Author Archives: Linda Barlow

“Not Being Able to Afford Medication for Our Child is Devastating”

During the month of August, Real World Health Care will take a short break from focusing on medical breakthroughs and the researchers who are shaping the future of medicine. We will instead bring you a special series from our sponsor, the HealthWell Foundation, about what happens when families cannot afford the medical treatments their children desperately need. The families we will profile have turned to the Foundation for help, through the HealthWell Pediatric Assistance Fund®, the only fund of its kind.


Did You Know?

Thanks to HealthWell’s Pediatric Assistance Fund, more than 400 children suffering from 90 life-altering conditions have been able to access critical medical treatments.


Since its launch in 2013, HealthWell’s Pediatric Assistance Fund has awarded more than $850,000 in grants to help more than 400 children start or continue critical treatments covering more than 90 disease areas and conditions, including ADHD, autism, cerebral palsy, Type 1 Diabetes, epilepsy, scoliosis, seizure disorder and many more. The Fund covers family cost-shares for surgical procedures, medical devices, counseling services, prescription drug copays and other out-of-pocket costs. This week, we’d like you to meet Alejandro, who was diagnosed with Cystic Fibrosis when he was six weeks old.

In the following letter, Alejandro’s parents, Ruben and Thelma, share the challenges of affording care for their child and the big difference that HealthWell’s Pediatric Assistance Fund grant made in their lives.

Aljeandro

Aljeandro

“Our son, Alejandro, was diagnosed with Cystic Fibrosis (CF) when he was six weeks old. This was a time with many mixed emotions for our family. Alejandro is a twin and we were thrilled to welcome two new babies into our family. Along with our excitement, there were many sad times because we were scared of the unknown: CF and our biggest fear as parents came true with his diagnosis. He has a chronic illness that can be managed, somewhat, but has no cure. 

CF is a disease that requires Alejandro to take many medications and breathing treatments. As part of his treatment, his doctors prescribed medication during the respiratory syncytial virus (RSV) season. Alejandro was prescribed one shot per month for a total of five shots; one for each month from November through March. Our out-of-pocket cost is $750 [$150 per shot], which is a huge financial burden. We applied to the HealthWell Foundation for financial assistance in order to be able to pay the copayment for Alejandro’s treatment. We also contacted the manufacturer of the drug. Unfortunately, having CF does not make you eligible to receive financial support. Having a child with a chronic illness has placed a lot of stress on our family, especially on my husband and me. 

Not being able to afford medication for our child is devastating and extremely frustrating for us as parents. This is why we are so thankful for the Pediatric Assistance Fund through the HealthWell Foundation. Without a grant, we would not have been able to afford this extremely important medication for Alejandro. Receiving help was heartwarming to us because, although the contributors to the Pediatric Assistance Fund do not know our son, they were willing to donate money to ensure a child who is in need of medication receives it. On behalf of Alejandro and our family, we would like to thank all of those kind people who donate their hard earned money for children like Alejandro who need extras in order to live.”

Ruben & Thelma (Alejandro’s parents)

Companies: An average Pediatric Assistance Fund grant is $2,500. With your corporate donation, you can help children like Alejandro afford the medical treatments they desperately need. Donate today to HealthWell’s Pediatric Assistance Fund.

“I Don’t Know What I Would Have Done without HealthWell”

During the month of August, Real World Health Care will take a short break from focusing on medical breakthroughs and the researchers who are shaping the future of medicine. We will instead bring you a special series from our sponsor, the HealthWell Foundation, about what happens when families cannot afford the medical treatments their children desperately need. The families we will profile have turned to the Foundation for help, through the HealthWell Pediatric Assistance Fund®, the only fund of its kind.


Did You Know?

100 percent of donations to HealthWell go directly to patient grants and services.


Sophie

Sophie

Since its launch in 2013, HealthWell’s Pediatric Assistance Fund has awarded more than $850,000 in grants to help more than 400 children start or continue critical treatments covering more than 90 disease areas and conditions, including ADHD, autism, cerebral palsy, Type 1 Diabetes, epilepsy, scoliosis, seizure disorder and many more. The Fund covers family cost-shares for surgical procedures, medical devices, counseling services, prescription drug copays and other out-of-pocket costs. This week, we’d like you to meet the Ambassador of the Pediatric Assistance Fund, Sophie.

Sophie suffers from a chronic illness affecting millions of Americans: asthma. In her own words, Sophie describes what it’s like to live with asthma and how HealthWell helped her family afford the medication she needs.

