Health Costs Still A Barrier Despite Low Uninsurance Rate, Report Finds

DATE : December 21, 2017

By Katie Lannan

STATE HOUSE, BOSTON, DEC. 20, 2017.....The Massachusetts uninsurance rate remained well below the rest of the nation for health coverage this year at 3.7 percent, but nearly one in 10 Bay State residents were underinsured, according to a new state report.

This year's Massachusetts Health Insurance Survey from the Center for Health Information and Analysis also found that more than a quarter of respondents reported experiencing an unmet need for medical or dental health care -- including prescription drugs, substance use treatment and mental health care -- because of cost during the past year.

Early estimates show the unisurance rate for the rest of the nation at 8.8 percent, CHIA said.

Massachusetts passed a universal health coverage law in 2006, and its uninsurance rate has remained relatively steady recent years -- 3.6 percent in 2015 and 3.7 percent in 2014, according to CHIA -- but the report indicates that even with coverage, paying for care remains a challenge for many. The survey was not conducted in 2016.

Among age groups, people 65 and older were more likely to be considered underinsured, which the CHIA report defines as having health insurance coverage all year and spending 10 percent or more of family income on out-of-pocket health care expenses.

More than 12 percent of people over age 65 fell into the underinsured category, compared to 8.2 percent of non-elderly adults and 8 percent of children up to age 18. The overall statewide underinsurance rate was 8.8 percent, according to the report.

About a quarter of respondents said they spent $3,000 or more on out-of-pocket costs including deductibles, copays, coinsurance and non-covered medical, dental and vision services in the past 12 months.

Among people who said they had problems paying family medical bills or had medical debt, 54.7 percent said they cut back on saving or withdrew from a savings account, 30.8 percent said they borrowed money or took on credit card debt, and 40.5 percent were contacted by a collection agency.

The report tracked various approaches families take to lowering their health care costs -- 27 percent of respondents said someone in their family "tried to stay healthier," while 11.5 percent said someone went without needed care and 4.8 percent said someone went without health insurance entirely. Nearly 6 percent said someone switched to a lower-cost provider, and more than 9 percent said someone switched to a lower-cost plan.

Among respondents who reported eschewing needed medical or dental care because of cost, 65.2 percent had health insurance. Nearly half said they skipped the care because it was not covered by their plan, and more than one-third avoided the doctor because the copay was too high.