Consumers frustrated with health insurance coverage, costs

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Americans worry about the costs of insurance coverage and would like to see more solutions around transparency and out-of-pocket costs from health care facilities. That’s according to a new PhRMA/Ipsos survey, which revealed some frustrations over payment and navigating the health care system.

Many frustrations with health care stem from inadequate health insurance coverage, confusion with navigating insurance barriers to access, and unexpected costs and coverage issues that patients experience.

Conducted among 2,510 American adults, the poll found that a bipartisan supermajority (87%) of Americans think politicians have lost touch with what the public needs from their health care.

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

For this, there is agreement across party lines; 92% of Democrats and 84% of registered Republican voters agree.

Relatedly, when given the choice between the two options, Americans would like Congress to focus more on reducing overall costs of coverage such as premiums, deductibles, and copays (71%) rather than reducing prescription drug costs ( 29%).


When navigating the health care system, overcoming insurance coverage barriers, insurance coverage confusion, costs of care and lack of transparency are some of the biggest obstacles for Americans, the numbers showed.

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

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

More than two in five Americans (43%) report having difficulty understanding or navigating their health insurance.

In particular, consumers with private insurance are among the most likely to agree that health insurers should publicly share any records they have of denying claims to a group of people or patients with a particular disease (87%) and disclose how they often deny the doctor’s recommendation. 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 create the most positive personal impact on out-of-pocket costs and affordability, one in three (33%) believe that putting a cap on the amount that health insurers can force patients to pay for their deductibles, co-payments and other out-of-pocket costs would create 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 people think would benefit them personally include giving insurers more incentives to keep health plan costs manageable for people who are sick and taking prescription drugs (17%), and requiring for health insurance companies to be more transparent about which drugs are covered. and what patients will pay out of pocket for prescription drugs (16%).

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