by Nora OBrien-Suric, Ph.D.
Traditionally, the end of the calendar year is a time for reflection and planning. In that spirit, and to commemorate International Universal Health Coverage Day on December 12, our team at the Health Foundation is taking time to consider what 2020 and beyond holds for our goal of improving health care access for all New Yorkers.
At the Health Foundation, we believe that access to affordable health care is a basic human right. This includes both universal coverage and affordable out-of-pocket costs.
This position is shared by an increasing number of high-profile leaders and policymakers, including the United Nations, who declared in 2019 that “everyone, everywhere, has the right to accessible, high-quality, affordable care that promotes physical and mental health.”
The Health Foundation’s mission is to improve the health and healthcare of the people and communities of Western and Central New York. That’s why this issue is so important to us—when members of our community don’t have access to health care, or are unable to pay for it, those impediments have a direct impact on their short- and long-term health.
Earlier this year, we funded two reports to examine the barriers to health coverage faced by residents of Western and Central New York. This kind of research is part of our ongoing efforts to elevate the voices of uninsured western and central New Yorkers who are not always heard or recognized in these conversations.
The reports—led by United Hospital Fund and the National Council on Aging, separately—both found a number of reasons why New Yorkers may be unable to access health coverage, including cost and difficulty navigating the health care system.
The report from UHF, entitled Reaching the Five Percent, uncovered a startling statistic: over half of New York’s uninsured residents are eligible for existing programs and assistance. Identifying and addressing the reasons why eligible people are unable to obtain coverage could drastically improve these rates.
Both reports funded by the Health Foundation overwhelmingly showed that the costs of health care and insurance coverage are major barriers to care and force many New Yorkers to make difficult choices every day.
- Toni, a 57 year old New York resident cited in the UHF report, shared the following quote: “When your employer gives you coverage and it’s $18 a week with a $5,000 deductible, I might as well put that $18 in my pocket and save it and pay the fine. I’m never going to be able to come up with a $5,000 deductible.”
- Two people interviewed by UHF shared that the costs of care had put them in a position where they had to extract their own teeth rather than seek care from a dentist.
- A single mother of two fighting thyroid cancer said that she always made sure her kids were covered, but had to pay for her cancer screenings and medication out of pocket.
Similarly, many participants surveyed by NCOA indicated they were struggling to balance the costs of living expenses, medication, and maintaining a health insurance plan.
- One woman from Jamestown noted that she remained uninsured because she had to choose between paying for groceries or health insurance premiums.
- Another participant in his early 30s stated that he was forgoing paying for health insurance because of anticipated costs of the upcoming winter season.
This daily risk analysis—food or medicine, rent and heat or health insurance—is a harmful and often dangerous situation that many New Yorkers find themselves in due to the costs of health care and insurance premiums.
Additionally, we must address the needs of a group of New York residents who were not included in these reports: the uninsured who are not currently eligible for existing support programs. Ongoing efforts to reverse or weaken public health programs mean too many people still fall into this category.
The urgency of this issue cannot be overstated. Uninsured adults are far more likely than those with insurance to postpone health care or forgo it altogether. A Kaiser Family Foundation report found that one in five nonelderly adults without coverage say they went without care in the past year because of cost.
The same report shows that because people without health coverage are less likely than those with insurance to have regular outpatient care, they are more likely to be hospitalized for avoidable health problems and to experience declines in their overall health. When they are hospitalized, uninsured people receive fewer diagnostic and therapeutic services and have higher mortality rates than those with insurance.
The research we noted shows overwhelmingly that without access to affordable health care, other attempts to improve the health of residents may be in vain. We strongly encourage our leaders to work in 2020 and beyond to find a bipartisan, evidence-driven solution to close the gaps in health care access.
Several states have taken steps recently to close the gaps and help their residents access health care. New Jersey, Rhode Island, Vermont and Massachusetts have implemented an individual mandate to have health insurance, which has increased the number of insured people and helped lower premium costs by stabilizing the insured pool. Maryland recently incorporated a method of easing access to public programs by adding an opt-in check box on state income tax forms. Checking the box results in the person receiving information about their eligibility for options and assistance in applying.
These are just a few examples of how we can make it easier to gain access to care. Dismantling the barriers to universal, comprehensive health coverage is an essential part of making the lives of New Yorkers better, longer and healthier.
We remain committed in 2020 and beyond to helping dismantle those barriers. Stay tuned to our next e-newsletter (published later this month) to learn more about upcoming events and programs funded by the Health Foundation that are working toward improving access to health care for all New Yorkers.