Healthcare Affordability: Majority of Adults Support Significant Changes to the Health System

Bipartisan consensus exists on ideas to lower out-of-pocket costs.

A patient pays cash for services in a medical office.

This national survey of adults helps illuminate respondents’ experiences with healthcare costs, perceptions of who is to blame, appetite for change, and feelings about a range of policy reforms.

The Issue

Healthcare costs continue to rise putting access to high-quality health services out of reach for too many individuals and families, especially those with lower incomes who are disproportionately people of color.

Key Findings

All of the policy ideas tested achieved a majority of support from a bipartisan group of respondents with several receiving 80 percent or more, including:

- Put limits on what drug companies can charge for specific drugs that save lives or that millions of people use to treat life-long health conditions like diabetes. (89%)

- Prevent drug companies from blocking cheaper generic drugs from being sold in the United States. (86%)

- Put limits on the prices that hospitals can charge for services. (85%)

- Allow the government to negotiate lower drug prices for employers and consumers. (84%)

- Put limits on the prices that doctors can charge for services. (81%)

- Eliminate health insurance deductibles and copayments so that people don't have to pay more to use their health insurance. (80%)

Conclusion

Now more than ever, there is widespread support for policies to lower healthcare costs as consumers continue to make sacrifices such as delaying or forgoing care. Those with lower incomes, who are disproportionately people of color, report feeling the strain of high healthcare costs more than others, illustrating that lowering costs can help advance health equity.

About the National Survey

About the National Survey
About the Survey

The 18-minute survey was conducted online June 25–July 12, 2021 using NORC/AmeriSpeak’s online panel. The base survey is n = 2,555 adults nationwide plus oversamples for totals of:
- N = 689 Black adults
- N = 618 Latinx adults
- N = 476 AAPI adults
- N = 113 adults enrolled in the Marketplace plans
- N = 524 adults enrolled in Medicare
The survey was offered in English and Spanish. The margin of sampling error for total results: + 3.05 percentage points.

State Surveys

Blame for high healthcare costs is shared between government, prescription drug companies and health insurance companies. But when asked, respondents believe the government has the most responsibility to fix these rising costs.

Now more than ever, there is widespread support for policies to lower healthcare costs as consumers continue to make sacrifices such as delaying or forgoing care. Majorities express uncertainty about paying for usual healthcare services and aren’t very confident about paying for costs related to a major illness or injury. Respondents of color report feeling this strain more than others, illustrating that addressing healthcare affordability can help advance health equity.

Majorities in Florida, Colorado, New Mexico and New York are sacrificing care and facing financial hardship. Surveys conducted in these states help illuminate respondents’ experiences with healthcare costs; perceptions of who is to blame; and appetite for a range of policy reforms.

Colorado
Florida
New Mexico
New York

Colorado
Colorado: Key Findings

Nearly 1 in 2 Coloradans say they have put off a recommended medical procedure or treatment because an insurance company denied it, was too unaffordable, or they couldn’t get services where they lived.
- 4 in 10 Coloradans (42%) have appealed or fought a bill.
- 80% of Coloradans agree that someone’s background – income, gender, sex, language they speak, or immigration status – should not make it harder to get quality healthcare. And 61% think that everyone, regardless of immigration status, should be able to get affordable healthcare coverage in the state.
- When asked about specific reforms, majorities support several policies. This includes:
  - hospitals requiring insurance companies to lower the costs for prescription drugs (82%),
  - limiting what hospitals can charge (80%),
  - eliminating or capping deductibles (79%),
  - lowering premiums via tax credits (77%),
  - Medicare-for-all (58%),
  - and expanding Medicaid for immigrants and non-citizens (53%).
About the Survey

The 18-minute survey was conducted by telephone (cell and landline) January 12th to 31st, 2022, using Braun Research, Inc. The survey included n = 872 Coloradans 18 and older and included oversamples of: Black (n = 240) and Latino / Hispanic (n = 201) adults to ensure their views were included.

