A new survey found that most New Yorkers still struggle to afford healthcare and are worried about affording care in the future. This probably isn’t news to many of us – but the findings make the state budget’s lack of action on health care even more glaring.

New York has traditionally been a healthcare leader, and we have one of the lowest uninsured rates in the country. But insurance isn’t enough. Many of the survey questions were asked of insured New Yorkers. They are having trouble managing the costs of their premiums, co-pays and deductibles.

The survey shows the toll this takes – almost half of New Yorkers (45 percent) have avoided care or taken drastic actions like cutting pills in half or not filling prescriptions. Over a third of New Yorkers (35 percent) reported serious financial repercussions including using up all or most of their savings, being put in collections, or being unable to pay for food, heat, or housing on top of medical bills.

New Yorkers blame health plans, the pharmaceutical industry, and providers like hospitals almost equally. They are ready for the government to step up and do something. But the only proposal in the governor’s budget that could address costs is one that would license pharmacy benefit managers. That’s a great start in reining in prescription drug costs, but it’s a step many other states have already taken. The state could do a lot more to help New Yorkers manage this problem, including a state premium assistance program, a drug utilization board that could set prescription drug rates, or creating a public option for the lowest-income people in the individual market (see our budget testimony here for more information).