Americans are increasingly being left high and dry when it comes to health and medical insurance, caught in a pincer movement of employer-sponsored programmes being cut back and individual policies becoming way too expensive to afford.
A study by healthcare foundation the Commonwealth Fund has found that the vast majority of adult Americans who try to buy individual medical insurance are unable to because of prohibitive costs or because they get turned down.
Of 1,878 working age adults surveyed, 89 per cent who had sought individual coverage said they had never bought a plan.
And more than half Ė 58 per cent Ė said they had found it very difficult or impossible to find affordable coverage.
Some 21 per cent said they were turned down or charged more because of a pre-existing condition or had been offered plans that excluded coverage of their pre-existing conditions.
In a climate where U.S employers are increasingly looking to curb the cost of their own healthcare programmes, this is creating a significant problem, argued the Commonwealth Fund.
Soaring medical and insurance costs had prompted many business either to scale back coverage or pass on more of the premiums to their employees, it added.
"More workers and their families are losing employer-sponsored health insurance," said Sara Collins, lead author of the report.
"Although the individual market is a last resort for those shut out of employer-sponsored coverage, it is by no means a safe or secure haven for everyone," she added.