How do Minnesotans feel about health care costs, especially against the backdrop of possible changes to Medicare and Medicaid? A survey of more than 1,000 state residents shows that while the vast majority have health insurance, respondents are worried about the rising costs of health care. Drug prices are a concern, as are looming changes at the federal level.
Recently the Minnesota Governor’s Council on Developmental Disabilities (MNCDD) replicated a 2004 health care costs survey. Minnesota Healthcare Attitudes 2018 shows that while the health care landscape has changed since the launch of the Affordable Care Act, some familiar worries remain.
The original survey was launched when then-Gov. Tim Pawlenty appointed former U.S. Senator David Durenberger to head the Minnesota Citizens Forum on Health Care Costs. The forum was asked to address a crisis in affordable health care. Its 18 members traveled the state for three months, conducting town hall meetings and listening sessions. Members gathered ideas from fellow citizens on what the state’s health care system should look like.
At the time Pawlenty said the forum would likely find much common ground on health care reform, and would find solutions to help cut health care costs for Minnesotans. The forum worked with the Minnesota Board on Aging and MNCDD to develop and conduct a 20-minute telephone survey of a representative sample of 800 Minnesotans.
“When this study was first commissioned 14 years ago, a pressing issue was running buses to Canada to buy prescription drugs. In this study, a pressing issue is the high cost of prescription drugs and the need for government oversight,” said Sen. John Hoffman (DFL- Champlain).
One-fourth of the current respondents stated that they will be worse off in three years, when considering access to good quality, affordable healthcare. In households with a family member with a developmental disability, this pessimism was particularly pronounced. Respondents indicated fear of potential federal cuts to Medicaid, rising costs of healthcare premiums, deductibles and co-pays, and decreased access to health insurance and medical services for people with preexisting conditions and disabilities.
But other results today are more optimistic than 14 years ago. Today, one key finding is that the vast majority of the respondents had some kind of health insurance coverage (92 percent). More than half or 56 percent of survey respondents have private health insurance through their employer, and another 8 percent recently purchased insurance through the Health Insurance Exchange recently.
Forty percent have some kind of government-provided healthcare coverage. The split is 21 percent Medicare and 19 percent Medicaid. Medicaid coverage has grown from seven percent in 2004 to 19 percent in 2018.
On average, Minnesotans with government-provided healthcare coverage (Medicare or Medicaid) had more positive perceptions of their overall health coverage and care, as compared to Minnesotans with private insurance. This seemed due, in part, to frustrations over confusion related to the billing and payment process, as well as by the “baffling” array of plans available, and uncertainty in how to “navigate the options.”
As for attitudes on “public or government-run” versus “private” health insurance coverage, Minnesotans are evenly split. In order to assess Minnesotans’ attitudes on government healthcare policies, the question was asked: “Do you think it is the responsibility of the federal government to make sure all Americans have healthcare coverage, or is that not the responsibility of the federal government?” Just over half (54 percent) of all respondents believe the federal government is responsible for ensuring that all Americans have healthcare coverage.
There are concerns that potential cuts or caps at the federal level will have a negative impacts on Minnesotans who utilize Medicaid. The majority of Minnesota respondents (60 percent) believe the federal government should continue to “honor the commitment” to match the state’s spending for Medicaid, as opposed to putting a limit on federal Medicaid spending. If cuts are needed, then the respondents recommended that provider rates be reduced rather than cutting services or covering fewer people.
Cost issues vary
Two-thirds of Minnesotans (65 percent) who have any kind of health insurance coverage believe their cost for premiums and additional costs have been going up over the past couple of years. But these perceptions of rising costs are not as severe as they were in 2004, when 89 percent of respondents believed the same thing. These perceptions of rising costs made a difference in whether people actually went to the doctor when they thought they needed to.
But red flags remain about care postponed due to costs. Just over one-third of Minnesotans (38 percent) have delayed medical treatment because of the cost they would have to pay. Of those Minnesotans who have delayed treatment, one-half, or 19 percent, had a serious or somewhat serious condition or illness.
Drug costs are another worry. When it comes to the government’s role in the pricing of drugs, the majority of Minnesotans (83 percent) believe the government should play a role in drug pricing, with 39 percent stating that the government should be very involved in controlling prices.
Thirty-nine percent of Minnesotans give their overall health coverage and care a less than good rating; one-third (32 percent) gave a good rating, and 28 percent gave better than good ratings.