Houston Chronicle

Many Texans have to skip health care over costs

Rising health costs for visits, medicine getting out of reach

- By Jenny Deam

Six in 10 Texans say someone in their household has recently skipped or postponed needed health care and medication because the cost is now out of reach, according to a new national study.

Six in 10 Texans say someone in their household has recently skipped or postponed needed health care and medication because the cost is out of reach, according to a new national study.

Rising costs also mean Texans, even those with insurance, struggle significan­tly to pay the medical bills when they seek care, the Houston Episcopal Health Foundation and the national Kaiser Family Foundation’s joint study found. The survey of 1,367 adults in the state was conducted between March and May and is part of an ongoing partnershi­p between the two foundation­s examining health care issues in the state.

In Texas, about 38 percent — more than 1 in 3 — said they had trouble paying health care bills in the past year. Nationally the rate is 27 percent, the report said.

“The reality is when you’re trying to pay the rent and the utilities and food, health care always comes in last,” said Bob Sanborn, president of Children At Risk, a Houston nonprofit group that sees the people behind the numbers every day.

Policy analysts say this is especially troubling because as people delay treatments, their conditions often worsen over time, leading to higher costs.

Kathy Eckhold is one who lives with the ever-tightening squeeze. Her husband lost his $16-per-hour job in the grocery industry last year. When the job vanished, so did his health insurance. And while he has since

found a similar position, she said it came without benefits, as does her job as an office manager.

They need coverage because years ago her husband, now in his mid-50s, had a stroke. Even though he is recovered, he needs maintenanc­e doses of medication, she said.

So, they rely on COBRA, the federal program that allows people to temporaril­y retain their coverage from a previous job — but at a cost.

Not only must former employees pay the full freight of a typically expensive policy without employer contributi­on, the plans usually come with a tacked-on administra­tive cost.

The couple pays $800 a month — a brutal stretch of an already tight budget, she said. The past two months they have afforded it by using their tax refund.

Soon they will begin draining savings.

“When COBRA runs out, I don’t know what we’re going to do” this fall, Eckhold said.

‘You just never know’

For now, her husband has kept his doctor appointmen­ts and faithfully refilled prescripti­ons. But that, too, could change.

“I’m really scared,” she said Wednesday. “People our age, poor health is looming large. We take care of ourselves, but you just never know.”

The study found that 61 percent of Texans skip or postpone health care due to its cost, which includes missing recommende­d tests or treatments, not filling prescripti­ons or cutting medication in half to make the prescripti­on last longer.

Others report avoiding dental care or mental health treatment.

That compares with the stillhigh 48 percent nationally who resort to similar measures, a previous Kaiser study showed.

“Texans said that their state government should be doing more to help many people get access to health care, and these numbers show why they feel this way,” Elena Marks, president and CEO of the Episcopal Health Foundation, said in a statement.

This week’s collaborat­ive study is the second in an ongoing series looking at the state of Texas health care access.

A survey released last month found that two-thirds of Texans said the state is not doing enough to help low-income adults get health care.

Obvious culprit

An obvious culprit in the affordabil­ity problem facing Texans is the lack of health insurance, Drew Altman, Kaiser Family Foundation president and CEO, said in a statement.

Texas continues to lead the nation in the rate and number of uninsured with about 4.5 million people without coverage including nearly 700,000 children, according to health statistics.

Perhaps most striking, though, is that the new study shows even those with insurance struggle with high health care costs.

Nearly half, or 48 percent, of those with coverage reported it was very or somewhat difficult to afford care.

One trend in health insurance in recent years is the prevalence of high-deductible plans, which means policy holders must pay hundreds if not thousands of dollars out-of-pocket before their coverage kicks in.

As a result, many people avoid care.

Upcoming reports will look at Texans’ attitudes about private insurance, women’s health issues, the health care experience­s of Hispanics in the state, and how outside social influences affect the health of communitie­s.

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