More Texans are skipping care due to uncertainty over medical bills

J.P. Morgan, the famous financier, was reported once to have said, “If you have to ask what the price is, you can’t afford it.”

That adage would seem to apply as well to the perception of a growing number of Texans when it comes to health care, according to a recent Texas voter poll conducted on behalf of Texas 2036.

In our most recent survey of Texas voters in August, 41% reported that they or a household member postponed or skipped medical treatment or surgery because of uncertainty over what the final price of care might run.

That number is also on the rise. When we last asked this question in September 2022, just 31% reported that they or a household member had postponed or skipped care.

In healthy markets, informed consumers can shop for care, compare providers on both price and quality, and select them on the basis of their overall value. In order for Texas to achieve that vision, our markets need to be informed, competitive and engaged.

We are not the only ones to notice increased fears among Texans about medical bills. The Episcopal Health Foundation released the results of its own tracking survey this week, in which 68% of Texans said they or a family member had postponed some sort of health care, which includes things like check-ups, filling prescriptions, recommended tests and treatment, and dental care, because of the cost within the last year.

Our poll: What voters told us

In our poll, Texas voters also told us that they are inclined to back active measures by the government to curb consolidation in the health care sector, which independent research from health economists tells us is leading to higher prices for health care.

Nearly nine in 10 voters told us they were concerned about consolidation in the health care sector. Voters also strongly backed actions like enhanced government antitrust enforcement, with 53% in favor and just 31% opposed. They similarly backed prohibitions on hospital or insurer-owned doctor groups and pharmacies, with 52% in favor and 35% opposed.

But not all potential solutions appear popular among Texas voters. Moving toward a single-payer, government run health care system was favored by just 37% of voters. Even less popular was the option of doing nothing and maintaining the status quo. Only 18% favored that course of action.

Texans, in other words, are clear that doing nothing isn’t an option, and they have expressed a preference for market-based solutions that harness competition and transparency, rather than a wholesale government takeover. But if lawmakers don’t engage to empower healthy markets, single-payer alternatives loom on the horizon as more popular than the status quo.

Policymakers interested in addressing high prices for Texas health care could consider policies to limit opportunities for further market concentration, reduce existing concentration of markets and mitigate the harmful impacts that existing concentration has on prices.

By addressing any of these underlying causes of high health care prices, Texas could make major improvements in the availability of affordable care.

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