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Nationally, consumer worry about healthcare affordability is well documented but now—for the first time—a new survey reveals how affordability concerns and ideas for action play out in Minnesota.1
A survey of more than 930 Minnesota adults conducted from Dec. 20, 2018 to Jan. 2, 2019, found that:
Like many Americans, Minnesota residents currently experience hardship due to high healthcare costs. All told, 47% of Minnesota adults experienced one or more of the following healthcare affordability burdens in the prior 12 months.
1.) Being Uninsured Due to High Premium Costs
43% of uninsured adults cited “too expensive” as the major reason for not having coverage, far exceeding reasons like “don’t need it,” “don’t know how to get it” and other reasons.
2.) Delaying or Foregoing Healthcare Due to Cost
40% of Minnesota adults who needed healthcare during the year encountered one or more cost-related barriers to getting that care. In descending order of frequency, they reported:
Moreover, cost was by far the most frequently cited reason for not getting needed medical care, exceeding a host of other barriers, including transportation, difficulty getting an appointment, lack of childcare and other reasons.
Of the various types of medical bills, the ones most frequently associated with an affordability barrier were doctor bills, dental bills and prescription drugs, likely reflecting the frequency with which Minnesota adults seek these services—or, in the case of dental, lower rates of coverage for these services.
3.) Struggling to Pay Medical Bills
More than one-quarter (27%) of Minnesota adults experienced one or more of these struggles to pay their medical bill:
Minnesota adults worry about affording healthcare in the future in numbers that exceed the number currently experiencing a healthcare affordability burden. Overall, more than three-fourths (79%) reported being “worried” or “very worried” about affording some aspect of healthcare, including:
In addition, respondents were “worried” or “very worried” about not being able to afford health insurance in the future (65%). The greatest concern was among those that buy private health coverage or have Medicaid (Minnesota Care or Medical Assistance)—nearly three quarters of those adults were worried (see Figure 1). In addition, more than half of Medicaid recipients were worried about losing their coverage. Veterans, or those with TRICARE, experience lower levels of worry about affording health insurance.
Families with household incomes of less than $50,000 reported starkly higher levels of healthcare affordability burdens (see Figure 2) and worry (see Table 1). Surprisingly, the data also show affordability burdens and worry affect families quite far up the income ladder. As a reminder, median household income in Minnesota was $65,699 in 2016.2
In light of these healthcare affordability concerns, it is not surprising that Minnesota residents were extremely dissatisfied with the health system. Statewide:
The survey asked about both personal and governmental actions to address healthcare system problems.
Minnesota residents do see a role for themselves when asked about personal actions that could address healthcare affordability. When asked to rank the top three personal actions, out of ten options, that would be most effective in addressing the affordability of healthcare, top vote getters were:
Respondents also report specific actions they are willing to take, such as:
But far and away Minnesota residents see government as the key stakeholder that needs to act to address health system problems. Moreover, addressing healthcare problems trumps other issues that Minnesota residents want their elected representatives to work on.
At the beginning of the survey, respondents were asked what issues the government should address in the upcoming year, healthcare was the most frequently cited issue, far exceeding the other eight options. The top vote getters were:
When asked about the top three healthcare priorities the government should work on, the top vote getters were:
Of more than 20 options, the options cited most frequently as being a “major reason” for high healthcare costs were:
When it comes to tackling costs and other fixes, respondents endorsed a number of strategies, including these top vote getters:
Support for Action Across Party Lines
What is remarkable about the findings is high support for change regardless of the respondent’s political affiliation (Table 2).
The high burden of healthcare affordability, along with high levels of support for change, suggest that elected leaders and other stakeholders need to make this consumer burden at top priority. Annual surveys can help assess whether or not progress is being made.
1. For other survey results, including Minnesota residents’ concerns about prescription drug costs and regional reports go to https://www.healthcarevaluehub.org/Minnesota-2019-Healthcare-Survey.
2. Guzman, Gloria, Household Income: 2016, American Community Survey Briefs, U.S. Census Bureau (September 2017). https://www.census.gov/content/dam/Census/library/publications/2017/acs/acsbr16-02.pdf
Altarum’s Consumer Healthcare Experience State Survey (CHESS) is designed to elicit respondents’ unbiased views on a wide range of health system issues, including confidence using the health system, financial burden, and views on fixes that might be needed.
The survey used a web panel from SSI Research Now containing a demographically balanced sample of approximately 1,000 respondents who live in Minnesota. The survey was conducted only in English and restricted to adults ages 18 and older. Respondents who finished the survey in less than half the median time were excluded from the final sample, leaving 934 cases for analysis with sample balancing occurring in age, gender and income to be demographically representative of Minnesota. After those exclusions, the demographic composition of respondents is as follows.