Data Brief | No. 27 | February 2019

Twin Cities Region of Minnesota: 45% of Adults Experienced Healthcare Affordability Burdens in the Past Year

Residents of the Twin Cities Region experienced healthcare affordability burdens at rates similar to the other regions of Minnesota. All told, nearly half (45%) of Twin Cities Region adults experienced one or more of the following healthcare affordability burdens in the prior 12 months. 1.) Being Uninsured Due to High Premium Costs 43% of uninsured adults cited “too expensive” as the major reason for not having coverage, far exceeding reasons like “don’t need it” and “don’t know how to get it.”

2.) Delaying or Foregoing Healthcare Due to Cost

Well over one-third (38%) of Twin Cities Region adults who needed healthcare during the year encountered one or more cost-related barriers to getting that care. In descending order of frequency, they reported:

• 30%—Delayed going to the doctor or having a procedure done
• 20%—Avoided going altogether to the doctor or having a procedure done
• 20%—Skipped a recommended medical test or treatment
• 13%—Did not fill a prescription
• 11%—Cut pills in half or skipped doses of medicine
• 9%—Had problems getting mental healthcare

Cost was far and away the most frequently cited reason for not getting needed medical care, exceeding a host of other barriers like transportation, difficulty getting an appointment, lack of childcare and other reasons.

Of the various types of medical bills, the ones most frequently associated with an affordability barrier were dental care, doctor bills and prescription drugs, likely reflecting the frequency with which Twin Cities Region adults seek these services—or, in the case of dental, lower rates of coverage for these services.   

3.) Many Who Received Care Struggle to Pay the Resulting Medical Bill 

Nearly one-quarter (23%) of Twin Cities Region adults experienced one or more of these struggles to pay their medical bills:   

• 9%—Racked up large amounts of credit card debt 
• 8%—Contacted by a collection agency 
• 8%—Used up all or most of their savings 
• 7%—Borrowed money or got a loan or another mortgage on their home 
• 6%—Were unable to pay for basic necessities like food, heat, or housing 
• 5%—Placed on a long-term payment plan

High Levels of Worry About Affording Healthcare in the Future

Residents of the Twin Cities Region also exhibited high levels of worry about affording healthcare in the future. In descending order, respondents were “worried” or “very worried” about: affording nursing home and home care services (66%); costs when elderly (63%); health insurance becoming too expensive (62%); cost of a serious illness or accident (59%); prescription drug costs (49%); and losing health insurance (28%).

Dissatisfaction with the Health System and Support for Change

Twin Cities Region residents were extremely dissatisfied with the health system: Just 27% agreed or strongly agreed with the statement “We have a great healthcare system in the U.S.,” while 83% agreed or strongly agreed “the system needs to change.” 

Respondents see a role for themselves in solving healthcare affordability problems. They reported actions they have already taken, like researching the cost of drug beforehand (37%), as well as future actions—60% believe that taking better care of their personal health is one of the top things they can do personally to address affordability. 

But in far greater numbers they see a role for their elected representatives. The following strategies received support across party lines, including (Total/Republican/Democrat/Neither):

• Authorize the Attorney General to take legal action to prevent price gouging or unfair prescription drug price hikes (92%/87%/96%/90%)
• Require insurers to provide upfront cost estimates to consumers (92%/90%/93%/93%)
• Show what a fair price would be for specific procedures (93%/90%/93%/95%)
• Make it easy to switch insurers if a health plan drops your doctor (94%/93%/95%/95%)

The high burden of healthcare affordability, along with high levels of support for change, suggest that elected leaders and other stakeholders need to make this consumer burden a top priority. Annual surveys can help assess whether or not progress is being made.

Note: For survey methodology and state-wide data, see www.HealthcareValueHub.org/Minnesota-2019-Healthcare-Survey.