Southwest Virginians report experiencing the highest levels of health care affordability burdens in the state in a survey released earlier this month.

The Virginia Consumer Healthcare Experience State Survey polled adults across the commonwealth to find that 55% reported experiencing health care affordability burdens, and 78% were worried about being able to afford future health care.

Health care affordability burdens include being uninsured due to high premium costs, delaying or forgoing health care due to cost and struggling to pay medical bills.

Respondents from the southwestern region of the state reported the highest level of health care affordability burdens, with 63% of adults saying they experienced at least one kind of affordability burden in the past year.

Southwest Virginians also tied with respondents from the northwestern part of the state for the highest rate of worry about affording health care in the future, with 85% reporting being “worried” or “very worried” about at least one element of affordability, including nursing home and home care services, the cost of a serious illness or accident, health insurance becoming too expensive, health care costs when elderly, prescription drug costs and losing health insurance.

Most respondents in Southwest Virginia are dissatisfied with the current health care system. The majority — 72% — said they agreed or strongly agreed with the statement, “The system needs to change.” About a quarter, 24%, agreed or strongly agreed that “We have a great health care system in the U.S.” This mirrored statewide responses for these questions, in which 74% said the system needs to change and 28% agreed that the system is “great.”

Altarum — a nonprofit research and consulting group — conducted the survey of about 1,100 Virginia adults between March 12 and April 2. In addition to affordability issues, Altarum looked at unexpected medical bills among privately insured Virginians, finding that 29% reported getting a bill for an unexpected expense in the past year.

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

On July 9, Quincy presented survey results to leaders of the Virginia Center for Health Innovation.

Southwest Virginians supported a number of potential solutions for addressing affordability issues, including authorizing the attorney general to take legal action to prevent price gouging or unfair prescription drug price hikes, 84% support; showing what a fair price would be for specific procedures, 89%; requiring insurers to provide upfront cost estimates to consumers, 87%; and making it easier to switch insurers if a health plan drops your doctor, 87%. These ideas received similar levels of support across the state.

The survey results underscore that affordability is a major issue at the same time as Virginia’s health care landscape changes.

“The ACA Marketplace and Virginia’s new Medicaid expansion have helped over 600,000 Virginians get health insurance,” Jill Hanken, a health attorney with the Virginia Poverty Law Center, said in the release. “But there are still many legitimate and urgent concerns about health care costs, access to services and medical debt. This survey offers important support for new initiatives in Virginia to, for example, address premium costs and balance billing.”

More than 290,000 Virginians have enrolled in Medicaid since the state’s expansion started on Jan. 1, according to the state’s Department of Medical Assistance Services. This figure includes more than 23,100 people in Southwest Virginia.

Ashley Edwards, chief innovation officer at the Virginia Center for Health Innovation, said the survey was done after Medicaid expansion went into effect in Virginia and “even still, a lot of Virginians are reporting affordability burdens and/or worry about future health care costs.”

She added that the survey offers important new information to policy-makers about “how consumers actually feel and perceive the health care system.”

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