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The latest studies and documentation that out-of-pocket costs are harming working families, hurting American competitiveness, and worsening physician practice. 

High Out-of-Pocket and Deductible Health Plans

More Patients Cite Out-of-Pocket Costs as Care Access Barrier
The number of patients saying out-of-pocket healthcare costs are a care access barrier is the highest it’s been since the start of the COVID-19 pandemic. Three in 10 Americans are citing high out-of-pocket patient costs as a care access barrier, with those patients telling a West Health and Gallup poll that they skipped necessary medical care in the past three months because of financial challenges. The survey of over 6,500 respondents, obtained via email, showed out-of-pocket healthcare costs are a problem even for the richest people. Among those households making more than $120,000 annually, 20 percent said they did not access healthcare in the past three months due to high costs. These figures represent a peak for the nation. The overall rate of cost-related delayed care is the highest it’s been since the start of the COVID-19 pandemic. For the richest households, the rate of cost-related delayed care is 3 percent higher than it was between March and October of 2021.

The Patient Engagement HIT | December 2021

How a Minnesota man who died from soaring insulin prices could change US diabetes care forever
Alec Smith died alone in his room at age 26 because he couldn’t afford life-saving insulin. But the tragedy has sparked a movement that is rattling Big Pharma and forcing politicians to take action. When Nicole Smith-Holt went to confront the bosses of Eli Lilly in May 2018, she had not been an activist for long. 

The Independent | December 2021

44% of Americans Put Off Medical Checkups Because of Cost

The average American spent over $5,000 on medical care in 2021 — a figure that would be much higher if patients pursued all of the care that’s necessary for them. According to a new survey from financial services company Discover, many people are skipping out on fundamental medical care needs (including medication and regular checkups) for fear of the bill. Americans have been shouldering both physical and mental health challenges that have been exacerbated by the pandemic, according to benefits provider LifeWorks' most recent Mental Health Index. According to the Discover survey, 58% of respondents said they've had to cover an unexpected expense as a result of the pandemic. In addition, respondents said they used their emergency savings (29%) and credit cards (13%), paid bills later (16%) or borrowed from loved ones (19%) to cover the costs of emergency expenses. A previous report from HSA platform Lively also showed that the majority have also reduced their health savings contributions in 2021.

Value Penguin | December 2021

Americans with Medical Debt Are More Worried about Making Payments than Getting Better
An annual survey from Discover Personal Loans also finds six in 10 Americans took steps to cover an unexpected expense amid the pandemic. A new survey from Discover Personal Loans revealed 58% of Americans took steps to address an unexpected expense since the beginning of the COVID-19 pandemic.

Stockhouse | December 2021

A Third of U.S. Kids Lack Good and Consistent Health Insurance

The number of underinsured children grew by 2.4 million during the three-year period, bringing the number of kids with inadequate coverage to 23.7 million, according to a paper published in the journal Pediatrics Monday. Researchers from the University of Pittsburgh School of Medicine analyzed data from the annual National Survey of Children's Health and found the increase was mainly driven by increased rates of inadequate private insurance. The authors define "inadequate" insurance as coverage not meeting children's' needs, not allowing patients to see their providers and leaving families with high out-of-pocket expenses.

University of Pittsburgh School of Medicine | December 2021

It shouldn't be this hard to grow old in America
The idea of growing old in America today is becoming more uncertain and even scary, and it shouldn’t be. This is one of the wealthiest nations on earth. While many seniors are fortunate to have adequate retirement income, affordable health care, and the means to live independently after decades of working, millions of others do not. They live on fixed incomes – some near or below poverty level – and struggle to maintain basic retirement and health security.  Many find themselves contending with chronic illnesses and need help with the tasks of daily living, but can’t afford proper care.  Or they are housed in nursing homes which recent history has proven can be substandard, if not outright dangerous.

The Hill | December 2021

In the Years Before the COVID-19 Pandemic, Nearly 13 Million Adults Delayed or Did Not Get Needed Prescription Drugs Because of Costs
More than one-quarter of adults with Medicare (25.4%) and 5.3% of privately insured adults spent more than 1% of their family income on their individual out-of-pocket prescription drug costs. More than 3% of Medicare beneficiaries—and nearly 7% of beneficiaries with unmet prescription drug needs—spent over more than 10% of their family income on prescription drugs. About one-in-ten adults who were uninsured all year (9.5%) or part of the year (11.6%) reported unmet prescription drug needs, compared with 4.9% of Medicare beneficiaries, 3.0% of privately insured adults, and 5.6% of nonelderly adults with Medicaid. For Medicare beneficiaries and privately insured adults, unmet prescription drug needs were most common among women, people with low incomes, and people with multiple chronic health conditions.

