While it has dropped in the rankings of American’s top public policy concerns, health care costs and access remain a significant issue for most people, as reflected in a recent survey. (APNORC Report) The survey covered about 1000 consumers aged 18 to 64 who had private insurance, about 82% of whom received it from their employer and the rest on the insurance exchanges. A primary topic of the survey related to the increasing percentage of people in high-deductible plans, which impose substantial cost-sharing on patients. About 52% of respondents said they would pay a higher premium to get lower deductibles and copays and 40% said they would pay higher cost-sharing to get lower premiums. Across all types of plans, 19% of people didn’t go to the doctor when sick, 18% skip certain preventive care, spend less on other basic needs or use savings, all due to health care costs. The 36% of all respondents who are enrolled in high-deductible plans are even more likely to report these problems, with less than half having confidence in their ability to pay even routine medical costs.
With reform has come significant movement among health plans. For those who have had to change plans, 41% say the new plan costs more and 23% say it is less expensive. Most, 62%, perceive no change in quality of care under their new plan. A large minority, 35%, say the plan they are currently enrolled in was the only option available. For people who had a choice, cost and services covered were the most important factors, followed by whether particular doctors were in the network. And while many consumers don’t like high out-of-pocket costs, 40% said they did not want to be in a plan with narrow networks even if that feature would lower their expenses. Most respondents, 57%, said they were very confident they could pay for routine medical care and another 30% are somewhat confident, but a fourth of people say they aren’t sure they could pay for a major medical problem and only 36% are confident they could pay for such an unexpected health expense. The survey validates the notion that reform has not lessened cost anxiety around health care, indeed may have exacerbated it by pushing more use of high-deductible plans.