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Massachusetts health care — wonky, with a healthy dose of reality

New Report: Learn the Numbers and Meet the People Hurt by High Health Care Costs

New Report: Learn the Numbers and Meet the People Hurt by High Health Care Costs

April 30, 2015

Report - Rising Health Care Cost in MA: What it Means for ConsumersThe Blue Cross Blue Shield Foundation just released a blockbuster report on the impact of high health costs on Massachusetts consumers.

The stark conclusion should have strong policy implications:

Though the Commonwealth leads the nation in health coverage, with 95 percent of Massachusetts adults insured, a significant number of people struggle with the affordability of health care.... [N]early one of five reported problems paying medical bills or reported paying them off over time. People who have low incomes, those who are in poor health or have chronic conditions needing regular care or medication, and those who are only intermittently insured experience even greater difficulties with the high cost of health care.

Massachusetts consumers have many problems due to high health care costs

The report, prepared by Carol Gyurina, Jennifer Rosinski and Robert Seifert of UMass Medical School, is full of compelling statisical analysis to back up its findings. The findings are based on the Foundation's Massachusetts Health Reform Survey. Looking at the annual surveys, they found that:

  1. Consumer health care costs are increasing much faster than incomes. From 2006 to 2012, median incomes went up 15%, while consumer-paid health care spending went up 38%.
  2. High deductible plans are growing in Massachusetts - now around 45 percent of those with individual plans, and 38 percent of those with coverage through a small (under 50 workers) employer. As a result, nearly one in ten adults spent over 10 percent of their income on out-of-pocket health care costs.
  3. And so, an increasing number of people in Massachusetts are avoiding needed health care due to cost. Around one in seven of all adults who were covered all year report avoiding needed care because of the cost. The most frequently avoided services due to costs are dental care and prescription drugs. The problem is worse for younger adults, parents, people who identify themselves as Hispanic or Latino, and those buying coverage on their own.

In addition to the analytic conclusions, the report ends with four moving, personal stories detailing how Bay Staters are responding to these high out-of-pocket costs. HCFA assisted the UMass team in finding the people profiled, using our HelpLine and other contacts to locate them. The stories personalize the difficult real-world choices they face and make them relatable and real. So, beyond the detailed charts, in the report you will meet:

  1. Katharine Jackson, from Plymouth, who came down with a rare inflammatory disease and ended up with some $10,000 in medical bills just for doctors' visits and tests, despite having employer-sponsored health care insurance.
  2. Ronald Boisvert, from Newbury, whose in-network doctor sent a biopsy to an out-of-network lab, resulting in a bill of $1,900. This was on top of co-pay charges for surgery, imaging and consultations he received as part of his cancer treatment.
  3. Marisabel Melendez, a Lawrence mother with employer coverage, whose high cost of caring for her diabetes led her to tempt malnutrition in an attempt to lessen her need for diabetes drugs. Later, she  moved in with her mother to save enough rent money to pay her copays.
  4. Stephen Slaten, from Worcester, who started taking just half the prescribed dose of his Crohn's disease medication when he became unemployed. The result was a major flare-up, causing him to need more medication and tests.

HCFA has long been concerned with the impact of high out-of-pocket health care costs on Massachusetts consumers. Our "No-Copay" bill (S. 606 / H. 984, An Act to keep people healthy by removing barriers to cost-effective care) would eliminate cost-sharing for cost-effective preventive care for people chronic disease. This report should spur all of us to action on the issue of ever-growing health care costs.

     - Brian Rosman