One in five Americans with health insurance has had problems paying for medical expenses, according to a new survey.

While the number of people with health insurance continues to increase in the U.S., people grappling with their country’s complex healthcare system are cutting back on household expenses, working more hours and depleting their savings to pay for healthcare.

This challenge is felt more deeply by the uninsured, 53% of whom face problems with medical bills, according to the Kaiser Family Foundation and New York Times survey released on Tuesday.

The survey gathered information from more than 2,500 people aged 18 to 64 who were asked whether they were able to pay their medical bills in the past 12 months. The results included testimonies from the people surveyed.

One woman who had not been able to pay her medical bill said that she had a $636 ultrasound before miscarrying her baby at 10 and a half weeks.

“I was eligible for pregnancy-related Medicaid, but it wasn’t billed right and a year and a half later I got the bill,” she wrote. “I am still trying to get it straightened out.”

Even the insured can face out-of-pocket costs or will have to pay for out-of-network providers and services. Survey respondents said their bills were for services including doctors visits, prescription drugs and emergency room visits.

For 66% of people who had problems paying their medical bills, it was the result of a one-time or short-term medical expense like an accident or single hospital stay.

“I had a tooth that went bad and had to have it pulled,” another respondent said. “I now need another tooth in its place. The dentist wants all the money for the procedure up front. I do not have thousands of dollars to give.”

About six in 10 people said they had to draw on most or all of their savings because of the burden of medical expenses.

The most common solution was to cut back on major household purchases or delay vacations. More than 70% of people cut spending on food, clothing and household items and 41% took on a new job or worked more hours at their job.

Some respondents however, said they had to take more extreme measures.

“Sold everything we could spare,” said one person. “I am losing my house,” said another.

Originally published by The Guardian