Opinion: The Cost of Medical Care is Unaffordable for California’s Most Vulnerable. We Need Policy Change

Photo by Caique de Abreu/iStock.

When Anaheim resident Daisy Chavez lost her job in 2018, she knew she’d lose her health insurance too. She also knew that, without health insurance, she wouldn’t be able to afford the medical care and prescriptions she needed to manage her diabetes. 

“I remember being concerned taking my last pill for diabetes and thinking to myself, ‘After this, I really have to watch what I’m eating because I won’t have the medication,” Chavez said. 

Once her medication ran out, Chavez tried to make do without it. She’d test her sugar levels and, when they rose, would do things to try to lower them on her own, like go for a walk. But not having access to medical care made her feel powerless.

Chavez is one of millions of Californians who feel they can’t afford to address their health needs, whether through medication, doctor’s visits or insurance coverage. On average over the past year, about 1 in 4 Californians say they or a family member couldn’t afford a medical bill. The problem is hitting Latinos, like Chavez, and Black Californians the most. 

The problem is, median salaries have not kept pace with the rising cost of medical care.  California’s new Office of Health Care Affordability recently proposed capping medical spending growth at 3 percent, an action that my organization, the California Pan-Ethnic Health Network,  believes could better help lower-income and non-white people access medical care. This would mean that there would be a set limit to how much things like insurance premiums or the cost of certain medical services could rise every year.

Opponents include hospitals and health care providers concerned that a spending target for medical costs could further impede access to quality care. That doesn’t mean much when patients can’t afford that care in the first place.

Being unable to pay for health care leads to poorer health. For Chavez, the stress of not being able to afford any medical care for her diabetes caused her to self-medicate in other ways, which damaged her overall health. A 2022 survey found that half of Californians reported skipping or delaying health care due to cost in the past 12 months. People who are Black or Latino were more likely to skip or delay care (67 percent and 53 percent respectively). Of those who skipped or delayed care, half said their condition got worse as a result. This increases the burden on an already overtaxed health care system, pushing costs up further.

Today, Californians, especially Californians of color, die from preventable problems because the incentives in the system are wrong. If we truly want to address health inequities, we must start by tackling the cost of health care. 

After securing another job with health insurance, Chavez recently found herself unemployed and uninsured again. She’s applied for Medi-Cal, the state health insurance program for low-income people, but is anticipating at least a three-month lag in her care due to processing times. That means she’ll once again be forgoing care for her diabetes.

“I’m stocked up (on medications) for three months and once those three months end, if I don’t have a job or Medi-Cal, then I have to assess my finances and figure out, ‘Is it worth paying for this medication, or would I rather use this money to offset my bills or rent?’” she said.

She knows that puts her at risk of getting sick, but she’s resigned.

“If someone calls an ambulance, I will not get in that ambulance because I can’t afford it,” she said. “Just leave me here. If I can make it, I will, and if I don’t, I don’t.” 

The Office of Health Care Affordability is expected to vote on the 3 percent cap on health care cost increases in mid-April. 

Kiran Savage-Sangwan is executive director of the California Pan-Ethnic Health Network and serves on the Office of Health Care Affordability’s Advisory Committee. 

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