Consumers frustrated with health insurance coverage, costs

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Americans worry about insurance coverage costs and would like to see more solutions around transparency and out-of-pockets costs from healthcare institutions. That's according to a new PhRMA/Ipsos poll, which uncovered some frustrations over paying for and navigating the healthcare system.

Many frustrations with healthcare hinge on inadequate health insurance coverage, the confusion with navigating insurance barriers to access, and the unexpected expenses and coverage issues patients experience.

Conducted among 2,510 American adults, the poll found a bipartisan supermajority (87%) of Americans feel politicians have lost touch with what the public needs from their healthcare. 

In line with how the public ranks healthcare issues – with "health insurance costs and coverage" topping the list of priorities, only behind the "coronavirus pandemic" – 86% of Americans agree that Congress should focus on cracking down on abusive insurance practices that make it harder for people to get the care they need. 

On that, there's agreement across party lines; 92% of Democratic and 84% of Republican registered voters agree.

Relatedly, when given the choice between two options, Americans would rather see Congress focus more on reducing the overall costs of coverage, such as premiums, deductibles and copays (71%), than reducing the costs of prescription drugs (29%).

WHAT'S THE IMPACT?

When navigating the healthcare system, overcoming insurance coverage barriers, the confusion of insurance coverage, the costs of care and the lack of transparency are some of the biggest obstacles for Americans, numbers showed.

In the past year, 43% of people who take prescription medications or their families have faced at least one insurance barrier to their care. These experiences range from waiting for an insurer to approve a medicine their doctor prescribed – prior authorization – to the insurer requiring a patient to try a different medicine or not covering a doctor-prescribed medicine at all. This is in the context of 89% who say taking their medications helps them stay healthy.

Thirty-nine percent report worrying about how to pay if they or their family need treatment. Thirty-one percent have avoided going to the doctor because of the cost.

More than two in five Americans (43%) report that they had a difficult time understanding or navigating their health insurance.

Notably, consumers with private insurance are among the most likely to agree that health insurers should publicly share any record they have of denying claims to a group of people or patients with a particular disease (87%) and disclose how often they deny doctor-recommended care (82%). Additionally, 78% of privately insured consumers agree that insurers should share the savings they negotiate.

THE LARGER TREND

When asked to pick the top two ideas that would create the most positive personal impact on out-of-pocket costs and affordability, one in three (33%) believe that placing a cap on the amount health insurers can make patients pay for their deductibles, copays and other out-of-pocket costs would create a positive impact for them personally. 

Here, Democratic registered voters (40%) are more likely to see a positive personal impact from this approach than Republican (31%) or independent (34%) registered voters.

Other ideas that people feel would benefit them personally include giving insurers more incentives to keep the costs of health plans manageable for people who are sick and taking prescription medication (17%), and requiring health insurance companies to be more transparent about which medicines are covered and what patients will pay out-of-pocket for prescription medicines (16%).
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com