“Finding HealthWell was like a breath of fresh air,” says Pat, Sophie’s father.

Sophie is one of 14 million children in the United States whose family is underinsured. You can help kids like Sophie afford the medical treatments they desperately need by donating your tax deductible gift to HealthWell’s Pediatric Assistance Fund. Donate today. Watch Sophie’s story.

Sophie TY

 

Most Americans Say They Can Afford Drugs but the Sick Still Struggle

According to an August Kaiser Health Tracking Poll, it appears that most Americans (72%) can afford their prescription drugs. However, one in four Americans surveyed indicate difficulties, including more than four in ten people who are sick. Others facing difficulties paying for their prescription drugs include those with low incomes (33%) or those taking four or more prescription drugs (38%).

KFFPollAmong those with insurance, prescription drug costs rank among a number of other health expenses, with 11 percent saying their prescription drug costs is their most burdensome health care cost, while 17 percent say it is the deductible, 14 percent say it’s their health insurance premiums, and 44 percent say that paying for health care and health insurance is not a financial burden. For those with lower incomes, paying for prescription drugs tops the list, with 17 percent reporting it is their greatest financial burden when it comes to health care costs.

Most of Americans (62%) surveyed in the poll say that prescription drugs developed in the past 20 years have made lives of people in the U.S. much better, including 42 percent who say a lot better. Do you agree? Let us know your thoughts in the comments section.

Categories: Cost-Savings, General

Many Insured Americans Not Getting the Healthcare They Need

Last month, FamiliesUSA.org issued a sobering report about the disconnect between having medical insurance and receiving the healthcare one needs. The report concluded that for many Americans with non-group coverage (as opposed to having insurance from an employer or a public coverage program), deductibles and other out-of-pocket costs are prohibitively high and are associated with many of these insured consumers forgoing needed healthcare. According to the report, more than one in four adults who bought insurance for themselves or their families last year had to skip medical care because they couldn’t afford it.

Linda Barlow

Linda Barlow

“The Affordable Care Act has increased access to health insurance and financial assistance for millions of Americans,” wrote the report’s authors. “But even with the new assistance that helps consumers pay their premiums and out-of-pocket healthcare costs, one-quarter of consumers who buy insurance on their own still have problems being able to afford needed care.”

According to the report, adults with non-group coverage went without:

  • Tests, treatments or follow up care (15% of adults)
  • Prescription drugs (14%)
  • Medical care (12%)
  • General doctor care (12%)
  • Specialist care (11%)

High deductibles, copayments and coinsurance can leave some people in the position of having to make very tough decisions. Pay for needed medications or the electric bill? Pay for a doctor-recommended test or make a car payment? Pay for treatments and follow up care or pay the monthly mortgage?

These are decisions no one should have to make. No one should have to decide between cancer treatments and putting food on the table. No one should have to sell their car to pay for their child’s asthma medication. No one should go into bankruptcy just because they’ve been diagnosed with a life-changing illness.

If you or someone you know is facing decisions like these, know that help is available. Patient advocacy organizations, drug manufacturers, and charitable patient assistance programs may be able to provide financial assistance.

Do you know of an organization that helps provide a financial lifeline to Americans with inadequate insurance? Let us know about it in the comments section.

 

 

Awareness and Assistance Are Crucial to Fighting Hepatitis C

May is Hepatitis Awareness Month, a time when the healthcare and patient advocacy communities rally support for the millions of Americans afflicted with the disease, including an estimated 3.2 million suffering from chronic Hepatitis C (also known as HCV).

HepatitisAwarenessMonthOver time, chronic Hepatitis C can cause serious health problems, including liver damage, cirrhosis, liver cancer, and even death. In fact, Hepatitis C is a leading cause of liver cancer and is the number one cause of liver transplants.

While millions live with Hepatitis C, many don’t even know they are infected. This “hidden epidemic” can strike just about anyone, but those born from 1945 to 1965 are five times more likely to have the disease than those in other age groups. That’s why the CDC has issued a recommendation for all Americans born during that time to get a blood test for the disease.

