Dive Brief:

• Unexpected medical bills are the American public's second-highest financial worry, trailing gas prices, according to a new poll from the Kaiser Family Foundation.
• Despite 58% of the public saying they're worried about being able to afford surprise bills, the majority of people with private insurance — 56% — said they knew nothing about a federal law that took effect in January that prohibits patients being charged when they unknowingly receive out-of-network care. Just 22% said they knew "a little" about the law, while 18% know "some" and 3% know "a lot."
• Meanwhile, proposals to lower out-of-pocket costs for drugs tops the public's list of health priorities for Congress as Americans continue to cite high prices as a barrier to receiving care, KFF found. Half of respondents to the survey said they'd delayed or gone without healthcare in the past year because of cost.

Dive Insight:

The bipartisan No Surprises Act passed in 2020 started shielding patients from large surprise out-of-network bills in January, requiring payers and providers to arbitrate any billing disputes.

However, the law faces ongoing controversy over the specifics of its implementation that have sparked a number of legal challenges. There also are notable exceptions to its protections, including that it only cover privately insured patients and doesn't prohibit balance billing for ground ambulances, causing researchers to note it only covers a fraction of large medical bills Americans face. Now, similar shares of both Republicans and Democrats are saying they're unaware of the law.

The lack of clarity as to consumer protections already in place may be contributing to the high percentage of Americans that are worried about being able to afford surprise medical bills.

Exorbitant out-of-network bills have been a major contributor to healthcare costs and medical debt in past years. Despite 90% of the population having some sort of coverage, Americans owe at least $195 billion in medical debt, according to recent research from KFF and the Peterson Center on Healthcare.

The majority of Americans say inflation is the biggest problem facing the U.S., while the coronavirus pandemic ranked fourth. Just 6% of adults said COVID-19 is the country's biggest problem, the survey published Thursday found.

Likely due to rampant concerns about rising prices, the public most wants Congress to focus on what they're paying for medical products and services, according to the poll. This includes capping prescription drug price increases to the inflation rate, with 61% saying it's a top priority.

Drug costs continue to be a top issue for the public, with 29% of Americans saying they either didn't fill a prescription, cut pills in half, skipped doses or elected for an over-the-counter product instead of a prescription because of cost in the past year.

That percentage rose to 43% among people with annual household incomes under $40,000, KFF found.

Drug pricing legislation has been a key focus area for President Joe Biden and congressional Democrats, though legislators have been deadlocked on the scope and strategy for driving down costs.

Capping out-of-pocket costs for insulin, placing a limit on how much seniors pay for care and allowing the federal government to lower drug prices for Medicare beneficiaries also were cited frequently as top priorities for Congress, by 53%, 52% and 48% of respondents, respectively.

Fewer than half of people said expanding coverage to low-income Americans in states that didn't expand Medicaid under the ACA, upping funding for mental health services or improving safety and quality in nursing homes are top health priorities.

About a fourth of respondents said increasing spending for COVID-19 and making temporary subsidies for ACA plans during the public health emergency permanent are top priorities for legislators.

"The public's priorities in health reflect deep concern about the prices of everything right now, including drug prices," KFF CEO Drew Altman said in a statement. "That doesn't mean other things that have long been popular do not have public support too; they do. It just means prices are the preeminent concern."