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Consumers in the US are overall satisfied with their healthcare and its expense since the Affordable Care Act took effect, but some say the costs are becoming more unaffordable over time, according to the Patients' Perspectives on Health Care survey from National Public Radio, the Robert Wood Johnson Foundation and the Harvard TH Chan School of Public Health.

The research includes information from consumers in Florida, Kansas, New Jersey, Ohio, Oregon, Texas and Wisconsin to represent a diverse selection of states with and without Medicaid expansion under the Affordable Care Act.

"When it comes to healthcare costs, most US adults believe their personal costs are reasonable, if getting costlier over time. Most adults in the US also say healthcare costs are a major problem in their state and more than half believe state costs have increased in the past two years," according to the research report. "In terms of health insurance costs, more than a third of US adults believe their health insurance co-pay, deductible and premium costs have increased in the past two years, while only about one in six say the same of their benefits."

Sixty percent of consumers surveyed said their personal costs for healthcare are reasonable, while 29 percent report their costs are unreasonable, according to the report.

Healthcare costs also cause other financial problems for consumers, according to their survey responses.

Twenty-six percent of adults in the US said healthcare costs led to a "serious financial problem" on an individual basis or for their family.

Among those adults, 23 percent said they have credit card debt that may be difficult to pay off as a result of their medical bills.

Additionally, as a result of medical bills, forty-four percent of survey respondents said they had to set up a payment plan with a healthcare provider; 42 percent said they spent all or most of their personal savings; 39 percent said they were contacted by debt collectors; 27 percent said they were unable to pay for basic necessities; 19 percent said they took out a loan that may be difficult to pay back; and 7 percent said they declared bankruptcy.

Overall, 52 percent of adults in the US report healthcare costs are a "major problem" where they live, compared to 16 percent who say costs are a minor problem, according to the report.

"Most adults in the US also say healthcare costs are a major problem in their state and more than half believe state costs have increased in the past two years," according to the report. "In terms of health insurance costs, more than a third of US adults believe their health insurance co-pay, deductible and premium costs have increased in the past two years, while only about one in six say the same of their benefits."

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