How the DuPage Health Coalition is helping the uninsured

She was struggling with exhaustion.

Carmen had hypothyroidism, a condition that caused hair loss and muscle aches. If left untreated, a thyroid disorder can lead to other health problems. But Carmen couldn’t see a doctor for about a year because she didn’t have medical coverage.

“I felt extremely tired,” said Carmen, 57, who asked that only her first name be used for privacy reasons. “It was almost like I couldn’t get out of bed. I was depressed.”

The Downers Grove woman launched a program that helps uninsured people in DuPage County get access to low-cost health care. Patients enrolled in Access DuPage pay no more than $15 for a basic doctor visit. Carmen is currently paying $4 for medication to deal with her thyroid problem.

“I have no pain now,” she said through a translator. “Chronic fatigue is gone. Now my life is much more normal, as normal as it could be with such a diagnosis.’

Before the Affordable Care Act was passed in 2010, about 12,000 to 15,000 people signed up for Access DuPage each year. In recent years, Illinois has expanded a Medicaid-like program to cover more adults, regardless of immigration status. But coverage gaps remain: Access DuPage served 5,741 people in fiscal year 2022, nearly 8 percent more than the previous year. Most are low-income workers.

        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        

In the economic fallout from the pandemic, “there are just an awful lot of families who still don’t have enough resources to make ends meet,” said Cara Murphy, president of the DuPage Health Coalition, the nonprofit that runs Access DuPage.

“So while there are some new avenues for insurance coverage,” she said, “there are more people coming into the pipeline who also need help through programs like ours.”

The DuPage Health Coalition is among five grant recipients from the Neighbors in Need campaign, a partnership of the Daily Herald and the McCormick Foundation that helps fund agencies to address hunger, homelessness and health care disparities in the suburbs.

Physicians affiliated with every hospital in the county volunteer their time and expertise to care for Access DuPage patients. Dr. Kevin Most, chief medical officer of Northwestern Medicine Central DuPage Hospital, chairs the coalition’s board.

“Look at the diabetics we keep out of the ER, but we keep them out of the ICU. Look at the hypertensive patients we keep off dialysis by lowering their blood pressure,” Most said. “We stop them from having a stroke and ending up with a disability.” We stop them from having a heart attack.

“We’re extending their lives so they can watch their grandchildren grow up,” he said. “They can watch their children get married.

How the model works

Access DuPage began more than 20 years ago as a collaboration between social service agencies, county government, hospitals and physician groups.

Competition issues aside, hospital leaders agreed to provide health care services. Collectively, the hospitals donated the first $1 million needed to launch the program in 2001.

“The health of the community goes beyond those who can afford insurance, and I think that was the whole basis for it,” said Most, a board member from the beginning. “We have this group, this population that falls between the cracks. They are not eligible for Medicaid. Their workplace may not provide insurance and yet they still need medical care.”

The network of volunteers now includes hundreds of primary care physicians, Murphy said. The coalition processed more than 1,600 referrals to specialists last year. Over 28,000 prescriptions have been filled within the program.

The nonprofit covers about $325 in direct costs per patient. Through pro bono medical services and financial assistance, hospitals and health systems contributed more than $38 million in support in 2022.

“All the hospitals are very supportive of us financially, and the reason is because we’ve proven to them that we’re going to have less of these patients in your emergency rooms,” Most said.

The alternative: People without health insurance often go without treatment until they end up in the hospital with a crisis that could have been avoided with primary and preventive care.

“If a hospital has 20 percent of the people coming through its door who don’t have the means to cover the cost of their care … that leads to a number of things,” Murphy said. “Higher costs at the health system level, but also higher insurance premiums.”

“Big difference”

To qualify, uninsured adults must live in DuPage and have an annual income of up to 250% of the federal poverty level. For a household of four, that’s $69,375.

Patients live in every zip code in DuPage. The coalition is seeing the highest enrollments in West Chicago, Addison, Bensenville and Glendale Heights, communities with large Latino populations that were hardest hit early in the pandemic.

About 93% of patient households have at least one working adult. “A lot of our members work in pretty physically punishing jobs,” Murphy said, citing patients with orthopedic problems.

If a recession hits and unemployment rises, the coalition expects to see increased demand next year. Access DuPage enrollment skyrocketed during the last financial crisis, Murphy said.

It is not known whether state lawmakers will continue to expand Medicaid-like benefits, particularly to younger immigrants who do not qualify for Medicare or Medicaid.

“Then that can help balance some of the new needs that are coming our way,” Murphy said.

She emphasizes that Access DuPage is not a substitute for insurance.

“We would always want people to be insured if they had a path to it, but in the absence of that path, it really offers a pretty comprehensive set of resources and access to really the best providers that our community has.”

Patients are treated with dignity, Most said. They receive a card that they have to show at the doctor’s office to avoid having to fill out additional paperwork.

Carmen, the Downers Grove woman, remembers her first phone call to the coalition about three years ago. “Don’t worry,” the staff told her. “We’ll figure that out.”

“I would go so far as to say they personalize the treatment with us,” said Carmen, who now can’t work while her husband does.

When she ended up in the hospital with severe symptoms of COVID-19, everything was covered by Access DuPage. This has given her “a great sense of security”.

“It’s very difficult when you don’t have access to anything,” she said. “And just knowing there’s someone out there willing to help you makes a big difference.”

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