In addition to the baby boomer generation, others may be at high risk for HCV infection, including those who:

  • Use injection drugs
  • Used unsterile equipment for tattoos or body piercings
  • Came in contact with infected blood or needles
  • Received a blood transfusion or organ transplant before July 1992
  • Received a blood product for clotting problems made before 1987
  • Needed blood filtered by a machine (hemodialysis) for a long period of time due to kidney failure
  • Were born to a mother with HCV
  • Had unprotected sex with multiple partners
  • Have or had a sexually transmitted disease
  • Have HIV

For people at risk, knowing they have Hepatitis C can help them make important decisions about their healthcare. Successful treatments can eliminate the virus from the body and prevent liver damage, cirrhosis, and even liver cancer. But sometimes, the cost of those treatments are out of reach, even for those with medical insurance.

Financial Relief Available

The HealthWell Foundation’s new Hepatitis C Fund is bringing financial relief to underinsured people living with the disease. Through the fund, HealthWell will provide copayment assistance up to $15,000 for HCV treatment to eligible patients who are insured and have annual household incomes up to 500 percent of the federal poverty level. To determine eligibility and apply for assistance, or learn how to support this program, visit http://bit.ly/HepC2015.

“The new generation of hepatitis C treatments has brought excitement to patients who have been hoping for a breakthrough,” said Krista Zodet, HealthWell Foundation President. “Through the generosity of our donors, our Hepatitis C Fund is able to help more people receive these treatments while minimizing the worry over financial stress.”

Because many HCV infections are identified only after the patient becomes symptomatic, community health centers are extremely important for getting patients into care. BOOM!Health is a community service organization located in the Bronx, New York, the epicenter of the Hepatitis C epidemic in New York City. It offers a variety of services to those living with HCV infections, including a fully staffed health center, pharmacy services, case management, nutrition education, counseling, pantry services, syringe exchange, behavioral care, and more.

“People living with HCV continue to face serious challenges, such as stigma and lack of access to treatment,” said Robert Cordero, President and Chief Program Officer, BOOM!Health, a community health center based in the Bronx that supports individuals on their journey towards health, wellness and self-sufficiency. “Non-profits that provide funding assistance like HealthWell fill a gap that we’ve watched grow.”

“Nearly 3.2 million people in the United States and about 150 million people worldwide are chronically infected with HCV,” said Tom Nealon, Esq., National Board Chair of the American Liver Foundation, a national patient advocacy organization that promotes education, support and research for the prevention, treatment and cure of liver disease. “The HealthWell Foundation and other independent copay charities play a vital role in seeing that those who are insured but can’t afford their medication copay are able to access and stay on treatment.”

If you or someone you know is living with Hepatitis C, emotional, physical and financial support are critical. What organizations and programs are you turning to for help? Let us know in the comments.

“It’s Lupus”: The Words No Woman Wants to Hear

They’re in the prime of their lives: young women who are finishing college, getting married, starting careers and families. Then comes the devastating diagnosis: systemic lupus erythematosus (SLE), otherwise known as lupus.

Linda Barlow

Linda Barlow

One and a half million Americans are afflicted with lupus, but the disease occurs 10 times more in women than in men and typically strikes when women are between the ages of 15 and 44. Lupus is the leading cause of kidney disease, cardiovascular disease and stroke among young women. Women of color are two to three times more at risk for lupus than Caucasians and are more likely to have disease that is severe.

Lupus is an unpredictable and misunderstood autoimmune disease that ravages different parts of the body; it is difficult to diagnose, hard to live with, and a challenge to treat. Lupus is a cruel mystery because it is hidden from view and undefined, has a range of symptoms, strikes without warning, and has no known cause and no known cure. Its health effects can range from a skin rash to a heart attack.

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A note from our sponsor:  If you or someone you know is living with lupus and struggling to afford the treatments, the HealthWell Foundation may be able to help.  Click here to visit HealthWell’s eligibility page.

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While many people may have heard of lupus, research shows that two-thirds of the public know little or nothing about the disease, and medical research has remained underfunded relative to its scope and devastation.

Lupus Awareness Month was established to provide people around the world the opportunity to unite and raise awareness of the disease. Several patient advocacy groups are recognizing May as Lupus Awareness Month with a variety of activities and outreach programs. We highlight two of them here.

To draw attention to the devastating effects of lupus in women in their twenties — the decade in which lupus is most often diagnosed — the Lupus Research Institute unveiled “Window on Lupus 2020,” a larger-than-life window display at New York City’s Rockefeller Plaza. Seen by about 250,000 people daily, the window display urges young women to talk with their healthcare professional if they have common symptoms of lupus such as persistent fatigue and fevers, swollen joints and/or skin rash.

