Nearly half of New Yorkers are “very concerned” about being able to pay for medical coverage for themselves and their families, as some premium costs rise and the strength of certain federal health subsidies remains uncertain, polling released Tuesday shows.

Forty-seven percent of New Yorkers held that sentiment, while another 25% were “somewhat concerned” about being able to afford health coverage, according to a Siena College poll of registered voters between Nov. 10 and 12. In New York suburbs, including Long Island, 42% of respondents were “very concerned” and roughly 25% had some level of concern.

Overall, the poll, and a recent West Health-Gallup Center survey where residents gave the state a D+ grade for health care cost, shows a worrisome perception of health coverage that’s becoming too expensive for some people to keep, experts say. Factors that have added, or could add, to health care premiums include medical inflation, soaring hospital cost and the potential expiration of certain Affordable Care Act (ACA) subsidies.

“I think we’re going to see a whole lot more uninsured people,” said Jeffrey Reynolds, president and CEO of Garden City-based Family and Children’s Association, referring to the potential end of the ACA subsidies. “And generally, we know when folks are uninsured, two things happen: They delay care, they skip routine visits.”

WHAT NEWSDAY FOUNDNearly half of New Yorkers are “very concerned” about being able to pay for medical coverage for themselves and their families, a new poll found. Factors that have added, or could add, to health care premiums include medical inflation, soaring hospital costs and the potential expiration of certain Affordable Care Act (ACA) subsidies.A West Health-Gallup Center survey conducted in June and August said that health care was a “major financial burden” for 18% of New Yorkers.

“We’re walking headlong into a pretty significant storm,” he added. 

For employer-provided insurance in 2024, New York’s average annual premium for an individual was the highest in the nation, coming in at $9,589, according to KFF, a health research nonprofit.

The West Health-Gallup Center survey conducted in June and August said that health care was a “major financial burden” for 18% of New Yorkers. Roughly 20% of people said they “avoided a doctor-recommended procedure, lab test or evaluation in the past year because they couldn’t afford it,” according to the survey, which included 20,000 adults from across the country. 

Elisabeth Benjamin, vice president and managing director at the Community Service Society of New York, said the most significant component of a health insurance premium dollar is hospital care.

“What we really need is for the government to step up and start controlling health care prices, especially at hospitals and start resetting the rates or doing things that will pull down the reimbursement rates that we’re all paying for these hospital prices,” she said in a phone interview.

To help lower prices, the organization supports creating a state office of health care affordability to regulate mergers and consolidations, along with legislation in which health insurers are required to spend more of the premium dollar on primary care instead of hospital care.

“So, we’re spending on primary care in hospitals, which is the most expensive place to spend that money,” she said.

Wendy Darwell, CEO of the Suburban Hospital Alliance of New York State, countered much of those claims, saying, “There are many factors that contribute to health care costs as a proportion of the overall spend on health care.”

Many hospitals, she said, are contending with higher labor, pharmaceutical and energy costs and Medicare and Medicaid reimbursement rates that have not kept up with the price of care.

Hospitals, she said, often have to merge to survive the financial environment. She said that there is room for cost health care efficiencies such as malpractice reform, but cautioned “we still have to understand that we have an aging population, we have many more people with chronic conditions that are more complex.”

“It’s very hard to lower health care prices when the demand for care is just so much more intense,” she said.

Among the key reasons why many New Yorkers may be facing higher health care premiums is the end of specific Affordable Care Act subsidies. Should those tax credits expire, health care premiums could be more than twice as high, KFF said. The credits go to residents who make above 400% of the federal poverty level and sign up for them.

Reynolds, of the Family and Children’s Association, is particularly concerned that residents might choose cheaper plans that typically offer substandard mental health coverage.

“And so, they buy insurance accordingly and say, ‘You know, I don’t have a lot of money. The premiums are exorbitant. Let me just buy something. If I’m going to buy anything, let me buy something that just hedges my bets against a severe emergency,’” he said in a phone interview.

But what often happens is that mental health and some other issues tend to get worse over time and land people in hospital emergency rooms, where the care can be much more expensive, he said. For some uninsured or underinsured patients, they may get unreimbursed care that the hospital often must take into its debt load. Eventually, the government and the taxpayers generally must pay higher hospital debts.

“It’s inherently in our self-interest to make sure that the people stay well, because getting sick costs everybody money,” he said.

Tiffany Cusaac-Smith

Tiffany Cusaac-Smith is a general assignment reporter for Newsday. She previously worked at USA TODAY and is an alum of Howard University.