One in five Kentuckians aged 18 to 65 are delaying medical care or going without it due to cost, according to a study done for the Foundation for a Healthy Kentucky. It found that almost one in four went without dental care, and nearly one in five skipped prescription medications, due to cost.
"Too many Kentuckians continue to delay or skip health care because the cost is just not in their budget, and they're probably hoping the decision won't undermine their health," Foundation President and CEO Ben Chandler said in a news release. "But we know that delaying or forgoing routine and preventive care doesn't save money in the long run, and it certainly doesn't result in better health outcomes. Access to health care is critical to improving Kentucky's health, and we simply have to do better."
The findings are based on a survey in Spring 2016 that asked people if cost had caused them to defer health care or medicine in the previous 12 months. It was part of an ongoing, three-year study of the impact of the Patient Protection and Affordable Care Act in Kentucky, done for the foundation by the State Health Access Data Assistance Center at the University of Minnesota. The foundation is paying SHADAC more than $280,000 for the work.
The survey found that almost 21 percent of Kentucky adults delayed or skipped medical care due to cost. The figures was 29.4 percent among Medicaid-eligible Kentucky adults, those with incomes up to 138 percent of the federal poverty level ($33,534 for a family of four in 2016), and 26 percent for those between 138 and 200 percent of the poverty level. Kentucky adults above 200 percent of poverty only skipped medical care due to cost 13.9 percent of the time.
The report also found that 39 percent, or nearly two in five, of Kentucky adults had trouble paying their medical bills in 2014, though this was a 10-percentage-point drop from 2012, when nearly half of Kentucky adults were struggling in this measure. The national rate in 2014 was 28.7 percent.
Compared with its neighboring states, Kentucky was the only one to show a significant decrease in the percentage of people who had trouble paying medical bills, but among those states, "No state had a rate that was significantly higher than Kentucky's," says the report.
Kentucky adults without insurance were more than twice as likely to forgo care due to cost compared to Kentuckians overall in this measure and three times as many who described themselves in poor health delayed or went without care compared to those who said their health was excellent.
The report also found that more than half (56.2 percent) of Kentucky adults without health insurance in 2016 said they didn't have it because they couldn't afford it, 17 percent said they simply weren't interested and 25 percent indicated they weren't opposed to obtaining coverage.
Of those who had health insurance in 2016, almost half (48.1 percent) had private insurance. This group was primarily white, married, employed, had some college education and incomes more than double the poverty line. Otherwise, 44.2 percent had coverage through an employer and the rest had it through the individual market.
Private health insurance in 2014 was most common in Northern Kentucky, where 61.5 percent reported having it, and the Lexington area, at 56.1 percent. The Louisville area and Western Kentucky, 48.8 percent and 47.6 percent respectively, had rates similar to the overall state rate of 48.1 percent. At 35.5 percent, Eastern Kentucky adults were the least likely to have private insurance.
The report also found that 41 percent of non-elderly Kentucky adults were on public coverage such as Medicaid, Medicare and military. This group was more likely to have a high-school diploma or less, be unemployed or a full-time student, be divorced or widowed, report fair or poor health, or live in Eastern Kentucky, says the report.
This semi-annual report analyzed data from several sources regarding health coverage, access to care, cost of care, quality of care and health outcomes and included the results of a spring 2016 Kentucky Health Reform Survey of non-elderly adults. Click here for a copy of the report.
"Too many Kentuckians continue to delay or skip health care because the cost is just not in their budget, and they're probably hoping the decision won't undermine their health," Foundation President and CEO Ben Chandler said in a news release. "But we know that delaying or forgoing routine and preventive care doesn't save money in the long run, and it certainly doesn't result in better health outcomes. Access to health care is critical to improving Kentucky's health, and we simply have to do better."
The findings are based on a survey in Spring 2016 that asked people if cost had caused them to defer health care or medicine in the previous 12 months. It was part of an ongoing, three-year study of the impact of the Patient Protection and Affordable Care Act in Kentucky, done for the foundation by the State Health Access Data Assistance Center at the University of Minnesota. The foundation is paying SHADAC more than $280,000 for the work.
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| Percent who delayed or went without medical care due to cost by income, 2016. Graphs from report. |
The report also found that 39 percent, or nearly two in five, of Kentucky adults had trouble paying their medical bills in 2014, though this was a 10-percentage-point drop from 2012, when nearly half of Kentucky adults were struggling in this measure. The national rate in 2014 was 28.7 percent.
Compared with its neighboring states, Kentucky was the only one to show a significant decrease in the percentage of people who had trouble paying medical bills, but among those states, "No state had a rate that was significantly higher than Kentucky's," says the report.
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| Percentage of population delaying needed medical care in 2014 because of cost (SHADAC chart) |
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| Forgone care due to cost by health status, 2016 |
The report also found that more than half (56.2 percent) of Kentucky adults without health insurance in 2016 said they didn't have it because they couldn't afford it, 17 percent said they simply weren't interested and 25 percent indicated they weren't opposed to obtaining coverage.
Of those who had health insurance in 2016, almost half (48.1 percent) had private insurance. This group was primarily white, married, employed, had some college education and incomes more than double the poverty line. Otherwise, 44.2 percent had coverage through an employer and the rest had it through the individual market.
Private health insurance in 2014 was most common in Northern Kentucky, where 61.5 percent reported having it, and the Lexington area, at 56.1 percent. The Louisville area and Western Kentucky, 48.8 percent and 47.6 percent respectively, had rates similar to the overall state rate of 48.1 percent. At 35.5 percent, Eastern Kentucky adults were the least likely to have private insurance.
The report also found that 41 percent of non-elderly Kentucky adults were on public coverage such as Medicaid, Medicare and military. This group was more likely to have a high-school diploma or less, be unemployed or a full-time student, be divorced or widowed, report fair or poor health, or live in Eastern Kentucky, says the report.
This semi-annual report analyzed data from several sources regarding health coverage, access to care, cost of care, quality of care and health outcomes and included the results of a spring 2016 Kentucky Health Reform Survey of non-elderly adults. Click here for a copy of the report.
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