In U.S., Large Racial Divide in COVID-19 Cost Concerns

WASHINGTON, D.C. -- Significant differences in the level of concern over the potential cost of COVID-19 care exist between White Americans and non-White Americans. Over half (58%) of non-White adults versus 32% of White adults report that they are either "extremely concerned" or "concerned" about being able to pay for the cost of care if they are diagnosed with COVID-19. These results, based on a new study by West Health and Gallup, also show that White adults are far more likely than their non-White counterparts to report being "not at all concerned."

	Extremely concerned/Concerned	Not at all concerned	Net difference in concern
	%	%	pct. pts.
U.S. adults	40	41	-1
RACE:
White adults	32	48	-16
Non-White adults	58	26	+32
ANNUAL HOUSEHOLD INCOME:
$100,000 or more	20	56	-36
$40,000 to <$100,000	36	43	-7
Less than $40,000	60	25	+35
Gallup-West Health U.S. Healthcare Study, June 8-30, 2020

The difference between the percentage who are concerned about the cost of care and those not at all concerned yields a 32-percentage-point surplus of concern for non-White Americans versus a 16-point concern deficit for White Americans.

This study is based on 1,017 interviews conducted with U.S. adults from June 8-30, 2020. Respondents from households with annual incomes under $40,000 were three times more likely to report concern over the cost of care than their counterparts from households with incomes of $100,000 or more, showing clear differences by socioeconomic status, in addition to race, and underscoring the relationship between the two.

Non-White Workers Twice as Likely to Report Staying in Unwanted Job

Amid broad concern regarding paying for the cost of COVID-19, health insurance benefits are likely more important than ever for U.S. workers. A recent study by Families USA estimates that 5.4 million American workers lost their insurance through the end of May because of large-scale COVID-related job losses in the country.

Dovetailing with these results, Gallup finds that 12% of workers who remain in the workforce are staying in a job they want to leave because they are afraid of losing their benefits, a sentiment that is about twice as likely to be expressed by non-White workers as by White workers (17% vs. 9%).

	U.S. total	White adults	Non-White adults
	%	%	%
Among working U.S. adults	12	9	17
Gallup-West Health U.S. Healthcare Study, June 8-30, 2020

Medication Insecurity Edges Higher

Concerns over the cost of care if diagnosed with COVID-19 are likely grounded in broader difficulties Americans are having with the high and rising cost of care. One key component to this is medication insecurity, defined as lacking money to pay for at least one prescribed medicine in the past 12 months. Reports of medication insecurity among U.S. adults have risen by statistically significant levels, climbing from 19% in an early 2019 West Health survey to 24% now.

This rising burden has been more heavily borne by non-White adults (up 10 points to 31%) than by White adults (up three points to 20%).

	January-February 2019	September 2019	June 2020	Change since Jan-Feb 2019
	%	%	%	pct. pts.
U.S. total	19	23	24	+5*
RACE:
White adults	17	17	20	+3
Non-White adults	21	34	31	+10*
* Statistically significantly increased, design effect included (p<.05)
Gallup-West Health U.S. Healthcare Study

High Public Support for Government Negotiation of Drug Costs

The latest West Health-Gallup study also investigated public sentiment toward the role of pharmaceutical companies in political campaigns and drug pricing. The findings were:

• Nearly nine in 10 U.S. adults (89%) think the federal government should be able to negotiate the cost of a COVID-19 vaccine with the drug manufacturer, while 10% say the drug manufacturer should be allowed to set the price.
• Eighty-six percent of U.S. adults say there should be limits on the price of drugs that government-funded research helped develop. Meanwhile, 13% disagree and say pharmaceutical companies should be allowed to set the prices of those drugs.
• Seventy-eight percent of U.S. adults say political campaigns should not be allowed to accept donations from pharmaceutical companies during the coronavirus pandemic, compared with 21% who report that they should be allowed.

In each instance, significant majorities of White and non-White Americans say pharmaceutical companies should be constrained, although non-White Americans are less uniform in holding to these beliefs.

	U.S. total	White adults	Non-White adults
	%	%	%
Gov't should be able to negotiate price of COVID-19 vaccine with the drug manufacturer (% in favor)	89	91	84
There should be limits on drug prices for gov't-funded research (% favoring limits)	86	91	76
Allow political campaigns to accept donations from pharmaceutical companies during pandemic? (% No)	78	85	62
Gallup-West Health U.S. Healthcare Study, June 8-30, 2020

Implications

To some extent, the high percentages of White and non-White Americans who are concerned about the cost of treating COVID-19 likely reflect financial hardship resulting from the economic shutdown. In March and April, an estimated 22 million jobs were lost (about 7.1 million have since been added back), and since March, more than 50 million Americans have filed for jobless claims, an unprecedented spike.

Concerns over the cost of COVID-19 care, losing healthcare benefits and rising medication insecurity among non-White adults in particular, however, are not indiscriminate. Before the novel coronavirus pandemic, workers of color were far more likely to be paid poverty-level wages than their White worker counterparts. And amid the pandemic itself, the Congressional Budget Office recently projected that 47% of state unemployment benefits in the month of July are expected to be issued to non-White recipients (PDF download), indicating the disproportionate economic effects of the shutdown.

The grave outcomes of the COVID-19 pandemic are not limited to economic ones. Since the pandemic hit the U.S., people of color have suffered its negative health effects at greatly elevated levels, with non-White adults requiring hospitalization at nearly five times the rate of White adults (PDF download).

The rise of medication insecurity among all adults from an estimated 19% in early 2019 to the current 24% is significant, and cuts across all U.S. demographic groups, distinctly revealing how key components of the U.S. healthcare cost crisis are similarly grave, regardless of race or ethnicity. The notable increase in medication insecurity among non-White adults, however, underscores how the U.S. healthcare cost crisis disproportionately affects people of color and is worsening over time.

Notably, although non-White Americans clearly report elevated concerns and cost-of-care issues relative to White Americans, both groups report substantial support for disallowing political contributions by pharmaceutical companies during the pandemic, and for government intervention in setting price limits for government-sponsored research and for a COVID-19 vaccine.