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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 Utah.
A survey of more than 1,000 Utah adults conducted from August 28 to September 14, 2018, found that:
Like many Americans, Utah residents currently experience hardship due to high healthcare costs. All told, 60% of Utah adults experienced one or more of the following healthcare affordability burdens in the prior 12 months.
1.) Being Uninsured Due to High Premium Costs
58% 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
More than half (53%) of Utah 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 like 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 Utah adults seek these services—or, in the case of dental, lower rates of coverage for these services.
3.) Struggling to Pay Medical Bills
One-third (33%) of Utah adults experienced one or more of these struggles to pay their medical bill:
Utah adults worry about affording healthcare in the future in numbers that exceed the number currently experiencing a healthcare affordability burden. Overall, more than four out of five (85%) 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 (69%). The greatest concern was among those that buy private health coverage or have Medicaid—almost three quarters of adults were worried (see Figure 1). In addition, more than half of Medicaid recipients were worried about losing their coverage.
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 Utah was $65,977 in 2016.1
In light of these healthcare affordability concerns, it is not surprising that Utah residents were extremely dissatisfied with the health system. Statewide:
Just 26% agreed or strongly agreed with the statement “We have a great healthcare system in the U.S.,”
While 77% agreed or strongly agreed “the system needs to change.”
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 health costs and other fixes, respondents endorsed a number of strategies, including these top vote getters:
What is remarkable about the findings is high support for change regardless of the respondent’s political affiliation (see Table 2).
While Utah residents are united in calling for a role for government in addressing high healthcare costs, they also see a role for themselves:
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 need a top priority. Annual surveys can help assess whether or not progress is being made.
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 Utah. 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 1,080 cases for analysis with weighting occurring in age, gender and income to be demographically representative of Utah. After those exclusions, the demographic composition of respondents in found in the table below.