More than half (55%) of Virginians have had trouble affording health care in the last year, and 78% are worried about affording health care in the future, according to the Virginia Consumer Healthcare Experience State Survey (CHESS).

The survey, conducted by the Altarum Healthcare Value Hub and the Virginia Center for Health Innovation, polled 1,100 Virginians on a wide range of healthcare-related issues. 

Among the more startling findings was that 63% of respondents were “worried” or “very worried” about not being able to afford health insurance in the future. People who buy private health coverage as individuals or on Medicaid reported the highest levels of concern over affordability.

Healthcare is also the most important issue for Virginians, with 63% citing it as a top issue they want lawmakers to work on in the coming year. 

The top three factors respondents want the government to address are:

  • High health care costs, including prescription drug costs (cited by 55%)
  • Preserving consumer protections such as protections for pre-existing conditions (cited by 36%)
  • Providing health insurance to those who can’t afford coverage (cited by 35%)

Virginians primarily blame drug companies for high healthcare costs, with 73% saying drug companies charge too much money. 

So how bad have things gotten on the prescription drug front?

Americans spent $535 billion on prescription drug costs in 2018, a 50% increase since 2010, according to an estimate from Pew Charitable Trusts. 

The price of insulin rose by 99% from 2012 to 2016, according to the Health Care Cost Institute. Drug makers kicked off 2019 by raising the prices on more than 1,000 medications by an average of 6.3%. The opioid OxyContin, one of the most prescribed drugs in America, saw a 9.5% increase, while blood-thinner Pradaxa shot up by 8%.

As for what Virginians want lawmakers to do about high costs, 91% of respondents said they would like access to information showing a “fair” price for specific procedures, 89% support requiring insurers to provide upfront cost estimates to consumers, and 88% support allowing the Attorney General to take legal action to prevent price gouging or unfair prescription drug price hikes.

A handful of lawmakers in Virginia’s General Assembly have made efforts to tackle drug costs in recent years. 

Sen. John Edwards (D-Roanoke) sponsored legislation in both 2018 and 2019 that would have prevented prescription drug price gouging and authorized the Secretary of Health and Human Resources to designate certain drugs as “essential.” But the bills died in committee. 

In the House, Del. Chris Hurst (D-Blacksburg) introduced a bill in 2018 that would have required prescription drug companies to disclose information about how much it actually costs them to develop and produce drugs that cost more that $10,000. The bill was defeated on a party-line vote by Republicans on the Commerce and Labor committee.

Most other bills meant to tackle the issue have met the same fate, though in 2019 Virginia lawmakers banned insurance companies from not counting the value of coupons or copay assistance towards a patient’s deductible, thus raising their costs.

There were also a pair of bipartisan bills passed in 2018 that allow pharmacies to tell customers if a prescription would be cheaper without using their health insurance. Pharmacies were previously barred from telling their customers that.

But significant reductions in drug spending have been elusive as costs continue to surge, and Virginians are clearly frustrated. Only 28% of survey respondents agreed or strongly agreed with the statement “We have a great healthcare system in the U.S.,” while more than 70% agreed or strongly agreed that “the system needs to change.”

The Virginia Consumer Healthcare Experience State Survey also found that in 1 in 3 respondents with private health insurance received a surprise medical bill.

The White House is also trying to address the issue of healthcare costs and surprise medical bills, though the Trump administration is simultaneously trying to repeal the Affordable Care Act, which could send Virginians’ costs skyrocketing and throw the entire health care system into turmoil. 

Even if the ACA remains in place, the CHESS data also clearly indicates that Virginians want more done when it comes to health care.

“These data confirm what we already knew anecdotally,” said Lynn Quincy, director of Altarum’s Healthcare Value Hub. “Virginians experience healthcare affordability problems and surprise medical bills at an alarming rate. Virginia residents would benefit significantly from state actions to alleviate these unfair and burdensome healthcare affordability problems.”

One change that has reduced healthcare costs for many Virginians is the state’s Medicaid expansion, which finally passed in 2018 after years of Republican opposition. The expanded program has allowed nearly 300,000 low-income Virginians to enroll in the program. Despite this progress, healthcare advocates continue to point out that healthcare affordability remains a top issue for Virginians.

Jill Hanken, health attorney for the Virginia Poverty Law Center (VPLC) said “The ACA Marketplace and Virginia’s new Medicaid expansion have helped over 600,000 Virginians get health insurance. But there are still many legitimate and urgent concerns about healthcare costs, access to services and medical debt.”