Cost barriers to asthma care - a comparison by insurance status: National health Interview Survey and National Asthma Call-Back Survey 2009

Health insurance coverage is a key factor that determines whether people with asthma can afford and obtain the care they need. Although national data indicate that most people with asthma have insurance coverage, they remain more likely than those without asthma to forgo needed medical care because of cost and report that they cannot afford to buy prescription medications. These findings suggest that health care coverage for people with asthma may not be keeping pace with increasing costs. Data from the 2009 National Health Interview Survey (NHIS) and the Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey (ACS) were used to estimate access to primary/specialist care and ability to the afford prescription medication among adults with current asthma. In 2009, most adults with asthma reported having insurance coverage (87.5%). More than half (53.2%) with asthma and no coverage reported that they could not afford prescription medications in 2009; this represents an increase from 45.4 % in 2008. Those with coverage were twice as likely to report seeing a specialist or primary care physician, compared to those without coverage. When asked about cost barriers specific to asthma, adults with asthma and no insurance were more likely to report cost barriers to medication (41.3% vs. 12.6%), specialist care (23.5% vs. 4.8%), and primary care (40.9% vs. 8.1%) compared to those with coverage. These findings indicate that insurance coverage may be only one of several factors that influence access to medications and medical care for adults with asthma.