“Twenty is the age when the future beckons with the brightest promise,” said Margaret Dowd, LRI President and CEO in a statement to the media. “But for many young women diagnosed with lupus, the future can hold the threat of serious consequences — the potential for a stroke, a heart attack, and kidney disease. We want people with lupus to know that there is hope in their future as we work to achieve our 2020 milestone to help prevent organ damage and progression.”

The Lupus Foundation of America is another patient advocacy group working to increase awareness of the disease. The Foundation launched a multi-media campaign this month called “KNOW LUPUS.” The campaign features a series of television public service announcements (PSAs), which include a collection of testimonials and statements from people living with lupus, along with celebrity advocates including Whoopi Goldberg, Tim Gunn and Susan Lucci.

The PSAs encourage people to play an online game that engages them to KNOW LUPUS and make a donation to lupus research.

“The goal of the KNOW LUPUS campaign is to bring greater awareness of lupus and raise funds for lupus research by engaging support from corporations, media, celebrities and community partners,” said Sandra C. Raymond, President and CEO, Lupus Foundation of America. “Everyone needs to KNOW LUPUS to create a future with NO LUPUS.”

Are you or is someone you know suffering from lupus? What are you doing to help spread the word about this disease, especially among young women? Let us know in the comments.

Speaking Up: Let Patients Have a Say

One of the main tenets of patient-centered care is giving patients more control over their health and health decisions made on their behalf. Patients have a clear and important role in their own care through a concept called “patienthood” — the self-management behavior that ensures we either give to ourselves or get from others the care we need to manage our health risks and medical problems.

Linda Barlow

Linda Barlow

On the surface, patienthood seems like a simple concept: our body, our health, our decisions. What might be right for the patient next door may not be right for us. At one end of the spectrum, patienthood may involve strategies like eating right and exercising to avoid problems related to obesity. At the other end of the spectrum, it may involve saying “no” to certain suggested treatments, as I did when I opted not to have chemotherapy after my breast cancer operation.

According to a report from Kaiser Health News, in many hospitals and clinics around the country, health care professionals simply tell patients what treatments they should have, or at least give them strong recommendations. But at UC San Francisco, a formal process called “shared decision making” allows patients to work with doctors to make choices –regarding their care. The approach has become a model for other programs around the country.

The report mentions a stumbling block to this approach: many patients aren’t accustomed to speaking up. Even the most engaged or educated patients may defer to their doctors because they are scared, they don’t want to be seen as difficult or they think the doctor knows best.

Doctors who recognize this stumbling block may want to take a cue from one family doctor profiled in the Washington Post who, when faced with a medical conundrum involving an elderly patient, pushed aside talk of possible treatments and asked the patient a simple question: “What are your goals for care, and how can I help you?”

This particular patient wasn’t looking for a cure. He simply wanted to live out his remaining days at home without worrying about falling. So the doctor put together a hospice and physical therapy plan that let him do just that.

Patients speaking up. Doctors asking the right questions…and listening to the answers. Patients and doctors deciding together on a course of care or treatment. The concept of patient-centered care cannot be fully realized until everyone involved has a say.

Have you ever played a role in deciding on your own course of treatment? Or do you typically hesitate to speak up to your health care providers? Let us know in the comments section.

30 Years of Health Disparities in Focus during National Minority Health Month

April is National Minority Health Month, a time to raise awareness about the health disparities that continue to affect minority populations. The observance traces its roots to a landmark 1985 report from the U.S. Department of Health and Human Services (HHS) that documented the existence of health disparities among racial and ethnic minorities in the U.S. The report called such disparities “an affront to both our ideals and to the ongoing genius of American medicine.”

Heckler_Report_logo_ribbon_site_highFast forward 30 years, and the HHS’s Office of Minority Health (established in 1986 and re-authorized in 2010 by the Affordable Care Act) continues its work to improve the health of racial and ethnic minority populations through the development of health policies and programs that will eliminate health disparities.