Urban Institute | December 2021

Coverage That Kills – Breast Cancer Care Is Undermined By High Deductible Health Plans
There are so many awful things about breast cancer. Here are two of them. (1) Receiving a diagnosis when your cancer is already advanced; (2) Not having enough money to pay for your treatment. Here is an awful thing about high deductible health plans: They delay breast cancer diagnosis and get in the way of proper breast cancer care.  We should all be bothered by high deductible health plans. For starters, the deductibles are often too high. For individual coverage, it’s increasingly common for people to face deductibles of $2,000 or more. For families, deductibles can exceed $6,000. To make matters worse, high deductible plans often burden people with other out-of-pocket. Add in these copays, and a family could face more than $13,000 of out of pocket expenses on top of their insurance premiums.  

Forbes | December 2021

Out-of-pocket costs may play larger role in telehealth visits than in-person care: survey
Out-of-pocket costs may play a larger role in choosing telehealth over in-person visits for those who would otherwise prefer virtual care, a new survey by the RAND Corporation suggests. In a study conducted in March by the nonprofit research organization and published in JAMA Network Open, researchers assessed post-pandemic patient preferences for telehealth versus in-person care. Nearly 67% of respondents said they wanted at least some of their care to be conducted virtually. But when the hypothetical cost of the virtual visit jumped from $10 to $30, nearly 62% of respondents who initially preferred video visits said they’d rather have an in-person visit instead. 

Fierce Healthcare | December 2021

13M people delayed or didn't fill prescription drugs pre-pandemic
An estimated 13 million adults delayed getting or didn't fill prescription drugs prior to the COVID-19 pandemic due to cost, according to a new survey. More than one-quarter of Medicare beneficiaries and 5.3% of privately insured adults spent more than 1% of their household income on their out-of-pocket prescription drug costs, according to the Urban Institute's estimated annual averages of 2018 and 2019 Medicare Expenditure Panel Survey data from nearly 30,000 Americans. 

Modern Healthcare | December 2021

Out-of-Pocket Costs Common With Colonoscopy After Fecal Screen— Study details cost-sharing in the face of legal mandate for screening coverage

Patients needing colonoscopy after a non-invasive, stool-based test (SBT) often paid out of pocket for it, a study showed. One in six older adults who had a colonoscopy in the 6 months after some form of SBT ended up with cost-sharing, including 48% of commercially insured and 78% of Medicare patients in the insurance database claims analysis. Those out-of-pocket costs ranged from $99 to $231, reported Nicole Princic, MS, of IBM Watson Health in Cambridge, Massachusetts, and colleagues in a research letter in JAMA Network Open. 

MedPage Today | December 2021

High-Deductible Health Plans Make the Chronically Ill Pay More for Less
High-deductible health plans (HDHPs) incentivize patients, particularly those with low incomes, to avoid care, because doing so subjects them to the financial burdens insurance was supposed to prevent. However, forgoing care could worsen their disease control and lead to higher expenditures from emergency department visits and hospitalizations. 

University of Chicago Medicine / University of Arizona | January 2020

Many Americans Face Choices: Pay Medical Bills Or Maintain Holiday Cheer

Many American households struggle to pay for medical expenses, forcing some to make difficult decisions. According to the 2021 Aflac Health Care Issues Survey released today, these choices include working more, forgoing medical care, cutting back on holiday spending and more. Even with health insurance, families that experienced COVID-19 and those with children are especially hard hit. With the latest Centers for Disease Control and Prevention data indicating more than 45 million Americans tested positive for COVID-19 since the pandemic began, millions of households may be facing similar financial challenges, especially as the holiday season approaches.

