During the previous decade, millions of Americans, regardless of whether they have insurance or not, found it increasingly more difficult to find — or afford — seeing the doctor or dentist, according to a new study from the folks at the Urban Institute.

The study looked at changes in three areas between 2000 and 2010: People who has unmet medical needs because of financial reasons; people who had gone to the dentist; and people who had made a routine checkup with their doctor.

Only one state, West Virginia, and the District of Columbia did not see a significant negative change in any of the three areas. However, that result isn’t necessarily reason for West Virginia to celebrate, as that state already had the highest rate (20.9%) of people whose medical needs went unmet for financial reasons in 2000.

A handful of states, including Georgia, Massachusetts, Minnesota and Virginia, each only saw significant negative changes in one category, while all remaining states had at least two. Those states in dark blue on the above map experienced negative changes in all three categories.

Overall, the number of people in America with unmet needs for financial reasons went up by 6% to 18.7% of the total adult population between the ages of 19-64. Meanwhile, 5.1% fewer people in this age group were getting routine check-ups and 3.9% fewer had seen the dentist for any reason.

One of the more startling results of the study is the number of people with private insurance who still mentioned being unable to see a doctor or get their health care needs met due to financial reasons. According to the study, that number doubled from 5% to 10% in the last decade. Meanwhile, the number of privately insured individuals who delayed seeing the doctor jumped from 4% to 7%.

You can check out the entire report HERE.

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