WEDNESDAY, March 7 (HealthDay News) -- One-third of Americans are in families that are having trouble paying for health care, a government report released Wednesday shows.

Data for the first six months of 2011 found that one in five families has difficulty paying medical bills, one in four pays bills over time and one in 10 can't pay medical bills at all, according to the U.S. Centers for Disease Control and Prevention.

"There are families in this country that are experiencing a financial burden of medical care, and the chance of being in a family experiencing a financial burden of medical care decreases with age," said lead report author Robin Cohen, a statistician in CDC's National Center for Health Statistics.

Insurance, public or private, frequently determines whether families can pay their health care expenses, Cohen noted.

"But even among people with private insurance, about 16 percent had trouble paying medical bills and 6 percent couldn't pay at all," Cohen said.

People over 65 with private health insurance are least likely to be financially burdened by medical care, while people without insurance have the highest burden, she said.

Race was another factor linked to financial burden. About 10 percent of blacks and 7 percent of Hispanics had bills they couldn't pay compared with less than 3 percent of whites.

Other highlights of the report, released March 7, include:

• Almost 24 percent of children under 18 years were in families having difficulty paying medical bills compared with 21 percent of 18- to 64-year olds, 10 percent of people 65 to 74, and 7 percent of those aged 75 and over.
• Poor or near-poor people under 65 were more likely to live in families having problems paying medical bills or to have medical bills they couldn't pay at all.
• More than one in five poor or near-poor people under 65 lived in families that had medical bills they couldn't pay.
• Those 65 and over who were poor or near poor were more than three times as likely as people who were not poor to live in families that struggled to pay medical bills in the past year.

Sara Collins, vice president for affordable health insurance at the Commonwealth Fund in New York City, said that "this is consistent with the trends we are seeing."

The number of people without health insurance, now some 50 million, has increased along with rapidly rising health care costs, she said.

In addition, many people have high deductibles and co-pays and skimpy coverage, Collins said.

"This underscores the reason we need health care reform," she said. "The coverage expansions will be critical in terms of insuring people who don't have health insurance, and helping to make health care affordable."

People without health insurance are likely to put off care until they are very ill, Collins said.

"We know that people who don't have health insurance get care at about 50 percent of the rate as people with health insurance," she said. "So, if you don't have health insurance you are going to delay care."

Sixty percent of people without insurance delay or avoid going to the doctor when they are sick because of costs, she added.

More information

For more about health insurance, visit the Commonwealth Fund.