COSTS FORCING MORE AMERICANS TO DELAY CARE

At a health-screening event in Sarasota, Florida, people gathered in a parking lot and waited their turn for blood pressure or diabetes checks. The event was held in Sarasota's Newtown neighborhood, a historically Black community. Local resident Tracy Green, 54, joined the line outside a pink-and-white bus that offered free mammograms.

"It's a blessing because some people, like me, are not fortunate, and so this is what I needed," she said.

Green wanted the exam because cancer runs in her family. And she shared another health worry: Her large breasts cause her severe back pain. A doctor once recommended she get reduction surgery, but she's uninsured and said she can't afford the procedure.

In a 2022 Gallup Poll, 38% of American adults surveyed said they had put off medical treatment within the previous year due to cost, up from 26% in 2021. The new figure is the highest since Gallup started tracking the issue in 2001. In a survey by KFF released last summer, 43% of respondents said they or a family member delayed or put off health care because of costs. It found people were most likely to delay dental care, followed by vision services and doctor's office visits. Many didn't take medications as prescribed.

The Newtown screening event - organized by the nonprofit Multicultural Health Institute in partnership with a local hospital and other health care providers - is part of an effort to fill the coverage gap for low-income people.

Green explained that her teeth are in bad shape but dental care will also have to wait. She lacks a stable job but when she can, she finds occasional work as a day laborer through a local temp office.

"I only make like $60 or $70-something a day. You know that ain't making no money," said Green. "And some days you go in and they don't have work."

If she lived in another state, Green might be able to enroll in Medicaid. But Florida is one of 10 states that haven't expanded the federal-state health insurance program to cover more working-age adults. With rent and other bills to pay, Green said, her health takes a back seat.

"I don't have money to go to the dentist, nothing," she said. "It's so expensive. Now, to get one extraction, one tooth pulled, it's like $200-$300 that you don't have. So I don't know what to do. It's like fighting a losing battle right now."

In the KFF poll, 85% of uninsured adults under age 65 said they found it difficult to pay for health care. Nearly half of their insured counterparts said they struggled with affordability as well.

"We see an increasing desperation," said Dr. Lisa Merritt, executive director of the Multicultural Health Institute.

The nonprofit, which helps people access low-cost care, is based in Newtown, where, inland from Sarasota's lavish beach communities, many residents live below the poverty line, lack insurance, and face other barriers to consistent and affordable care.

"It's very difficult for people to be concerned about abstract things like getting screenings, getting regular health maintenance, when they're contending with the challenges of basic survival: food, shelter, transportation often," Merritt said.

Merritt and her team of volunteers work to build trust with residents who may not be aware that support is available. They help people apply for low-cost insurance coverage, free medication programs, and other resources that can reduce treatment costs. Volunteer Bonnie Hardy said the people she serves have many financial worries, but one thing tops the list.

"Right now? A place to stay," said Hardy. "Housing is horrible."

High housing costs have started to ease in recent months, but data shows rent in Sarasota has risen nearly 47% since the pandemic began in 2020. Hardy helps people find housing and connects them with programs that cover costs like utilities and security deposits. The goal is to stabilize their lives, and she said that can improve health.

"Because they're more comfortable now," she said. "They feel like, hey, the rent is paid, I can let my guard down, maybe I can go get the medical attention I need."

Research shows putting off health care can lead to bigger problems. The Gallup Poll found 27% of respondents delayed treatment due to costs even for "very or somewhat serious" conditions.

Some people may be holding off on treating medical issues because of health care debt. An investigation from NPR and KHN found about 100 million people in America had medical debt. About 1 in 8 of them owe more than $10,000, according to a KFF poll.

Treating cancer or chronic conditions like diabetes early can save lives and be less expensive than treating advanced-stage illnesses, according to the Centers for Disease Control and Prevention.

Doctors at the health screening event in Newtown said it's critical to help residents obtain preventive care. At the health fair, substitute teacher Crystal Clyburn, 51, got a mammogram on the mammography bus and had her blood pressure checked.

Clyburn doesn't have health insurance and said she relies on free events to stay on top of her health.

"I just try to take advantage of whatever that's out there, whatever that's free," she said. "You have to take care of yourself because you can look healthy and not even know you're sick."

After the cuff came off, a doctor told Clyburn her blood pressure was a little high but not high enough that she needed to take medication. Clyburn smiled, thanked him, and left relieved to know that the cost of prescription drugs was one expense she wouldn't have to worry about.