tion; Kim chose to delay a gastroenterology appointment that would cost $75 per visit and $50 for bloodwork at another provider. Having public insurance can make finding providers more challeng- ing, especially when health needs are complex:
“[I’m] very limited by which dentists take which health insurance and which ones are good at—also, because of the chronic illness, there’s always that is- sue of, I guess, things are different. When you ask a provider, they take your insurance, but they’re not really comfortable dealing with someone who has a chronic illness or this particular chronic illness. It’s been really difficult.”
Over time, Kim has found it more important to find providers who are a good fit: “Before, I would just go with anyone as long as they take my insurance and they’re a provider. Now, I’m tryin’ to find someone who I’m comfortable with and who I can actually talk to and ask questions and get proper healthcare and not just, ‘Let’s fix this problem as quickly as possible.’” Kim’s experiences highlight that, although health insurance is necessary to receive care, insur- ance coverage is not a guarantee of access to needed services. While public insurance offers sta- ble coverage, the challenges with finding providers who take it undermine its effectiveness. High cost-sharing and rising premiums, paperwork burden, restrictive networks, and instability also un- dermine the benefits of having private insurance, including through an employer, leaving high-need New Yorkers with steep healthcare bills to pay. These challenges are consistent with our observa- tions that insurance- and cost-related barriers to care continue at high rates among high-need New Yorkers facing economic disadvantage, even though a majority of them have health insurance.
PATTERNS OF DELAYED HEALTHCARE AMONG NEW YORKERS WITH HIGH HEALTHCARE NEED 15
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