Perceptions of Health Care Affordability and Hospital Facility Fees in Maine
Topline Results From a Survey Conducted on Behalf of U.S. of Care and Maine Consumers for Affordable Health Care
by
February
2024
Introduction
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Background & Methodology
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Health Care Affordability and Medical Debt
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Half of surveyed voters in Maine believe it is difficult to afford health care.
Overall, including the costs of health insurance, medical care, and prescription drugs, how easy or difficult is it for your household to afford health care at this point in time?
(n=505)
Affordability of Health Care
Total Difficult to Afford Health Care:
48%
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Two out of three voters who have health insurance through an employer believe that health care has become less affordable over the past five years. Many – three out of ten – feel health care has become much less affordable over that time.
Overall, including the costs of health insurance, medical care, and prescription drugs, compared to five years ago, has health care become more or less affordable for your household?
Among those who have health insurance through an employer (n=165)
Change in Affordability of Health Care Over Past 5 Years
(Among those who have health insurance through an employer)
Total Less Affordable:
63%
“The rising cost of…medical expenses is getting out of hand. Seeking routine care or getting medical care that is required for sickness or chronic disease shouldn't be a burden to someone's bank account.”
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Two out of three voters would have at least some difficulty paying a $500 medical bill.
Let’s say someone in your household incurred an unexpected medical expense of $500 next week. If that happened, which of the following statements best describes your ability to pay that bill?
(n=505)
Ability to Pay an Unexpected Medical Bill of $500 in 30 Days
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Four out of ten Mainers have taken on medical debt within the past five years. �Hospital-owned facilities are, by far, the most common source of medical debt, with almost six out of ten saying the largest share of their debt came from a hospital facility.
At any point over the past five years, have you or has anyone in your household taken on medical debt?
Do you or does anyone in your household currently have any kind of medical debt?
Medical Debt
Primary Source of Medical Debt | |
A hospital or hospital-owned facility | 56% |
Currently Have
Medical Debt
(n=505)
Among those who have had medical debt in the past five years (n=196)
Three out of four who have taken on medical debt in the past five years still have medical debt (73%).
“Medical debt is one of the leading causes of bankruptcy for average citizens in the USA. No one should have to empty their savings account, and go to court, just so they can keep being alive. Even if it is for a simple headache, a hospital should be there to help.”
Using your best guess, where did the largest share of your medical debt come from?
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Half of Mainers with medical debt have been contacted by a collections agency because of that debt. �Closer to three out of ten are on a long-term payment plan, have taken on credit card debt, used most or all of their savings, or have struggled to pay for basic necessities as a result of medical debt.
In the last 5 years, have you or has anyone in your household experienced any of the following as a result of the cost of your medical care or medical debt?
(Please select all that apply.)
Challenges Resulting From Medical Debt
Among those who have had medical debt within the past five years (n=196)
Almost nine out of ten Mainers who have medical debt have experienced at least one of these challenges (86%).
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Hospital Facility Fees
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A total of one-quarter of surveyed Mainers say they have been charged a hospital facility fee.
To the best of your knowledge, has anyone in your household been charged a hospital facility fee as part of a medical bill within the past five years?
Experience With Hospital Facility Fees
(n=505)
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Six out of ten voters feel that hospital facility fees charged for health care not provided in a hospital are “excessive,” and half feel they are “expensive.” �Just one out of ten believe these fees can be described as “necessary” or “expected.”
Which of the following words or phrases do you think describe hospital facility fees that are charged for health care services are not delivered in a hospital? (Please select all that apply.)
Descriptors of Hospital Facility Fees
(Percentage who believe terms describe hospital facility fees)
(n=505)
“Hospital [facility] fees are so unfortunate. Medical providers…should do what they do. Charging additional fees for the purpose of making money is wrong.”
“The typical businesses that provide services or products don't charge a facility fee. I don't understand why health care businesses need to charge one. It appears to be a gimmick to increase profit without effectively managing overhead costs”
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When asked how they would feel if they were charged a hospital facility fee for health care received outside of a hospital, six out of ten voters in Maine say they would feel “taken advantage of.”�Only one out of twenty would be “accepting or understanding” if they were charged a hospital facility fee for care received outside of a hospital, and almost none would feel “comfortable.”
Let’s say you received a bill that included a “hospital facility fee” for health care services you received outside a hospital. How do you think you would feel? (Please select all that apply.)
