New Futures has partnered with the Health Care Value Hub at Altarum to conduct the New Hampshire Consumer Healthcare Experience State Survey (CHESS). More than 1,300 Granite Staters participated in the survey, which centered on access to health care in New Hampshire, and the results are clear: Granite Staters are struggling to afford health care; they are burdened by health care costs; and they are delaying care due to cost.
71% of survey respondents experienced health care affordability burdens in the past year.
Like many Americans, New Hampshire adults are experiencing hardship due to high health care costs: 71% of survey respondents reported experiencing one or more of the following affordability burdens in the past 12 months:
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Being uninsured due to high costs: almost half (47%) of uninsured respondents cited high costs as the main reason
for going without health insurance, far exceeding other reasons like "don't need it" and "don't know how to get it."
- 49% of those without dental insurance and 41% of those without vision insurance cited cost as the main reason for not having coverage.
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Delaying or going without health care due to cost: more than two-thirds (69%) of all respondents reported delaying or going without
health care during the prior 12 months due to cost.
- 32% skipped needed dental care
- 29% delayed going to the doctor or having a procedure done
- 29% skipped a recommended medical test or treatment
- 25% cut pills in half, skipped doses of medicine, or did not fill a prescription
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Struggling to pay medical bills: Many respondents were able to get the care they needed but experienced cost burden due to the
resulting medical bill(s). More than 41% of respondents reported experiencing one or more of these struggles to pay their medical bills:
- 17% were contacted by a collections agency
- 14% used up all or most of their savings
- 13% were unable to pay for basic necessities like food, heat, or housing
- 13% racked up large amounts of credit card debt
Equity
More respondents of color reported experiencing one or more health care affordability burdens in the past year compared to white respondents: 33% of respondents of color skipped needed medical care due to distrust of or feeling disrespected by health care providers, compared to 19% of white respondents.
People with disabilities and members of their households were also more likely to ration medication, delay or go without care, or find medical bills burdensome due to cost than those who did not have a disability or live with someone who does.
- More than half (53%) of survey respondents reported being somewhat or very worried about affording the cost of their prescription drugs. Concerns over
cost span across economic status, with at least 47% of respondents in each income group reporting being somewhat or very worried.
- Nearly two-thirds (62%) of respondents in households earning between $75,000-$100,000 reported worried about prescription drug costs.
- 80% of respondents believe drug companies charge too much money, while 76% believe insurance companies charge too much.
- Considering the challenges respondents reported regarding prescription drug affordability, it is not surprising that Granite Staters are generally dissatisfied with the health care system. 78% of respondents agreed that the United States health care system needs to change.
Prescription Drug
Affordability Solutions
New Hampshire respondents endorsed several prescription drug-related strategies:
- 92% support capping out-of-pocket costs for life-saving medications;
- 88% support prohibiting drug companies from charging more in the U.S. than abroad.
- Limited knowledge of health care costs can hinder consumers' ability to budget for care, which can be especially detrimental to the underinsured and uninsured. Fewer than half of survey respondents (48%) feel confident in their ability to find the cost of a procedure in advance. Nearly 1 in 4 people who did not search for cost before a procedure reported they did not know where to look.
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32% of respondents received a surprise medical bill in the past year.
- Among these respondents, those who purchased their own insurance (through the Marketplace) most frequently reported receiving a surprise medical bill (42%), followed by respondents with employer-sponsored health insurance (34%).
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More than 2 in 5 took more than one step in their attempt to resolve their unexpected bill.
- 49% contacted their health plan
- 44% contacted their provider
- 17% paid the bill without disputing it
- 10% filed an insurance appeal
- 21% report their billing issue is still unresolved
Have you received an unexpected medical bill? Tell us about the experience.
Hospital Costs
More than one in three respondents (36%) reported that they were aware of a hospital merger or acquisition in their community. Of those, 17% reported that they or a family member were unable to access their preferred health care organization because of a merger that made their preferred organization out-of network.
By far and away, New Hampshire respondents see the government as the key stakeholder that needs to act to address health system problems. Addressing health care problems is one of the top priorities that respondents want their elected officials to work on. When asked about the top health care priorities the government should work on, the top responses were:
- Address high health care costs, including prescription drugs (54%)
- Preserve consumer protections preventing people from being denied coverage or charged more for having a pre-existing medical condition (36%)
- Improve Medicare, coverage for seniors and those with serious disabilities (34%)
- Get health insurance to those who cannot afford coverage (29%)