What sort of health disparities exist in the U.S.? According to the Office of Minority Health:

  • The death rate for African Americans is generally higher than for Whites for heart diseases, stroke, cancer, asthma, influenza and pneumonia, diabetes, HIV/AIDS and homicide. African American children are three times more likely to be admitted to the hospital for asthma than non-Hispanic White children, and African American adults are 70 percent more likely than non-Hispanic white adults to have been diagnosed with diabetes. In addition, fewer African Americans have health insurance than non-Hispanic Whites and are more likely to rely on Medicaid.
  • American Indians and Alaska Natives have an infant death rate 60 percent higher than the rate for Whites. They are also twice as likely to have diabetes, and have a disproportionately high death rate from unintentional injuries and suicides. American Indians and Alaska Natives also frequently contend with issues that prevent them from receiving quality medical care, such as cultural barriers, geographic isolation, inadequate sewage disposal and low income.
  • Tuberculosis is 24 times more common among Asians than for the non-Hispanic White population. Asian Americans also contend with numerous factors that may threaten their health: infrequent medical visits due to fear of deportation, language/cultural barriers, and the lack of health insurance.
  • Hispanics have higher rates of obesity than non-Hispanic Whites. Puerto Ricans have a low birth weight rate that is twice that of non-Hispanic Whites. They also suffer disproportionately from asthma, HIV/AIDS and infant mortality. Mexican-Americans suffer disproportionately from diabetes. Hispanic health is often shaped by factors such as language/cultural barriers, lack of access to preventive care, and the lack of health insurance.
  • Native Hawaiians and Pacific Islanders have higher rates of smoking, alcohol consumption and obesity compared with other ethnic groups. This group also has little access to cancer prevention and control programs.

To address these disparities, HHS in 2011 issued the HHS Action Plan to Reduce Racial and Ethnic Health Disparities. In the Action Plan, HHS points to the related benefits of the Affordable Care Act (ACA): “The Affordable Care Act not only includes provisions related broadly to health insurance coverage, health insurance reform, and access to care, but also provisions related to disparities reduction, data collection and reporting, quality improvement, and prevention. The [ACA] will also reduce health disparities by investing in prevention and wellness, and giving individuals and families more control over their own care.”

The Centers for Disease Control and Prevention are also on the front lines of advancing health equity with several programs in place that support the HHS Action Plan:

  • In collaboration with the Centers for Medicare & Medicaid Services (CMS), CDC is leading the HHS-wide “Million Hearts Initiative” to enhance community and clinical interventions to prevent cardiovascular disease (CVD) and stroke among all Americans, including minority populations at greater risk for CVD.
  • In the U.S., rates of childhood obesity are high overall, but for minority and low-income communities, they are even higher. The Childhood Obesity Research Demonstration (CORD) Project seeks to determine whether coordinated approaches in the community that support healthy behaviors can improve underserved children’s health.
  • The CDC Undergraduate Public Health Scholars (CUPS) program supports internship programs that expose undergraduate students interested in minority health to the field of public health research and practice by providing hands-on, project-oriented assignments.
  • The National Influenza Vaccination Disparities Partnership, supported by the CDC, is comprised of multi-sector partners working to promote vaccination among underserved populations including African Americans, Hispanics, and American Indians/Alaska Natives.
  • CDC also continues to partner with states and other grantees to work on reducing tobacco use among racial and ethnic minorities.

Disparities also exist at the health care provider level. According to the NAACP’s Opportunity & Diversity Report Card: Healthcare Industry, released earlier this month, top management positions in health care remain firmly dominated by white employees, despite the establishment of diversity and inclusion programs and a significant increase in minority college graduates entering the workforce over the past 20 years.

“With the health care industry being one of the fastest growing sectors in the country, it is important for us to highlight opportunities in this industry and where we can strengthen people of color’s full participation,” said Roslyn M. Brock, chairman, NAACP Board of Directors, in a press statement.

Here at Real World Health Care, we believe that every American, regardless of race or ethnicity, should have access to affordable care and patient-centered prevention programs. We salute the efforts of governmental organizations, NGOs, health care providers and other groups working to eliminate health disparities.

Are you aware of any individual or group efforts to reduce health disparities? Let’s all learn from what is working. Please share your examples in the comments section.

 

Life-Saving Information: Only a Smart Phone Away

For people suffering with chronic medical conditions such as diabetes, allergies, or epilepsy, wearing jewelry or carrying wallet cards containing emergency medical information (EMI) can be life-saving. However, some people feel uncomfortable with the stigma attached to EMI, or don’t use such accessories due to cost or inconvenience. Children, especially, are not likely to carry EMI identification because they are often with caregivers who know their medical history and needs.

Linda Barlow

Linda Barlow

Despite these barriers, EMI is vital in emergencies. It can help people identify what is wrong, allow providers to give appropriate medical care, provide the necessary contact information for the patient’s physician and family, and improve time to treatment. But if EMI isn’t available or accessible, it won’t provide these benefits.

