Colorado Report Reveals Healthcare Inequities and Healthcare Illiteracy

MEDIA RELEASE

Wednesday, Sept. 25, 2024

Contact: Priya Telang, 720-443-6435, ptelang@cohealthinitiative.org

Katie Reinisch, 303-653-1009, katie@progressive-promotions.com

“Serious discrepancies in the health care experiences due to systemic racism”

DENVER – Today, the Colorado Consumer Health Initiative (CCHI) released two more reports on health equity and literacy from Healthcare Value Hub’s Consumer Healthcare Experience State Survey (CHESS). While affordability is a major barrier to care for all Coloradans, according to the survey, lack of affordability disproportionately affects people of color and people with disabilities more than others.

Last month, CCHI released three reports from the CHESS, a survey of more than 1,400 Coloradans, and included topics of affordability, prescription drug costs, and hospital prices, as well as government-led solutions.

The health equity report is the latest in the series to detail health care affordability burdens across race and ethnicity, income and education, disability status, as well as gender and sexual orientation. Because of systemic racism in the health care system, 28 percent of respondents of color skipped needed medical care due to distrust of, or feeling disrespected by, health care providers, compared to just 16% of white respondents. Sixty percent of respondents reported that they believe that people are treated unfairly due to their race or ethnicity, specifically due to practices built into the system as well as the actions and beliefs of individual health care providers. People living with a disability report rationing medication due to cost, delaying or going without care, and experiencing a cost burden due to medical bills.

Respondents of color more frequently reported experiencing one or more healthcare affordability burdens in the past year compared to white respondents, over a third (35%) of Latinos reported rationing medication compared to 22% of whites, and three-quarters (78%) of people of color reported delaying or going without care versus 63% of whites. While one-third (31%) of whites said they faced a “cost burden,” over half (52%) of people of color did so.

While Colorado families of all income levels struggle with healthcare prices, those with disabilities have even higher rates of going without care due to cost and incurring medical debt, depleting savings, and/or sacrificing basic needs due to medical bills.

In households that include a person with a disability, over one-third (37%) have rationed medication, while only 20% in other, non-disability, households have. A full 21% more have delayed or gone without care due to cost (83% vs. 62%). Additionally, 28% of respondents with a disability in their household reported problems getting mental health care compared to 15% of those without.

“This report outlines serious discrepancies in the health care experiences specifically due to systemic racism in the health care setting,” said Mannat Singh, executive director at CCHI. “Coloradans need to be able to access affordable, quality care regardless of their income level, the color of their skin, their identity, and documentation status. More work needs to be done to recognize and correct the root causes of distrust in the health care industry, which is key to creating a fairer health system for everyone.”

“I have to get ultrasounds annually, and an occasional MRI, to monitor a mass on my liver,” said Mikiva Lewis, of Larimer County. “Since I regularly received imaging services, I thought that getting a price estimate would be easy. I was wrong. Even after multiple phone calls and getting the right code, it was impossible to get an accurate estimate. The lack of price transparency for routine services made it impossible for me to plan how much I needed to save each year to afford the required tests. The most frustrating part about needing these routine services wasn’t the time I needed to take off work or even the fasting I needed to do beforehand it was the fact that I would spend hours trying to get an accurate price estimate just for it to not match the bill I received.”

The literacy report outlines continued confusion for consumers surrounding health insurance terminology, how to navigate the health care system confidently, and their “cost-sharing obligations.”

Despite local and federal legislation requiring price transparency, few Coloradans are confident in their ability to determine how much a procedure might cost. Not many know how to dispute a medical bill. Insurance terms are confusing and consumers do not feel well-equipped to manage their care or fight back against an unfair bill or overcharge.

Fewer than four in 10 felt confident they could fix a problem if their health plan or hospital was not being responsive and less than half of the respondents said they could find ratings for hospitals or doctors or find the costs of a procedure ahead of time. Coloradans who did not research cost or quality information reported the process felt confusing or overwhelming, or simply did not know where to look. Even those who did find cost information reported that the available cost information was confusing, that their provider or insurance would not provide a price estimate, or the pricing information was insufficient. Consumers of all income and education levels have difficulty understanding the different healthcare terms associated with health insurance and understanding their plan coverage.

This is why CCHI established the Consumer Assistance Program (CAP) in 2018: consumers often need assistance and a dedicated advocate to help with the complaint and appeal process when it comes to hospital bills. The CAP knows firsthand how difficult and lengthy the process is, and that the healthcare system is deliberately designed to be opaque and hard for patients to navigate and advocate for themselves.

The health literacy results underscore the need to simplify coverage and make our health system easier to understand, as well as the need for ongoing education around health insurance, accessing care, and patients’ rights. As we come upon Open Enrollment on November 1, patients need more support as they navigate their health coverage options through both marketplace insurance through Connect for Health Colorado and Medicaid/CHP+ this year.

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