Insurance coverage

Consumers frustrated with health insurance coverage, costs

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Americans are concerned about the costs of insurance coverage and would like to see more solutions around transparency and healthcare facility payouts. That’s according to a new PhRMA/Ipsos poll, which revealed some frustrations with paying and navigating the healthcare system.

Many health care frustrations hinge on inadequate health insurance coverage, confusion with barriers to insurance access, and unforeseen expenses and coverage issues experienced by patients.

Conducted among 2,510 American adults, the poll found that a bipartisan supermajority (87%) of Americans believe politicians have lost touch with what the public needs when it comes to health care.

Consistent with how the public ranks health issues — with “health insurance costs and coverage” at the top of the priority list, only behind the “coronavirus pandemic” — 86% of Americans agree that Congress should focus on cracking down on abusive insurance practices that make it harder for people to get the care they need.

On this there is agreement between the parties; 92% of Democratic voters and 84% of Republican voters agree.

Similarly, when faced with two options, Americans would rather Congress focus more on reducing the overall costs of coverage, such as premiums, deductibles, and copayments (71%), than on reducing prescription drug costs (29%).


When navigating the healthcare system, overcoming barriers to insurance coverage, insurance coverage confusion, costs of care and lack of transparency are among the biggest hurdles for Americans, according to figures.

In the past year, 43% of people who take prescription drugs or their families faced at least one insurance barrier to their care. These experiences range from expecting an insurer to approve a medicine prescribed by their doctor – prior authorization – to the insurer requiring a patient to try a different medicine or not covering a medicine prescribed by a doctor at all. This is against the backdrop of 89% who say taking their medication helps them stay healthy.

Thirty-nine percent say they worry about how to pay if they or their family needs treatment. Thirty-one percent avoided going to the doctor because of the cost.

More than two in five Americans (43%) say they have had trouble understanding or navigating their health insurance.

Notably, consumers with private insurance are among the most likely to agree that health insurers should publicly share any record they have of denial of claims to a group of people or patients with a particular disease. (87%) and disclose how often they refuse care (82%). Additionally, 78% of privately insured consumers agree that insurers should share the savings they negotiate.


When asked to choose the top two ideas that would have the most positive personal impact on out-of-pocket spending and affordability, one in three (33%) think capping the amount health insurers can charging patients for their deductibles, copays and other disbursements would have a positive impact for them personally.

Here, registered Democratic voters (40%) are more likely to see a positive personal impact from this approach than registered Republican (31%) or independent (34%) voters.

Other ideas that people say would personally benefit them include giving insurers more incentives to keep health plan costs manageable for people who are sick and taking prescription drugs (17%), and demand that health insurance companies be more transparent about which drugs are covered. and what patients will pay out of pocket for prescription drugs (16%).

Twitter: @JELagasse
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