Insurance NewsNet | December 2021

Study: Hospital prices for radiology services 2 to 6 times higher than Medicare rates

A new study indicates that the median commercial negotiated prices for 13 common shoppable hospital radiology services were about two to six times higher than the rates set by Medicare. Researchers at Johns Hopkins University and Michigan State University reviewed data this year from approximately 2,000 U.S. hospitals that disclosed pricing information. Price differences ranged from 2.2 times higher for mammography of both breasts ($289 median commercial price vs. $129 Medicare rate) to 5.9 times higher for a CT scan of the head or brain without contrast ($813 median commercial price vs. $137 Medicare rate).

BenefitsPro | December 2021

5 Tips for Avoiding Surprise Virus Test Bills

Experts worry the Omicron variant could seed a new coronavirus wave. That would probably mean a lot more tests — and, in the U.S., a lot more surprise bills. 

The New York Times | December 2021

Most Consumers’ Healthcare costs exceeded $400 during at least one month for more than a quarter of Americans in 2017, ballooning far above the amount Federal Reserve estimates that most U.S. consumers have saved for surprise expenses
Of the 18 million people studied using the 2017 IBM MarketScan Commercial Claims and Encounters database, researchers found that 83 percent of enrollees paid an average of $954 in out-of-pocket healthcare costs, while 17 percent reported no out-of-pocket healthcare costs.

Modern Healthcare | February 2021

Deductibles for traditional health plans are climbing as the average for single coverage workers increased from $460 in 2007 to $1,153 in 2018 (a 124 percent increase).

Some patients (17 percent of commercially insured patients) can even pay a separate pharmacy deductible for prescription medications in addition to their regular deductible.

Cover My Meds | 2020

Catastrophic Out-of-Pocket Health Care Costs: A Problem Mainly for Middle-Income Americans with Employer Coverage

High deductibles and out-of-pocket maximums in private insurance, combined with exposure to out-of-network bills for physician services, leave many Americans facing very high out-of-pocket costs.

The Commonwealth Fund | April 2020

Annual Out-Of-Pocket Spending Clusters Within Short Time Intervals: Implications For Health Care Affordability

Nearly one-third of people with above-the-median total annual health care spending (plan plus out-of-pocket spending) incurred half of their annual out-of-pocket spending in just one day. 

Health Affairs | February 2021

Enrollment of large-company workers in high-deductible plans reaches a historic high.

Nearly half of large-company workers have moved into high-deductible plans.

Healthcare Financial Management Association | August 2019

Employers Are Scaling Back Their Dependence On High-Deductible Health Plans.

Some employers say that, in a tight labor market, offering a more generous plan with a deductible that’s less than four figures can be an attractive recruitment tool.

Kaiser Health News | October 2019

The cost burden of blood cancer care.

A blood cancer diagnosis means high spending, both by payers and patients. These costs are driven by many factors across the healthcare system including service utilization, insurance coverage, and the use of in-network or out-of-network providers.

The Leukemia & Lymphoma Society / Milliman | October 2018

Kaiser Family Foundation/LA Times Survey Of Adults With Employer-Sponsored Insurance
The survey takes a special look at those in high deductible plans (including those paired with a health savings account or HSA), those with chronic health conditions, and those with lower incomes. 

Kaiser Family Foundation / LA Times | May 2019

Cost-Sharing Obligations, High-Deductible Health Plan Growth, and Shopping for Health CareEnrollees With Skin in the Game

The rapid growth of high-deductible health plans (HDHP) has been driven in part owing to a belief that consumers must share the costs of health care to make good  decisions.

JAMA Internal Medicine | March 2016

Consumers have no money to put any more “skin in the game” of health care.

"[W]hen you look back over the past decade, the cumulative increase is startling. Out-of-pocket costs have increased 100 percent or more in most states since 2003, according to The Commonwealth Fund."

Center for Public Integrity | March 2015

Premium contributions and deductibles in employer plans accounted for 11.5 percent of median household income in 2019, up from 9.1 percent a decade earlier.

Premium contributions and deductibles were 10 percent or more of median income in 37 states in 2019, up from 10 states in 2010. If premiums and deductibles do not fall in 2021, household income lost during the pandemic economic crisis will increase cost burdens for middle-income families.

Commonwealth Fund | November 2020

72-Year-Old Cancer Survivor Has Vaccine Cancelled Over $244 Medical Debt.

Michael Rogan, a 72-year-old cancer patient and resident of Longmont, Colorado said his scheduled appointment to receive his first dose of COVID-19 vaccine was canceled because of his outstanding medical debt of $244.