The margin of sampling error for total results: + 3.3 percentage points.
Florida
Florida: Key Findings
- More than 4 in 10 Floridians (43%) have faced financial hardship as a result of medical bills.
- When asked about who’s to blame for high costs, Floridians say the federal government, health insurance companies, and drug companies share the blame. When asked about who has the most responsibility to fix rising costs, a majority point to the government.
- More than three-quarters of Floridians (79%) agree someone’s gender, sex, language, and immigration status shouldn’t make it harder to get quality healthcare in the U.S.
- When asked about specific healthcare reform, majorities of Floridians support several policies, including:
  - limiting what hospitals can charge for services (84%),
  - expanding Medicaid so more people can qualify (78%),
  - eliminating or capping health insurance deductibles (82%),
  - lowering insurance premiums via tax credits (77%),
  - creating a public health coverage option (74%),
  - and moving to a Medicare-for-all system (62%).
About the Survey

The 18-minute survey was conducted by telephone (cell and landline) January 12th to 27th, 2022, using Braun Research, Inc. The survey included n = 764 Floridians 18 and older and included oversamples of Black (n = 237) and Latino / Hispanic (n = 200) adults to ensure their views were included.

The margin of sampling error for total results: + 3.5 percentage points.
New Mexico
New Mexico: Key Findings
- Most New Mexicans (65%) aren’t very confident they can pay for usual healthcare services. Latino / Hispanic and Black adults are among the most worried about paying for care.
- More than 1 in 2 (56%) New Mexicans have sacrificed medical services in the past two years because of cost.
- 86% of New Mexicans support allowing tax-paying immigrants to purchase insurance for the same costs as other state residents. And, 3 in 4 (75%) support allowing tax-paying immigrants to enroll in the state’s Medicaid program.
- When asked about specific reforms, majorities support several policies. This includes:
  - requiring full cost transparency for medical services and procedures (88%),
  - creating a Prescription Drug Affordability Board (84%),
  - limiting what hospitals can charge for services (82%),
  - eliminating or capping deductibles (81%),
  - opening up Medicaid to every New Mexican who needs it (74%),
  - and a public option (72%).
About the Survey

The 18-minute survey was conducted by telephone (cell and landline) January 12th to February 6th, 2022, using Braun Research, Inc. The survey included n = 824 New Mexicans 18 and older and included oversamples of Black (n = 214) and Latino / Hispanic (n = 282) adults to ensure their views were included.

The margin of sampling error for total results: + 3.4 percentage points.
New York
New York: Key Findings
- 31% of respondents have appealed or questioned a healthcare bill. 1 in 5 (20%) have paid a healthcare bill they thought was wrong out of fear of being sued or harassed for not paying.
- Respondents want help addressing medical bills: 73% want the state to fund an independent consumer assistance program.
- 8 in 10 respondents (82%) agree someone’s gender, sex, language, and immigration status shouldn’t make it harder to get quality healthcare in the U.S.
- When asked about specific reforms, majorities support several policies, this includes:
  - requiring hospitals to disclose prices (84%),
  - limiting what hospitals can charge for services (82%),
  - eliminating or capping health insurance deductibles (82%),
  - lowering premiums via tax credits (82%),
  - creating a public option (80%),
  - and moving to a Medicare-for-all system (65%).
About the Survey

The 18-minute survey was conducted by telephone (cell and landline) January 12th to 27th, 2022, using Braun Research, Inc. The survey included n = 805 New Yorkers 18 and older and included oversamples of Black (n = 255) and Latino / Hispanic (n = 202) adults to ensure their views were included.

The margin of sampling error for total results: + 3.5 percentage points.

Webinar: Perceptions on Healthcare Affordability

In November 2021, the Foundation hosted a webinar to present findings of a survey that illuminates respondents’ experiences with healthcare costs, perceptions of who is to blame, appetite for change, and feelings about a range of policy reforms.

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