Survey results show a “broken” health care system in Maine

Profit-centered. Unaffordable. Confusing. This is how Mainers describe our health care system.

When even people who are insured describe rationing medication, forgoing treatment, and thousands of dollars of medical debt, it’s clear our health care system isn’t healthy. A new survey from Consumers for Affordable Health Care finds that Mainers are suffering from high prices, unaffordable insurance plans, and a general inability to access affordable care. Despite improvements in recent years including the passage of the federal Affordable Care Act, the expansion of MaineCare eligibility, and several new state laws to improve affordability and access, most Mainers aren’t seeing the benefit. When asked whether “the health care system in Maine is broken,” three quarters of adults either somewhat or strongly agreed. Clearly, much more needs to be done.

Cost remains the biggest obstacle to health care

Health care costs take a heavy financial toll on Mainers and their families. Six in ten Mainers experienced at least one financial hardship due to medical expenses — including using up retirement savings, taking on debt, and struggling to pay for necessities like food and heat.

Even though 92 percent of respondents had health insurance at the time of the survey, more than two-thirds said, “just one major medical event or illness could cause a financial disaster for me, even if I were able to keep my job.”

The inability of insured Mainers to cope with health care costs shows just how inadequately some insurance plans cover expenses. More than half of respondents with commercial insurance found it “somewhat” or “very difficult” to afford their deductibles. Nearly half said premiums, coinsurance, or copayments were difficult to afford. Premium and out of pocket costs are the main reasons people without health insurance were uninsured.

Adding to these strains, most Mainers don’t even know how much they will be charged for health care. Almost half of survey respondents said they received a medical bill that was much higher than expected in the last two years, and an even larger number reported receiving a medical bill for something they thought was covered by insurance.

As a result, medical debt remains a substantial burden for Mainers. More than one in three respondents (38 percent) currently have medical debt and two thirds of those with debt have an insurance plan. The average amount of debt indicated was just under $5,000 and had been carried an average of 34 months.

Mainers are taking extraordinary measures

To deal with high costs of medical services, two thirds of respondents report taking measures that include delaying doctor appointments, cutting prescription pills in half, and self-medicating.

While Maine law requires hospitals to offer financial assistance and free care to Mainers with low income, the survey reveals the inadequacy of these programs. Only one in ten respondents with medical debt received financial assistance through the program, and more than two thirds did not apply. Half of those with hospital debt were not even aware of the availability of free care, suggesting that hospitals should do more to advertise the program to those who might need it.

Mainers broadly support a series of solutions

While the poll paints a grim picture of the way the health care system impacts Mainers financially, it also highlights strong public support for solutions to reduce economic hardship and improve the system:

  • 90 percent of Mainers support limiting hospital prices and making them more transparent
  • Three-quarters of respondents support requiring nonprofit hospitals to provide more financial assistance
  • Nearly nine out of ten Mainers support requiring insurance companies to lower their deductibles and other out of pocket costs
  • At the state level, more than 80 percent of Mainers support the work of the new Office of Affordable Health Care and the same number wanted the state to continue funding the work of Consumer Assistance Programs that are helping the public find affordable care
  • More than two-thirds of Mainers support a bill being considered by the legislature, LD 199, extending MaineCare access to all immigrants regardless of immigration status
  • More than three-quarters of Mainers support the creation of a government administered “public-option” health care plan offering a lower cost alternative to private plans

The message is clear: Mainers are fed up with a health care system that causes them significant economic hardship. No-one should be forced into debt or drastic actions to receive the basic care we all deserve. It’s time lawmakers address the underlying causes of our chronically ailing health care system and employ remedies to reduce Mainers’ financial strain.