Newsweek | February 2021

Pennsylvania residents are more worried than ever about health care costs, survey finds.

Half of Pennsylvania residents in a new survey by Pennsylvania Health Access Network and Altarum Healthcare Value Hub struggled with health-care costs in the last year and nearly two-thirds were worried about how they will pay for care in the future.

The Philadelphia Inquirer | February 2021

High out-of-pocket costs contribute to poor access to care and financial hardships for California workers

28 percent of U.S. adults under age 65 with job-based coverage are underinsured, meaning they have insurance, but are subject to high out-of-pocket costs such as deductibles and co-payments.

UC Berkeley Labor Center | December 2019

How Much U.S. Households with Employer Insurance Spend on Premiums and Out-of-Pocket Costs: A State-by-State Look
Faced with rising premiums, U.S. employers are sharing more of their costs with their workers, particularly through higher deductibles, copayments, and coinsurance. Recent research indicates that employer plan premium contributions and out-of-pocket costs, like those for prescription drugs, are eating up an increasing portion of household budgets.

The Commonwealth Fund | May 2019

How Much Do Medicare Beneficiaries Spend Out of Pocket on Health Care?

In 2016, the average person with Medicare coverage spent $5,460 out of their own pocket for health care. This average includes spending by community residents and beneficiaries residing in long-term care facilities who's average out-of-pocket spending on premiums and health care services was $4,519 in 2016. But some groups of beneficiaries spent substantially more than others. 

Kaiser Family Foundation | November 2019

Hospitals’ Covid-19 heroics have them poised for power in the new Washington

In 2016, the average person with Medicare coverage spent $5,460 out of their own pocket for health care. This average includes spending by community residents and beneficiaries residing in long-term care facilities who's average out-of-pocket spending on premiums and health care services was $4,519 in 2016. But some groups of beneficiaries spent substantially more than others. 

Kaiser Family Foundation | November 2019

Comparing Health Care Financial Burden With an Alternative Measure of Unaffordability.

For patients with COPD, enrollment in an HDHP was associated with cost-related barriers to care, financial strain, and more frequent emergency room visits and hospitalizations.

Harvard Medical School / Cambridge Health Alliance | January 2020

Comparing Health Care Financial Burden With an Alternative Measure of Unaffordability.

Health insurance plans with high deductibles increase exposure to health care costs, raising concerns about how the growth in these plans may be impacting both the financial burden of health care expenditures on families and their access to health care.

Journal of Health Care | October 2017

 
 

Medication Costs

Podcast: The complicated web of American drug pricing
Americans spend hundreds of billions on prescription drugs each year. In fact, about $370 billion as of 2019. And employers in charge of healthcare plans paid for about $166 billion of that. It's middleman firms that actually negotiate these drug prices on behalf of employers. But because they keep their data secret, companies have no idea whether they're getting a fair deal on drug prices or not. And an Axios investigation shows these intermediaries are working hard to keep it that way.

Axios | December 2021

Drug prices soared by nearly 4 times the inflation rate in 5 years, House investigation finds
From 2016-20, drugmakers raised the prices of brand name drugs by 36 percent, nearly four times the rate of inflation during that period, according to a report detailing the findings of an investigation by the U.S. House Committee on Oversight and Reform. 

Becker's Hospital Review | December 2021

Copay Use Continues to Increase Amid Pandemic
The use of manufacturer copay coupon programs continued to grow during 2020 and into 2021 amid the COVID-19 pandemic, with adoption rates as high as 80% for certain high-cost specialty medications, according to new data presented at Informa Connect’s 2021 annual Coupon & Copay Forum. “Last year, patients’ out-of-pocket exposure on prescription drugs totaled approximately $91 billion, with copay coupons offsetting $14 billion of that for a total net exposure of $77 billion,” said Chris Dowd, the executive vice president for market and product development with ConnectiveRx, citing data adapted from IQVIA’s “Use of Medicines in the United States” report issued in May 2021.

Special Pharmacy Continuum | December 2021

US drug prices are costing us more than we think
Aduhelm, the first new Alzheimer's drug in 18 years, could easily become the best-selling drug in Medicare, despite its potential massive cost and tremendous uncertainty about whether the drug even works, says Rachel Sachs, the Treiman Professor of Law and nationally renowned expert on drug pricing and health policy. Some experts have claimed that spending on the drug for Medicare patients could end up being higher than the annual budgets for the EPA or NASA, somewhere between $6 billion and $29 billion per year.

