11% in 2021), economically disadvantaged New Yorkers continued to skip or delay filling their prescriptions at similar rates (16% in 2021 and 17% in 2022). This shift led to a widening disparity in prescription utilization as the pandemic started receding, and suggests that, for high-need New Yorkers facing economic disad- vantage, there is a continued need for supports that enable these New Yorkers to regularly access, fill, and take their prescription medications. Share of high-need New Yorkers who skipped, took less, or delayed filling a prescription due to cost Figure 5 Figure 5. Share of high-need New Yorkers who skipped, took less, or delayed filling a prescription due to cost
2021
2022
25%
20%
17%
16%
15%
11%
10%
6%
5%
0%
Economic disadvantage
No economic disadvantage
Source: Poverty Tracker longitudinal survey data, cohorts three and four. High-need refers to New Yorkers with high healthcare needs, such as multiple chronic health conditions, serious psychological distress, or a work-limiting health condition.
Although health insurance can address many barriers to healthcare by reducing the out-of-pocket cost of prescriptions, care visits, and procedures, health insurance coverage is not a guarantee of access. Some health services may not be covered by insurance plans, and difficulty navigating coverage and find- ing care options can contribute to instances of delayed and forgone care. 11 Figure 6 shows differences in health insurance coverage among high-need New Yorkers over the course of the pandemic. Economical- ly disadvantaged, high-need New Yorkers appear to have experienced an eight percentage point drop in self-reported insurance coverage over the course of the pandemic (96% in 2021 versus 88% in 2022). Almost all more-advantaged, high-need New Yorkers had insurance coverage throughout the pandemic (98% in 2021 and 99% in 2022). The widening gap in health insurance coverage suggests that issues of affordability can especially hinder those experiencing poverty or hardship from pursuing—and eventually receiving—necessary healthcare.
11 While our results find a potential decline in health insurance coverage over the pandemic, some research suggests that there is a discrepancy between self-reported health insurance coverage and administrative counts of coverage. For more information, see Ding, Sommers, and Glied, “Unwinding and the Medicaid undercount: millions enrolled in Medicaid during the pandemic thought they were uninsured.”; McIntyre, Smith and Sommers, “Survey-re- ported coverage in 2019-2022 and implications for unwinding Medicaid continuous eligibility.”
PATTERNS OF DELAYED HEALTHCARE AMONG NEW YORKERS WITH HIGH HEALTHCARE NEED 12
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