 This study examined the effects of the COVID-19 pandemic on the proportion of people experiencing out-of-pocket expenses and the amount of money spent on these expenses. It also looked at whether having health insurance affected this outcome. The results showed that the proportion of people experiencing out-of-pocket expenses decreased in both those with and without health insurance, while the amount of money spent on these expenses increased in both groups. Additionally, the study did not find any evidence that health insurance reduced the amount of money spent on out-of-pocket expenses. This article was authored by Akram Hernandez-Vazquez, Carlos Rojas Roque, Antonio Baronecki Apulash, and others.