WASHINGTON — More than 1 in 4 adults who bought insurance for themselves or their families last year had to skip needed medical care because they couldn’t afford it, according to study released Thursday by Families USA, a consumer health group.

Some signed up for coverage on the new health insurance exchanges under the Affordable Care Act and received financial assistance to help pay their premiums and some of their out-of-pocket costs. Others bought their plans directly from insurance companies.

Even with the gains under the health-care law, 25.2 percent of adults who bought insurance on their own last year said they went without medical tests or treatments, prescription drugs or doctor visits because of cost. Because most adults who buy insurance on their own do not have dental care as part of their health coverage, the ability to see a dentist was not included in the main part of the report.

But when dental care is added to the mix, it becomes the most common type of care that adults skip because of its cost.

Hardest hit were lower to middle-income adults. That’s someone who earned from $16,200 to $29,199 last year, or a family of three earning from $27,400 to $49,499. Almost one out of three of these adults said they went without medical care because of high out-of-pocket costs.

The main reason: health plans with high deductibles. (A deductible is what consumers owe for services before their insurance plan begins to pay.) The report defines high deductibles as $1,500 or more per person.

More than half of adults had deductibles of $1,500 or more and 30 percent had deductibles of $3,000 or more.

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