Medical X Press | December 2021

Documents reveal the secrecy of America's drug pricing matrix
Americans spent $370 billion on retail prescription drugs in 2019, and employers shouldered about $166 billion of that, according to federal data. Employer drug spending rose by more than 6% in 2019 and by more than 5% in 2018. Those rising costs have prodded companies to look for savings anywhere they can.

Axios | December 2021

Making Health Care "Accessible and Affordable" Isn't the same as Making It Universal and Free 

Centrist Democrats use phrases like “accessible and quality health care” to sound like they support reforming the broken US health care system while avoiding the only genuine reform: removing health care from the market altogether. In promoting the latest phase of his legislative agenda, President Joe Biden recently tweeted the following: Access to quality, affordable health care should be a right in America — not a privilege. My Build Back Better Act will help fulfill that promise by extending tax credits to lower premiums for folks on the Affordable Care Act and lowering prescription drug costs. Notwithstanding its underwhelming second portion (Biden’s statement achieving the climbdown from sweeping moral proclamation to tax credits in a mere two sentences), plenty of well-meaning Democratic partisans probably missed the subtle rhetorical sleight of hand at work in its first.

Jacobin Magazine | December 2021

As Drug Prices Keep Rising, State Lawmakers Propose Tough New Bills to Curb Them

Fed up with a lack of federal action to lower prescription drug costs, state legislators around the country are pushing bills to penalize drug makers for unjustified price hikes and to cap payment at much-lower Canadian levels. These bills, sponsored by both Republicans and Democrats in a half-dozen states, are a response to consumers’ intensified demand for action on drug prices as prospects for solutions from Congress remain highly uncertain. Eighty-seven percent of Americans favor federal action to lower drug prices, making it the public’s second-highest policy priority, according to a survey released by Politico and Harvard University last month. That concern is propelled by the toll of out-of-pocket costs on Medicare beneficiaries, many of whom pay thousands of dollars a year. Studies show many patients don’t take needed drugs because of the cost. 
California Healthline | February 2021

CoverMyMeds: 2020 Medication Access Report

In 2019, patients spent $82 billion out-of-pocket for their medications.  Even with assistance from Medicare, the average 65-year-old couple faces $275,000 in medical bills throughout retirement. Seventeen percent of commercially insured patients pay a separate pharmacy deductible for prescription medications in addition to their regular deductible.  Despite coverage through Medicare, 19 percent of older Americans admit to skipping doses or medical care due to cost. Evidence suggests that prescription abandonment tracks with out-of-pocket costs; as costs escalate beyond $250, up to 69 percent of patients leave their medications at the

CoverMyMeds | 2020

Study: More evidence health care cost-sharing doesn't work

A growing body of research keeps undermining a key tenet of health economics — the belief that requiring patients to pay more out of their own pockets will make them smarter consumers, forcing the health care system to deliver value. Driving the news: Even a seemingly modest increase in out-of-pocket costs will cause many patients to stop taking drugs they need, according to a new working paper from Harvard economist Amitabh Chandra.     Raising Medicare recipients' out-of-pocket costs by just $10 per prescription led to a 23 percent drop in overall drug consumption, and to a 33 percent increase in mortality. And seniors weren’t simply ditching "low-value" drugs. People at high risk for heart attacks or strokes cut back on statins and blood-pressure medications even more than low-risk patients.

Axios | February 2021

The Health Costs of Cost-Sharing

Mortality is traced to cutbacks in life-saving medicines like statins and antihypertensives, for which clinical trials show large mortality benefits. Those at the highest risk of heart attack and stroke, who would benefit the most from statins and antihypertensives, cut back more on these drugs than lower risk patients. Price increases cause 18 percent more patients to fill no drugs, regardless of how many drugs they had been on previously, or their health risks.

National Bureau of Economic Research  | February 2021

Trends in Retail Prices of Brand Name Prescription Drugs Widely Used by Older Americans, 2006 to 2020

Retail prices for widely used brand name prescription drugs increased substantially faster than general inflation in every year from 2006 to 2020. Between 2019 and 2020, retail prices for 260 brand name prescription drugs widely used by older Americans, including Medicare beneficiaries, increased by an average of 2.9 percent. In contrast, the general inflation rate was 1.3 percent over the same period. Brand name drug prices have routinely increased much faster than general inflation over the past 16 years— the entire period during which the AARP Public Policy Institute has been publishing this report series.

