In recent years, the United States has made huge strides in healthcare access. Not only is the rate of uninsured people lower than ever before thanks partially to record Affordable Care Act enrollment, but recent reforms aimed at lowering prescription drug costs by taking on Big Pharma price-gouging in Medicare will continue to improve affordability for seniors and people with disabilities who often struggle the most with health costs.
But despite expansions in coverage and some progress on lowering costs, a new study from the Commonwealth Fund confirms that far too many Americans are still struggling to afford healthcare in today’s economy despite having insurance, which is supposed to make health care accessible. Over half of people with Medicare coverage struggle to afford it as do over half of people with ACA marketplace or individual coverage. Nearly half–45%–of people in Medicaid say healthcare is difficult to afford and even 43% of people with employer sponsored coverage say the same. Naturally, for the nation’s remaining uninsured population, things are even worse.
A key factor in the affordability problem is rising premiums. A new KFF report shows that the average cost of workplace health insurance premiums for family coverage reached nearly $24,000 this year, a 7% jump from 2022. Meanwhile, wages grew about on average 5.2% and inflation rose 5.8% last year. Plus, the cost of everything else including housing and groceries is also rising. Given these conditions, it’s easy to see why “Bidenomics” isn’t hitting home for many voters.
Currently, 2 in 5 patients report delaying getting care or skipping it all together because of affordability concerns including incurring medical debt. Nearly a third of adults reported having medical or dental debt, and nearly half of them said it’s at least $2,000. That’s a significant sum for seniors in Medicare on a fixed income or for low-wage working families. Currently, Medicare doesn’t cover dental, vision, or hearing and many private insurance policies also omit coverage for these services as well as for comprehensive mental health treatment.
Clearly, there’s more work to be done to put healthcare in reach even for people who now have coverage and much more to do for people without coverage. The number of uninsured people is also rising because of the end of Medicaid coverage following the Public Health Emergency connected to covid. In the last year, over 10 million people have lost Medicaid coverage. Some of these people will be able to get insurance during the current ACA open enrollment period and some will not be able to afford coverage, even with improved affordability on the ACA exchanges.
Without more progress reining in corporate price-gouging to reduce profits in healthcare, there’s little hope when it comes to bringing down costs for consumers. Policy-makers at every level should make this a top priority. It’s not just essential to the economic stability of families, it’s also politically popular.
Lowering drug prices is the tip of the spear for reining in healthcare costs more broadly given that prescription drug price gouging drives increases in premiums and contributes to medical debt. A recent poll from Hart Research showed that 96% of Americans agree that lowering drug prices and the cost of prescriptions is an important way to help people afford the cost of living and nearly three-quarters of Americans favor Biden and Democrats in Congress passing Medicare negotiations.
Appetite for lowering drug prices isn’t limited to Medicare enrollees: 7-in -10 voting age adults in the U.S. support lowering drug prices. Regardless of political affiliation, Americans want their lawmakers to lower drug prices and take on Big Pharma greed. That’s why Democrats in Congress are forging forward to build on the success of the Inflation Reduction Act. New Jersey Congressman Frank Pallone, a key architect of the original reforms that were included in the IRA has already filed a bill to expand negotiations, the insulin cap and accountability for drug corporation price gouging in the 118th Congress. If passed, that bill could lower costs for millions more people in Medicare and for hundreds of millions with private coverage.
Pallone’s leadership stands in stark contrast to some of his colleagues in the US House of Representatives who are actively trying to repeal the modest reforms in the existing law just one year after its passage. Led by Tennessee Republican Andrew Ogles, 23 GOP Members of the House are pushing a bill to repeal the law as their allies in Big Pharma file lawsuits to overturn Medicare negotiations. Johnson & Johnson, Astellas, Bristol Myers Squibb, and Merck joined the U.S. Chamber of Commerce and industry lobby group PhRMA to stop Medicare negotiations. Plus, GOP House Speaker Mike Johnson just hired former Pharma lobbyist Dan Ziegler, a former lobbyist for the drug corporations as his Policy Director.
Americans need healthcare they can depend on, but despite progress, we’re not there yet. The time is now for lawmakers to address what every poll is telling them: it’s time to lower profits, rein in price-gouging, and make healthcare truly affordable in our country.