Skipping care due to costs: Strategic Framework

This look at health care costs and affordability is a part of our blog series for Texas 2036’s Strategic Framework, which provides in-depth, cross-cutting data to inform key decisions about the most significant issues facing the state.

One of our goals at Texas 2036 is to ensure that health care is affordable. While there are many ways of evaluating affordability, we strive to look at the affordability of care both at the individual and systemwide levels.  

In Texas 2036’s Strategic Framework, the primary indicator for Goal No. 8 — Patient Affordability — looks at the percentage of Texans who skipped care due to cost in the last year. A nationally tracked measure by the Behavioral Risk Factor Surveillance System asks whether individuals needed to see a doctor but did not because of cost. Among our 11 peer states, Texas ranks last. A broader measure, tracked by the Episcopal Health Foundation, asks about not just doctor visits but any needed care or treatment, including prescription drugs. In this measure, 59% of Texans answered that they had skipped care due to cost. 

While skipping care due to cost is significantly higher among the uninsured at 78%, over half, 56%, of Texans with insurance have skipped care due to cost. Thus, while increasing the number of Texans with insurance is a valuable strategy to improving patient affordability, it is clear that insurance alone will not solve the problem. To make health care more affordable for patients, we will need to address the root cause: high prices.