American Association of Retired Persons | February 2021

Public Opinion on Prescription Drugs and Their Prices
KFF research has consistently found prescription drug costs to be an important health policy area of public interest and public concern. Below are some key findings on the public’s experience with and perceptions of prescription drugs and their prices.

Kaiser Family Foundation | June 2021

An Opportunity to Lower Drug Costs in the US

"For many in the US, health care is a privilege they simply cannot afford. Soaring prices, insurance coverage limitations, and high deductibles and copays result in out-of-pocket costs that undermine the right to health. Patients delay or forgo care due to these costs, worsening health outcomes. Bills drive millions of people into financial distress, debt, or bankruptcy. And people with low incomes and communities of color are most affected."

Humans Rights Watch | April 2021

Lower Drug Costs Now: Expanding Access to Affordable Health Care

Mortality is traced to cutbacks in life-saving medicines like statins and antihypertensives, for which clinical trials show large mortality benefits. Those at the highest risk of heart attack and stroke, who would benefit the most from statins and antihypertensives, cut back more on these drugs than lower risk patients. Price increases cause 18 percent more patients to fill no drugs, regardless of how many drugs they had been on previously, or their health risks.

American Action Forum | May 2021

Health Inequities and Disparities 

Black Americans in the South carry the largest share of medical debt. Advocates say Medicaid expansion can help
A new report reveals that Black Americans in the South carry the heftiest medical debt burden in the US. The Bloomberg study shows a myriad of ways medical and health care institutions pursue collecting more than $140 billion in US medical debt, which is the leading cause of bankruptcy in the country. According to Bloomberg, Black Americans in the South hold an average of $532 in medical debt. Black Americans are also more than twice as likely to be uninsured than their white counterparts, leading to higher mortality rates. Experts say this is largely due to Republican governors and state legislatures in southern states who continue to block the passing of Medicaid expansion. 

Insider | December 2021

Black Men Die Of Prostate Cancer At Double The Rate Of All Other Races
Thousands of Black men per year – from every socio-economic walk of life and every part of the U. S. – are disparately diagnosed with prostate cancer. Not only is the rate of prostate cancer among Black men higher than Whites, but the chances of Black men dying from it are more than double that of White men and men of other races, according to the National Cancer Institute. Doctors and medical administrators across the nation believe these grossly disparate numbers can be minimized or at least equalized by a therapy called Proton Beam. This is the reason that a list of insurance agencies are currently under fire by cancer advocates across the nation for refusing to cover the cost of proton beam therapy.

The Seattle Medium | December 2021

Health care disparities prevalent among employees at large companies
Employees of large U.S. companies — even those earning high salaries — face health care disparities, while women of color and LGBTQ+ employees face a higher share of unmet basic needs. Those are two key findings from first-of-its-kind research by management consulting firm McKinsey & Company that explored how employers across multiple industries can meet unmet needs and bolster health equity among employees.

BenefitsPro | December 2021

One State’s History of Hospital Debt Lawsuits Reveals Racial Gap
Hospitals sued patients to collect medical bills at an escalating pace over the past two decades in Wisconsin, according to a new analysis, and the suits disproportionately affected Black people. The rate of medical debt collection lawsuits in the state increased by more than a third from 2001 to 2018, researchers from Yale University and Stanford University reported in the journal Health Affairs. Lawsuits that led to wage garnishments also rose. The authors called it the first study of long-term trends in such suits by hospitals. Lawmakers in some states are scrutinizing the methods that health systems use to collect Americans’ estimated $140 billion in past-due medical debt. The analysis found that Wisconsin nonprofit hospitals were more likely to sue than for-profit medical centers. At the same time, hospital systems often benefit from tax breaks for nonprofit status and additional public funds meant to support treatment for patients who struggle to pay. Under pressure from consumer advocates, several states have passed laws to strengthen protections for patients.

