Nationally, consumer worry about healthcare affordability has been well documented, but now—for the first time—a new survey looks specifically at how affordability concerns and ideas for action play out in Ohio.
Like many Americans, Ohio residents currently experience hardship due to high healthcare costs. All told, 53% of Ohio adults experienced one or more of the following healthcare affordability burdens in the prior 12 months:
1) Being Uninsured Due to High Premium Costs
2) Delaying or Forgoing Healthcare Due to Cost
Two out of five (43%) Ohio 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 possible barriers like transportation, difficulty getting an appointment, and lack of childcare.
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 Ohio adults seek these services—or, in the case of dental, perhaps lower rates of coverage for these services.
3) Struggling to Pay Medical Bills
In some cases, Ohioans got the care they needed but struggled to pay the resulting bill. More than one-third (35%) of Ohio adults experienced one or more of these struggles to pay their medical bills:
In even greater numbers, Ohio adults worry about affording healthcare in the future. Overall, three out of four (78%) reported being “worried” or “very worried” about affording some aspect of healthcare in the future, including:
In addition, more than half (60%) of respondents were “worried” or “very worried” about not being able to afford health insurance in the future. The greatest concern was among those that buy private health coverage or have Medicaid—about three quarters of those adults were worried (see Figure 1). Moreover, many are worried about losing their coverage, with Medicaid recipients being the most worried.
Worries about affording healthcare go far up the income ladder. While lower-income households (less than $50K/year) have the highest levels of worry, more than half of high-income households (more than $100K/year) have healthcare affordability worries (see Table 1).
Lower-income households (less than $50K/year) reported the greatest healthcare burdens during the past 12 months but these burdens remain high for the middle income group: avoiding needed care and/or struggling to pay their medical bills (See Figures 2 and 3).
In light of these healthcare affordability concerns, it is not surprising that Ohio residents were extremely dissatisfied with the health system. Statewide:
The survey asked about both personal and governmental actions to address healthcare system problems.
Ohioans see a role for themselves in addressing healthcare affordability. When asked to rank the three personal actions that would be most effective in addressing the affordability of healthcare (out of ten options), top vote getters were:
Respondents also reported specific actions they have already taken, like researching the cost of a drug beforehand (58%), as well as action they are willing to take, such as switching from a brand to a generic when that is an option (81%).
But far and away, Ohio residents see government as the key stakeholder that needs to act to address health system problems. Moreover, addressing healthcare problems trumps other issues that Ohioans 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, top vote getters were:
Of more than 20 options, those cited most frequently as being a “major reason” for high healthcare costs were:
When it comes to tackling costs and other consumer problems, respondents endorsed a number of strategies:
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 addressing this consumer burden a top priority. Annual surveys can help assess whether or not progress is being made in the eyes of the consumers.
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 Ohio. The survey was conducted from March 21 - March 28, 2019 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 982 cases for analysis with sample balancing occurring in age, gender and income to be demographically representative of Ohio. After those exclusions, the demographic composition of respondents is as follows.