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First-Ever Survey of its Kind Shows Pennsylvanians are Struggling to Afford Healthcare

January 18, 2019

Anecdotally, it’s been clear that Pennsylvanians are struggling with rising healthcare costs, but until recently, Pennsylvania lacked the data to describe that struggle.  In the first-ever Pennsylvania-specific survey on healthcare affordability conducted in late 2018, it’s clear that the problem is widespread and serious:

  • 1 in 2 Pennsylvania adults struggled to afford healthcare in the past year
  • 4 in 5 are worried about affording healthcare in the future
  • Across party lines, 9 out of 10 believed that lawmakers should take action to remedy this situation

Struggling to afford healthcare can take many forms, including: being uninsured because of high premium costs, delaying or forgoing care due to cost, and struggling to pay medical bills.

How are Pennsylvanians Coping with High Healthcare Costs?

When people consistently struggle with healthcare costs, the data shows that they make healthcare decisions based on what’s in their wallets instead of their doctors’ recommendations.  Many Pennsylvania families have been forced to take actions that jeopardize their health, such as delaying care (29%), avoiding getting care altogether (21%), skipping a test or treatment (24%), failing to fill a prescription (19%), or cutting pills in half or skipping doses (17%).

When they do get care, nearly one third of Pennsylvanians struggled to pay the resulting bills. Commonly, they are being referred to collections, using up all or most of their savings, skipping payments on basic necessities like food, heat, or housing, or racking up debt.

Across Party Lines, Pennsylvanians Want to See Change

We can all agree that this is not the way healthcare is supposed to work, and so did those participating in the survey. Across party lines, more than 3 in 4 said the healthcare system needs to change.  Changes endorsed by respondents included: making it easier to switch insurers if a health plan drops your doctor (93%), showing what a fair price would be for specific procedures (92%), and requiring insurers to provide upfront cost estimates to consumers (91%).

In particular, drug companies were the most frequently cited as being a “major reason” for high healthcare costs (76%), and, unsurprisingly, Pennsylvanians across party lines overwhelming support action on prescription drugs:

Regional Differences

To understand regional differences in how Pennsylvanians experience rising healthcare costs, the data was divided into five geographic regions. Sub-reports for four of five regions (all but the Northwest) are currently available below along with the statewide report. Of note, the Southwest region had the highest levels of affordability burdens and concern for future costs of care as compared to the other three regions.


Northeast/North Central

South Central/Lehigh Valley



About the Survey

This survey, the Consumer Healthcare Experience State Survey, was done by Altarum’s Healthcare Value Hub with support from the Robert Wood Johnson Foundation. Altarum chose the Pennsylvania Health Access Network as its state partner to release the results. More information about the survey methodology can be found in the statewide report.