Bloomberg | December 2021

Racial and Ethnic Health Disparities Exist in Every State, Report Finds
While racial and ethnic health disparities have and continue to exist, the scope has not been well documented or quantified. Now, a new Commonwealth Fund report is demonstrating just how deep some of these health inequities run. “There’s a historical perspective that plays into why we want to do the report… We know that in every state and nationally, people of color tend to have worse [health] outcomes than White people,” David C. Radley, PhD, MPH, senior scientist at the Commonwealth Fund, told Verywell. “They face experience low quality of care and access barriers that many White people don’t have. It was important to be able to quantify that.”  The report found that racial and ethnic disparities in the healthcare system exist in every U.S. state. How dramatic those disparities are varied. For example, Minnesota ranked third as having the largest disparities between White and Black, Latinx, Hispanic, Asian American and Native Hawaiian/Pacific Islander, and Native American communities (AANHPI). Meanwhile, Mississippi demonstrated the lowest performance for all groups.

Very Well Health | December 2021

As Biden Pushes for Racial Equity in Vaccination, Data Is Lagging

Federal health officials are struggling to gather accurate data on the race and ethnicity of people being vaccinated against the coronavirus, hampering President Biden’s push for racial equity in a pandemic that has taken a disproportionate toll on communities of color. Mr. Biden has repeatedly said racial equity will be at the core of his administration’s coronavirus response. White House officials announced a program to ship doses of vaccine directly to a network of federally funded clinics in underserved areas. “Equity is our North Star here,” Dr. Marcella Nunez-Smith, a Yale professor who has been appointed by Mr. Biden to lead a Covid-19 equity task force, said during a White House virus team briefing. So far, the federal government has gathered race and ethnicity data for just 52 percent of all vaccine recipients, according to a report issued last week by the Centers for Disease Control and Prevention.

The New York Times | February 2021

Pandemic Highlights Vulnerability of California’s Latinx Community

In 2019, patients spent $82 billion out-of-pocket for their medications.  Even with assistance from Medicare, the average 65-year-old couple faces $275,000 in medical bills throughout retirement. Seventeen percent of commercially insured patients pay a separate pharmacy deductible for prescription medications in addition to their regular deductible.  Despite coverage through Medicare, 19 percent of older Americans admit to skipping doses or medical care due to cost. Evidence suggests that prescription abandonment tracks with out-of-pocket costs; as costs escalate beyond $250, up to 69 percent of patients leave their medications at the

California Health Care Foundation | February 2021

High-deductible health plans may increase racial inequities, study finds 

There is also evidence that patients of color face greater barriers to care than others because of high-deductible health plan costs.  For example, in a recent study in JAMA Network Open, Black cancer survivors with a high-deductible plan were more likely to skip medications to save money than white cancer survivors with the same plans (22.8% versus 8%, respectively).

Becker's Hospital Review | June 2020

Among Low-Income Respondents With Diabetes, High-Deductible Versus No-Deductible Insurance Sharply Reduces Medical Service Use
Private insurance with a deductible substantially and problematically reduces medical service use for lower-income insured respondents with diabetes who have an HD; these patients are more likely to report forgoing needed medical services.

American Diabetes Association | February 2017

Vulnerable and Less Vulnerable Women in High-Deductible Health Plans Experienced Delayed Breast Cancer Care

The effects of high-deductible health plans (HDHPs) on breast cancer diagnosis and treatment among vulnerable populations are unknown. We examined time to first breast cancer diagnostic testing, diagnosis, and chemotherapy among a group of women whose employers switched their insurance coverage from health plans with low deductibles ($500 or less) to plans with high deductibles ($1,000 or more) between 2004 and 2014. Primary subgroups of interest comprised 54,403 low-income and 76,776 high-income women continuously enrolled in low-deductible plans for a year and then up to four years in HDHPs. Matched controls had contemporaneous low-deductible enrollment.

Health Affairs | March 2019

Racial/Ethnic And Income-Based Disparities In Health Savings Account Participation Among Privately Insured Adults"

Our findings show a substantial increase in HDHP enrollment across all racial/ethnic and income groups from 2007 to 2018. However, Black, Hispanic, and low-income HDHP enrollees were significantly less likely than their White and higher-income counterparts to participate in HSAs, and these gaps increased over time. This means that the HDHP enrollees most likely to benefit from the potential financial protection of HSAs were the least likely to have them. If these trends persist, racial/ethnic and income-based disparities in cost-related barriers to care may widen."

Health Affairs | November 2020