Case for Access

 

 

At the start of this decade, about one in six Americans – 49.5 million people – lacked insurance coverage for health care services and prescription medications.  Of that number, some 36.3 million were between 18 and 64 years of age – in their prime working years.  An estimated 71 percent – 8 of 10 persons – were in families where an adult worked either full- or part-time but

  • did not qualify to receive health care benefits from their employers,
  • worked for employers who did not provide health care coverage,
  • lacked financial resources to pay premiums for private health insurance and/or
  • earned too much money to qualify for publicly supported health insurance through Medicaid and other programs.

The National Academy of Sciences’ Institute of Medicine estimates 18,000 adults die annually because they are uninsured and can’t get appropriate health care. IOM studies note hospitalized patients without health insurance receive fewer needed services and lower-quality care and have a greater risk of dying in the hospital or shortly after discharge than patients with insurance.
Increasingly, a struggling health care system nationally has faced additional pressures:

  • More unemployed adults without the resources to afford health care coverage,
  • Rising costs for health care that also raise health insurance premiums,
  • Fewer employers able to offer workers health care benefits,
  • Growing reliance of the uninsured public on emergency room service to meet routine as well as critical health care needs and
  • An aging population bulge at the top end of the 18-to-64 age group as "baby boomers" near retirement.

For nearly a decade before enactment of the Patient Protection and Affordable Care Act of 2010 (PPACA), grassroots initiatives had sprung up in communities across the country to meet these challenges and provide access to and coordinate health care for the large and growing number of uninsured individuals and families.

Today, 18 access to health care organizations work in Michigan, including UPHAC and the five Local Access Coalitions that serve the Upper Peninsula.

These community efforts to improve access to health care for needy neighbors, family and friends have the advantage of collaborative action by civic leaders, faith-based groups, medical care providers, social service agencies and interested citizens in addressing local needs for a health care "safety net."

Access-to-health-care organizations like the U.P.'s Local Access Coalitions are pieces of an evolving health care reform picture under the PPACA. They are crucial connections for those who need health care now and can't afford it or don’t yet qualify for insurance exchanges, coverage under employer plans created through tax incentives and state program expansions rolling out between now and 2014.

Local grassroots programs can support and complement the evolving array of public and private insurance options, offering assistance to an estimated 500,000 Michigan residents expected to remain uninsured after health care reforms are fully implemented in 2019.

Access Coalitions could not sustain their work if left to independently shoulder the full burden of providing access to care for all uninsured residents in their areas. Community support in the volunteered services of partner organizations and health care professionals and financial resources from the public are essential elements for these locally developed and focused access-to-health-care programs to serve U.P. residents.