Endocrinologists at the Children’s Hospital at Montefiore have studied this problem and a potential solution: a smartphone app that can be accessed without knowing the person’s password. Since most people — including kids and teens — carry their mobile phones with them all the time, a smartphone app can circumvent the problem of someone forgetting to carry their traditional EMI. And since it is simply part of their phone, it avoids the discomfort some people have about wearing EMI jewelry.

A report on this new way of sharing EMI, published in the journal Clinical Pediatrics, reviews the current choices for EMI, as well as its usage and barriers, and introduces a new EMI option for Apple mobile devices.

“A cell phone maintains anonymity of a person’s medical condition unless an emergency requires accessing the EMI,” suggest the report’s authors, noting that medical alert jewelry is more obvious. “Another advantage of cell phone-based EMI is the lack of additional cost for a MedicAlert device and membership or similar service.”

One of the traditional barriers to using smartphone apps for EMI is the need to enter the user’s password to access the app, which isn’t always possible during an emergency. However, Apple’s new iOS 8 software for iPhones and iPads has an application called “Health” that allows a user to enter information that can be accessed from the home screen, even on protected phones.

By opening the Health app and selecting the Medical ID option, patients can provide their medical conditions, medications, allergies, emergency contacts, blood type, organ donor status, and DNR requests. The information can be accessed on a locked home screen by tapping the emergency button and selecting the Medical ID option. On screens without a password lock, the user can access the information by opening the Health application.

“Cell phone-based EMI should be embraced by patients, health care providers, and cell phone programmers,” the authors write. “It remains to be determined whether patients will use technology-based EMI once they are aware of the option. Medical providers, including first responders, should be aware of this technology to educate their patients and to access the information in emergency settings.”

“We are embarking on an education campaign to spread awareness about traditional and modern EMI options,” says Kristina Derrick, MD, MSc, Pediatric Endocrine Fellow, Children’s Hospital at Montefiore. “To start, we are creating information sheets that have instructions on obtaining EMI for the smart phone and traditional forms like jewelry and wallet cards. We will be distributing this information to patients, families and pediatricians as well as to emergency department staff and first responders.”

“Some patients may not be convinced of the need to have emergency medical information accessible to others,” Dr. Derrick cautions. “But even a patient or parent who knows everything about the medical condition and contact numbers may not be able to recall or relay this information during an emergency incident.”

Have you or a loved one used a smartphone based EMI to share important medical information with providers? Or is this a technology you would consider using? Let us know in the comments section.

ACA Update: When Medical Insurance Doesn’t Result in Medical Care

Amid continuing partisan debate on Capitol Hill about the Affordable Care Act, the facts are clear: the law has significantly reduced the number of uninsured Americans. Last week the federal government issued a report indicating more than 16 million people who did not have health insurance before have gained coverage thanks to the ACA. According to the Department of Health and Human Services, these gains have delivered the largest drop in the uninsured rate in four decades, bringing that rate down to 13.2 percent.

Linda Barlow

Linda Barlow

“These numbers prove the Affordable Care Act is working, and families, businesses and taxpayers are better off as a result,” said HHS secretary Sylvia Burwell.

While few would dispute that having medical coverage is better than not having medical coverage, coverage is not always a panacea for all ills. First, consumers need to take advantage of the coverage they now have. The federal government recognizes the gap between having medical insurance and getting medical care and has established a website to help consumers use their new marketplace coverage.

For about 19 percent of privately insured adults, higher cost-sharing responsibilities are to blame for the lack of medical care received. Fortunately, the number of Americans reporting they did not receive needed health care because of its cost dropped for the first time last year since 2003, falling from 80 million in 2012 to 64 million in 2014. Still, twenty-one percent of adults with health insurance spent 5 percent or more of their income on out-of-pocket health care costs during 2014, and 13 percent spent 10 percent or more, according to a report from the Commonwealth Fund.

These underinsured Americans face tough choices every month: Do they use their limited funds to pay for needed health care visits, therapies and procedures, or do they use that money for essentials like rent, utilities, child care and food?

Our sponsor, the HealthWell Foundation, believes that no American should go without essential medications and other therapies because they cannot afford them. The Foundation has helped more than 200,000 underinsured patients afford their medical treatments since its launch in 2004. As we recognize the fifth anniversary of the passing of the ACA, we want to know if you agree. Has the ACA helped you and your loved ones receive needed care, or are high out-of-pocket costs still keeping you from seeking the care you need? Let us know in the comments.