Feelings About Hospital Facility Fees Charged for Care Received Outside of a Hospital
(Percentage who say they would feel specified way if charged a hospital facility fee)
(n=505)
“[I’d feel] upset and stressed.”
“I’d feel irritated.”
“I’d be less likely to seek medical attention in the future.”
“I’d feel deceived – like my trust had been broken.”
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Almost eight out of ten would support a law in Maine that banned hospitals from charging facility fees for care received outside of a hospital.
Support for Banning Hospital Facility Fees for �Care Received Outside of a Hospital
Total Support:
(n=505)
77%
Based on anything you may know or believe at this point, to what extent would you support or oppose a law in Maine that bans hospitals from charging “hospital facility fees” for health care services that are provided outside of a hospital, like at a clinic or doctor’s office?
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Nine out of ten voters would support laws that required medical providers to disclose their facility fees to patients or report the revenues they collect from those fees. Seven out of ten would strongly support those laws.
Below is a list of specific policy changes that have been proposed for hospital facility fees. For each, would you support or oppose lawmakers…?
Support for Specific Policy Actions to Address Facility Fees
(n=505)
Requiring medical providers to disclose their facility fees up front to patients, before they are seen |
Requiring hospitals to report data on facility fees, including how much revenue they are collecting from facility fees |
“I think hospitals are for-profit organizations and should be taxed like a business.”
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Roughly eight out of ten voters would support restricting facility fees for routine care, preventive care, or all services not performed on a hospital campus. �Seven out of ten voters would support banning facility fees everywhere for outpatient services.
Below is a list of specific policy changes that have been proposed for hospital facility fees. For each, would you support or oppose lawmakers…?
Support for Specific Policy Actions to Address Facility Fees
(n=505)
Banning or limiting facility fees for ROUTINE care, such as primary care and office visits, regardless of where those routine care services are provided |
Banning or limiting facility fees for PREVENTIVE services regardless of where those preventive services are provided |
Banning or limiting hospitals and health systems from charging facility fees for ALL SERVICES not located on a hospital campus |
Banning hospital facility fees for OUTPATIENT, same-day services, regardless of where the care is being provided |
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Profile of Participating Mainers
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Demographic Characteristics of Survey Respondents
Race | |
White or Caucasian | 96% |
Indigenous (American Indian or Alaska Native) | 2% |
Black or African American | 1% |
Asian | 1% |
Indigenous (Native Hawaiian or Other Pacific Islander) | 1% |
Prefer not to say | 2% |
Age | |
18-34 | 24% |
35-49 | 23% |
50-64 | 25% |
65+ | 28% |
AVERAGE | 50 |
Gender | |
Male | 48% |
Female | 50% |
Some other way/Prefer not to say | 1% |
Congressional District | |
CD1 | 50% |
CD2 | 50% |
Ethnicity | |
Hispanic origin or descent | 2% |
Education | |
High school graduate or less | 39% |
Some college, vocational degree, or an Associate’s degree | 31% |
Bachelor’s degree | 18% |
Post graduate work or advanced degree | 12% |
Employment Status | |
Employed full-time | 34% |
Employed part-time | 12% |
Not employed, looking for work | 7% |
Unable to work due to medical, health, or other issues | 9% |
Retired | 26% |
Student | 3% |
Stay at home parent or caregiver | 6% |
Political Party Affiliation | |
Democrat | 36% |
Republican | 28% |
Unenrolled or enrolled in another party | 37% |
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Demographic Characteristics of Survey Respondents
Household Income | |
Under $20,000 | 16% |
$20,000 to $34,999 | 15% |
$35,000 to $49,999 | 15% |
$50,000 to $74,999 | 21% |
$75,000 to $99,999 | 12% |
$100,000 to $149,999 | 12% |
$150,000 or more | 6% |
Number of Adults in Household | |
1 | 21% |
2 | 57% |
3 | 13% |
4 | 7% |
5 | 2% |
6 | 1% |
Number of Children in Household | |
0 | 72% |
1 | 13% |
2 | 9% |
3 | 3% |
4+ | 2% |
Insurance Coverage | |
Employer-provided Coverage | 33% |
Medicare / Medicare Advantage | 30% |
MaineCare / Medicaid | 30% |
Insurance purchased directly from an insurer or CoverME.gov | 5% |
Another government program (like TRICARE) | 2% |
Don’t have health insurance | 7% |
Something else | 1% |
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