Central Valley Residents Report Acute Challenges with Rising Health Care Costs, Medical Debt, and Access to Care — At Significantly Higher Rates than Other Californians

A new CHCF survey provides a window into health care issues facing 1.8 million people living in Mariposa, Madera, Fresno, Kings, and Tulare counties — 57% of whom are Latino/x and 45% of whom live below the poverty line.

63% of Central Valley residents report skipping or delaying care due to cost in the last year, while three in four worry about being able to afford out-of-pocket health expenses or unexpected medical bills — much higher numbers than the rest of the state.

Hundreds of thousands of people in the Central Valley continue to struggle to find health care. Half of residents say their community doesn’t have enough providers, and 23% report a recent hospital closure in their community.

OAKLAND — Residents of California’s Central Valley are facing acute challenges with health care costs, medical debt, and access to care at significantly higher rates than the rest of the state, according to a newly released 2024 CHCF Central Valley Health Policy Survey. The poll, a regional follow-up to CHCF’s annual statewide health survey, focuses on the health care experiences of the 1.8 million people living in the counties of Mariposa, Madera, Fresno, Kings, and Tulare. The survey was conducted among a representative sample of 1,525 Central Valley residents age 18 or older.

Health care costs and access are among the most urgent issues identified in the Central Valley, where 57% of the population is Latino/x and 45% of residents have family incomes below 200%

of the federal poverty level (compared to 30% statewide). With 91% of respondents saying health care is “extremely” or “very” important for state government to focus on, more than 8 in 10 identified these individual issues as a top priority: Reducing the amount of money people pay for care (86%), increasing access to mental health treatment services (86%), increasing the number of health care providers (86%), making information about cost more available to patients (83%), and decreasing wait times for people trying to see a provider (82%).

More than 6 in 10 Central Valley residents (63%) say they have skipped or delayed care due to cost in the last year — compared to 52% of Californians in the rest of the state. Among those who skipped care, half (49%) say it made their condition worse. More than three in four Central Valley residents are “very” or “somewhat” worried about being able to afford out-of-pocket health care costs (78%) and unexpected medical bills (77%). In contrast, less than two out of three Californians in the rest of the state say the same.

“Central Valley residents experience cost-related access issues and carry medical debt at much higher rates than residents in other parts of the state,” says Kristof Stremikis, director of Market Analysis and Insight at the California Health Care Foundation. “At the same time, health care workforce shortages are also negatively impacting access to care in the region. Unfortunately, cost problems and workforce shortages are now affecting the health care decisions of hundreds of thousands of Central Valley residents every year.”

Some of the other top issues highlighted in CHCF’s new Central Valley poll:

• Medical debt. Nearly half of Californians in the Central Valley (48%) have medical debt compared to 36% of Californians in the rest of the state. A total of 56% of Central Valley residents with low incomes and Latino/x residents report medical debt.
• Affordable care. More than one in three Central Valley residents (35%) say it is “somewhat” or “very” difficult to access high-quality, affordable health care for them and their families — including 44% of those with low incomes. That’s compared to 24% of respondents in the rest of California.
• Provider shortages. Half or more of Central Valley residents think their community does not have enough providers, especially mental health providers (56%). As a group, Central Valley residents are less likely to have a regular doctor or health care provider (78%) than residents in the rest of the state (85%).
• Weather and environment. Nearly 6 in 10 Central Valley residents (58%) and about two in three Central Valley residents with low incomes (67%) and Latino/x Central Valley residents (64%) are “very” or “somewhat” worried about the effect of weather and environmental factors — such as extreme heat, floods, wildfires, and air quality — on their or a family member’s physical or mental health.
• Hospital closures. Nearly one in four Central Valley residents (23%) report a hospital closure in their community in the last 12 months, more than four times higher than residents in the rest of California (5%).
• Insurance issues. Three in 10 Central Valley residents (30%) and one in three Latino/x Central Valley residents (33%) report experiencing a change in health insurance coverage in the past year, compared to 21% of people in the rest of California. Nearly half of Central Valley residents (47%) report waiting for insurance authorization of a treatment, procedure, or medicine prescribed by their doctor — compared to 39% of residents in the rest of the state.

Poll results will be published at 12:01 AM (PT) on Thursday, April 11, 2024, and can be found at this link after that time: The 2024 CHCF Central Valley Health Policy Survey

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