Nearly three in four Americans say the costs of prescription drugs are “unreasonable,” with most putting the blame on drugmakers, according to a poll released Tuesday.

The survey by the Kaiser Family Foundation found 74 percent of those taking prescription drugs find the costs unreasonable, as do 72 percent of those not taking such drugs. (KHN is an editorially independent program of the foundation.)

The poll builds on the results of an earlier Kaiser survey in April that identified high drug costs as the public’s top health care priority for Congress and the president. Drug costs have gained attention in the past year as a result of controversies surrounding Sovaldi and other new hepatitis C drugs, which can cure most cases of the deadly liver disease but at a price of $84,000 for a 12-week treatment. The high cost has strained Medicaid and Medicare budgets and left private insurers scrambling.

Half the public says they take prescription drugs. More than three quarters of those say they are easy to afford, with only one in five saying they have difficulty paying for them. But about a quarter of respondents said they or a family member have not filled a prescription in the past year, while 18 percent have cut pills in half or skipped doses to save money, the poll found.

More than three-quarters of the public cited drug company profits as the No. 1 reason for the high costs, followed by the expense of medical research (64 percent), the cost of marketing (54 percent) and the cost of lawsuits against pharmaceutical companies (49 percent).

About 10 percent of respondents also blame insurance companies, saying they require enrollees to shoulder too great a share of drug costs.

The survey also found most Americans are still not paying attention to the latest challenge to the Affordable Care Act in a case called King v. Burwell. The Supreme Court is expected to decide this month whether to cut off government subsidies to millions of people in about three dozen states that rely on a federal insurance marketplace, rather than a state-based marketplace. About 72 percent of respondents say they have heard little or nothing about the case.

However, the survey found more than half of respondents were “very” or fairly closely” following news about the 2016 presidential campaign. About 39 percent of respondents said they were closely following news about the House of Representatives banning abortions after 20 weeks of pregnancy — the most closely followed health policy issue.

The poll of 1,200 adults, conducted from June 2 to June 9, had a margin of error of plus or minus 3 percentage points.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

Having a baby is a common women’s health event, yet insurance coverage isn’t always assured.

Although the federal government recently clarified that many insurance plans must cover prenatal care as a preventive service without charging women anything out of pocket, it didn’t address a crucial — and much pricier — gap in some young women’s coverage: labor and delivery costs.

Perhaps it shouldn’t come as a surprise. Insurers and some employers have long tried to sidestep paying for maternity care, which includes prenatal, delivery and postpartum services. Individual plans typically refused to pay for pregnancy-related services until the health law established that maternity and newborn care together are a so-called “essential health benefit” that must be included in their individual and small group coverage.

Meanwhile, large employers that provide health insurance are required to cover maternity care for employees and their spouses under the Pregnancy Discrimination Act of 1978. But that protection doesn’t extend to dependent children, even though under the health law, adult children can now stay on their parents’ plans until they turn 26.

“I suspect that a lot of this goes back to dependents being kids,” says Adam Sonfield, a senior public policy associate at the Guttmacher Institute, a reproductive rights research and education organization. “That perspective is just outdated, and was never entirely correct in terms of need for care anyway.”

In May, the federal government clarified that dependent children are covered by the health law requirement that preventive services, including preconception and prenatal care, be covered without cost sharing in all plans, except those that were grandfathered under the law.

Typically, prenatal care for a young woman for a first pregnancy would include visits to her health care provider every four weeks for the first 28 weeks of pregnancy, every two weeks until 36 weeks and weekly thereafter, according to the American Congress of Obstetricians and Gynecologists. In addition, the U.S. Preventive Services Task Force recommends pregnancy-related services, including screening for gestational diabetes, anemia and Hepatitis B.

But prenatal care is a small portion of the cost of having a baby, and families that have to pay for an adult child’s labor and delivery charges, including the hospital bill, could be on the hook for thousands of dollars.

Insurers paid $18,329 for a vaginal birth and $27,866 for a cesarean birth on average in 2010, according to a study by Truven Health Analytics. Consumers paid an average of $2,244 and $2,669, respectively, out of pocket. The payment totals include all maternity care.

Hospitalization made up between 81 and 86 percent of the total cost of maternity payments, the largest proportion by far, the study found. Prenatal care accounted for most of the remaining cost.

“The payments that are made are highly concentrated in that little window,” Carol Sakala, director of the Childbirth Connection, one of the organizations that commissioned the study. Childbirth Connection is a program of the National Partnership for Women and Families.

But labor and delivery is exactly what some health plans don’t cover for dependent children.

Continuing a slow upward trend, the average age at which women have their first baby was 26 in 2013. Meanwhile, the proportion of first births to teenagers continues to decline. In 2010, 19 percent of first births were to teenagers under age 20, compared with 36 percent in 1970.

Although the extent to which large employer plans refuse to cover maternity care for dependent children isn’t known, benefits experts say it’s common.

In 2013, the National Women’s Law Center filed sex discrimination complaints with the Office for Civil Rights of the federal Department of Health and Human Services against five employers that exclude pregnancy-related coverage for the dependent children of their employees.

The law center brought the complaints under Sec. 1557 of the health law, which protects people from discrimination on the basis of sex, race, color, national origin, age, disability, gender identity and sex stereotypes in health care plans.

“Pregnancy discrimination is per se sex discrimination,” says Dania Palanker, senior counsel at the National Women’s Law Center. The center is still awaiting a response from the civil rights office.

The HHS Office for Civil Rights can’t comment on open cases or compliance reviews, a spokesperson said.

Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

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