From Coverage to Care: A People's Report on Healthcare in New York

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Through surveys of hundreds of New Yorkers, this timely report reveals the critical ways in which the state’s private, for-profit insurance system is failing to deliver the health care that people urgently need.

OUR METHODS

CNYH completed 2,409 Healthcare Rights and Access Surveys with residents all over New York state between August 2017 and January 2019. Read more about the survey and report methods here.

Download the Report From Coverage to Care: A People's Report on Healthcare in New York

Download the Executive Summary

KEY FINDINGS

INSURED YET UNABLE TO GET CARE

  • A striking number of respondents faced cost barriers and inadequate coverage that prevented them from getting medical care. 50% of all privately insured respondents reported skipping or delaying at least one type of care because of cost. Three out of four (72%) of these respondents skipped or delayed multiple types of care.
  • These findings reveal a crisis of underinsurance: insurance coverage is no guarantee of timely access to adequate and necessary care.

UNINSURED AND INSECURE

  • An overwhelming number of survey respondents (73%) reported being uninsured at some point in their lives. Lack of health insurance has been a fact of life for almost everyone.

THE MARKETPLACE FAILS TO MEET HEALTHCARE NEEDS

  • Respondents who purchased plans through the individual marketplace were more likely than respondents insured through other types of coverage to report problems getting the care they need (63% vs. 42%) and skipping or delaying care due to cost (63% vs. 49%).
  • Despite public subsidies and increased regulation, those with marketplace private insurance plans are struggling to afford and access care.

THE BURDEN OF HIGH COSTS

  • Many respondents reported problems paying bills out of pocket (40%), deductibles (31%), co-pays (31%), and premiums (29%).
  • When New Yorkers don’t get the right care when they first need it, they can develop more advanced, complex—and often more costly—illnesses, putting unnecessary strain on families, communities, and the health system.
  • Nationwide, medical debt is the single leading cause of personal bankruptcy.

THE HEALTH INSURANCE SYSTEM RESTRICTS CHOICE AND FREEDOM

  • New Yorkers who rely on insurance through an employer, spouse, or parent report not having the freedom to make significant life choices as they wish, for fear of losing insurance or access to covered providers or services.

WOMEN, PEOPLE OF COLOR, TRANSGENDER PEOPLE MOST IMPACTED

  • The survey revealed alarming results for women, transgender people, and people of color, communities more likely to experience barriers to healthcare.
  • Women are disproportionately adversely affected by the failings of the current health system.
  • Inadequate access to quality, timely care throughout women’s lives and a lack of healthcare resources in poor and Black communities are just some of the many complex causes of maternal mortality.
  • Transgender respondents overwhelmingly experienced problems at a greater rate than others getting the care they needed (69%), paying medical bills (67%), skipping or delaying needed care (77%), and developing more serious conditions because of delayed care (64%).
  • Hispanic respondents were more likely to be uninsured (26%) than non-Hispanic ones (5%).
  • Although we only had 20 respondents who identified as American Indian or Indigenous, 70% have had problems getting needed care.

HEALTHCARE WORKERS WITNESS UNEQUAL CARE

  • 65% of health professional respondents report witnessing different treatments for patients based on their health insurance status.
  • Insurance status and cost dictate the type of care that patients receive, undermining the relationship between healthcare professionals and their patients.

LONG-TERM CARE AND SUPPORT

  • Many people try to fill gaps in long term care by caring for their loved ones themselves, but they do so at a cost: their responsibilities at home make it difficult to find work and obtain health benefits.

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By sharing our personal stories struggling to get care in the current system, we let others know they are not alone. This is not a personal failure on their part, but rather a systemic problem. We need to join together to build the political will to change the system. Please share your story with the Campaign for New York Health in order to shine a light on the need for a universal healthcare system that guarantees care for all of us. A system where no one is left behind. 

 

Carlyn Cowen, Chief Policy and Public Affairs Officer at CPC (The Chinese-American Planning Council):

“This report confirms what we see at our community centers on daily basis: that whether or not people have insurance, they are suffering under a system in which they cannot afford the care that they need, and that people of color, immigrants, and women are disproportionately targeted. The data shows that the failures of our healthcare system are pervasive across the State, but more importantly, the stories show that they are pervasive across our families and communities.”

 

Rev. Emily McNeill, Executive Director, Labor Religion Coalition of NY:

"From Coverage to Care' puts new figures and faces to the healthcare crisis that both insured and uninsured New Yorkers are facing. The reality it exposes is simply unacceptable. Our profit-driven, insurance-based system erects barrier after barrier to getting healthcare - especially for the most vulnerable - and the consequences are heartbreaking. At the same time, this report is a hopeful milestone in the movement for universal healthcare in our state. Having told and heard these stories, we can't now turn back from winning the human right to healthcare for all."

 

Rebecca Fuentes, Lead Organizer, Workers' Center of Central NY:

"To truly understand the depth of the crisis facing workers in our state, whether it has to do with working conditions, wages, or healthcare, we must listen to the stories of working people in our communities. Workers are struggling to access healthcare and access is nearly impossible to the 600,000 undocumented workers in New York State who do not qualify for insurance. The challenges are especially great for undocumented agricultural workers, who are are isolated in rural areas and face additional challenges due to language barriers, lack transportation, and threats from Border Patrol. The People's Report on Healthcare in NY begins to shine a light on how we are all impacted by the inequities of the current system."

 

The Workers’ Center of Central New York is a grassroots organization based in Syracuse focused upon workplace and economic justice. Through community organizing, leadership development, popular education and policy advocacy, the Workers’ Center of Central New York aims to empower marginalized, low-wage workers to combat workplace abuses and improve wages and working conditions throughout the community.

 

Zahara Zahav, Community Organizer, Jews for Racial & Economic Justice

“The stories and findings of this report underline what New Yorkers have been sharing around kitchen tables and in town halls across the state - the vast majority of us are not getting the care we need, and especially the fastest-growing area of healthcare, long-term care. Seniors and people with disabilities should be able to stay at home and in our communities. Family caregivers and home care workers should be valued for the significant work of providing care. We need a healthcare system that meets our needs, and that means guaranteeing dignified long-term care.”

 

Azwade Rahman, Co-President, Students for a National Health Program SUNY Upstate:

“Providing quality care requires listening to our patients. The stories our patients and instructors share and the results of this report indicate that the current system isn’t work. That despite the high costs of the current health system don’t add up to better health outcome. We think it’s time to check our calculations and listen to the experiences of the patients and providers to determine the best way forward to a healthcare system where patients get the care they need and where physicians can do their jobs with the obstruction and waste that is create by the insurance industry.”

 

Pete Meyers, Tompkins’ County Workers’ Center:

"Since its inception, the Tompkins County Workers' Center has championed the cause of a Living Wage for everyone. Year after year, the out of control premium costs driven by the private health insurance industry severely impact costs of living for workers. Today, health insurance alone is more than two dollars per hour of the Living Wage in Tompkins County and it keeps rising. Meanwhile, small enterprises that seek to provide health benefits for employees are crippled by premium costs. Every person deserves full access to the health care system, and working people and employers deserve to have this access funded by progressive taxes rather than a private system that by design punishes workers with small budgets and employers with small workforces. "Studies like thePeople's Report on Healthcare are critical to understanding the impact of the current systems on the lives of workers and small local businesses.""