PCA Deep Dive: Covered but Not Accessible. The Chiropractic Copay Crisis in Pennsylvania

This episode argues that rising deductibles, copays, visit caps, and administrative barriers are pricing patients out of conservative musculoskeletal care, reshaping treatment choices, and increasing downstream costs. Citing the RAND Health Insurance Experiment, it notes chiropractic use drops about 50% with 25%+ cost sharing and that chiropractic demand is more price-sensitive than general medical care. Studies on high-deductible health plans show patients reduce spending largely by skipping care, disproportionately harming lower-wage workers. In contrast,e a Johns Hopkins study links higher out-of-pocket costs to reduced non-pharmacologic care without reducing opioid use. Evidence shows that removing copays reduces downstream physicia ...