Some users of Obamacare are finding the medical care they need to be too expensive to use due to high deductibles and high out-of-pocket costs.

Michelle Harris is one of those people. Harris, a 61-year-old retired waitress in northwest Montana, has arthritis in both shoulders but is doing everything she can to avoid seeing a doctor due to the $4,500 deductible and $338 a month in premiums under her Blue Cross Blue Shield plan.

“It hurts, but we don’t have that kind of money,” Harris said to Bloomberg Politics. “So I deal with it.”

Some insurance plans under Obamacare are designed not to kick in until patients have spent thousands of dollars in out-of-pocket costs, which put many healthcare services out of reach for patients.

Even though the uninsured rate in America is at a record low, a study from the Commonwealth Fund found that four out of 10 adults in Obamacare plans aren’t confident that they can pay their medical bills if they got sick, Bloomberg Politics reported.

“A lot of people are still one catastrophic illness away from really feeling the financial impact of this,” said Jonathan Oberlander, a health policy professor at the University of North Carolina-Chapel Hill. “They’re underinsured, and that means they’re not going to get all the services that they want or that they need.”

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A survey by the Kaiser Family Foundation and the New York Times found that one in five people with insurance said they or someone in their household had difficulty paying medical bills compared to half for those without insurance, Bloomberg Politics reported.

Courtney Shove, a 38-year-old who lives in Memphis works at a small non-profit without health benefits and spends about $267 a month for a Blue Cross Blue Shield plan with a $2,500 deductible.

Next year, the cheapest plan for her will cost about $40 more with a $6,650 deductible.

“When I think about what’s going to come out of my pocket, I’m not happy about it at all,” she said. “I’ve never been without insurance, so I guess I’ll probably just get the cheapest plan and go from there.”