Workers Give Low Ratings to Healthcare System, but Report Few Cost Increases

Five years after Congress passed the Affordable Care Act of 2010 (ACA), most workers surveyed by the Employee Benefit Research Institute (EBRI) and Greenwald & Associates continue to give low marks to the US healthcare system. The survey was conducted online with 1500 US workers between the ages of 21 and 64 years in June 2015. The data are weighted by gender, age, and education to reflect the actual proportions in the employed population.

The EBRI survey found that many workers describe the US healthcare system as poor (25%) or fair (30%). Dissatisfaction appears to be primarily focused on cost. Only 4% rate the US healthcare system as excellent or very good (13%) and 20% consider it good. Healthcare is not the issue the majority of workers consider to be the most pressing in the nation: the economy was named as the most critical issue, with healthcare named the second most critical issue.

Half of workers with health insurance coverage report having experienced an increase in healthcare costs in the past year, a historic low in the survey. The percentage reporting that they did not experience a change in healthcare costs increased from 36% to 47% between 2014 and 2015. Workers who said they were experiencing cost increases report that they are changing the way they use the healthcare system: 69% say because of increased costs they try to take better care of themselves, and 52% say they choose generic drugs more often. Half say they go to the doctor only for more serious conditions or symptoms (49%) and about 43% delay going to the doctor.

Interestingly, however, workers’ ratings of their own health insurance plans continue to be generally favorable, with half of those having health insurance coverage reporting being extremely or very satisfied and 41% being somewhat satisfied. Only 9% were not satisfied with their current health plan.

Satisfaction with healthcare quality continues to be fairly high, with 47% of respondents saying they are extremely or very satisfied with the quality of the medical care they have received in the past 2 years; 35% are somewhat satisfied, and 13% not too (8%) or not at all (5%) satisfied. In contrast, only 17% are extremely or very satisfied with the cost of their health insurance plans and only 15% are satisfied with the costs of healthcare services not covered by insurance.

Data from earlier ERBI studies show that the percentage of workers rating the healthcare system as poor has more than doubled between 1998 and 2006 (rising from 14% to 32%). That percentage fell between 2006 and 2013, then jumped to 29% in 2014, and fell to 25% in 2015. Between 2006 and 2013 the percentage of workers reporting that the healthcare system was fair or poor fell from 61% to 55% and then increased to 61% in 2014 and fell again to 55% in 2015.