. 

Learn More about Paying for Health Care with Insurance

Partial Fact: While it is true that hospital emergency rooms are required to see all patients, costs can keep people away, increasing the risk of serious illness and death. Two-thirds of bankruptcies in the U.S. are related to health care costs, and up to one-third of COVID-19 deaths have been linked to insurance gaps. 

Myth: If you are a new patient, you may already have to wait months to see a physician. In the U.S., even people with a doctor’s referral may still have to wait four to six months to get an appointment, particularly with a specialist. However, if you have an emergency and need an MRI, the hospital will prioritize your needs and perform the MRI as quickly as possible.

Mostly Fact: Under the ACA, most plans must cover preventive services at no out-of-pocket cost to you. This includes blood pressure screenings, testing for cholesterol and diabetes, mammograms, colonoscopies, vaccines, well-woman visits, and well-child visits.

You may be charged a fee if your doctor is out-of-network, the preventive service is not the primary purpose of your office visit, or if you have a grandfathered health insurance plan.

Myth: Contrary to public belief, even high-income families have trouble affording health care in the U.S. A 2025 survey of 2,539 adults by KFF found that 30% of adults with an annual household income above $90,000 reported it being very or somewhat difficult to afford their health care costs.