by Alexa Spencer
The number of Americans living without health insurance has hit record lows during the pandemic due to the government’s push for coverage, but experts like Sarah Collins, a senior scientist at the Commonwealth Fund, say that despite these victories, “the work is not done.” .
A recent study conducted by the Commonwealth reveals that although more Americans than ever have coverage, many struggle to afford the care they need or are not covered at all.
“Millions of people are still uninsured,” Collins told Word In Black in a phone interview. “A lot of people have patchy coverage, so they have gaps in their insurance.”
Nearly half of working Americans have access to health insurance through their employers, but 29 percent of people with employer coverage say the plans don’t meet their needs, according to the survey.
Collins says a lot of it has to do with costs, that programs “can have very high deductibles, high out-of-pocket limits, and that leaves people very exposed to health care costs when they get care.”
What are the health consequences of not having enough insurance?
The inability to afford an insurance plan can cause people to avoid health care. 42% of survey respondents reported skipping or postponing care due to cost.
“People who are underinsured report high rates of delays in care, not getting care when they need it,” she says. “And those receiving care report high rates of problems paying their medical bills.”
And when those bills go unpaid, they become debt that can affect a person’s livelihood.
The medical debt crisis is particularly hard on the black community. 27% of black households carry medical debt, compared to 17.2% of white households, for example.
And according to the Commonwealth study, those unpaid bills are more likely to be sent to a collection agency. This can affect a person’s credit score and prevent them from making purchases – such as buying a home.
Just earlier this year, the Biden-Harris administration announced a plan to reduce the impact of unpaid medical bills on credit and remove it as a factor in the mortgage approval process.
Why are so many black people uninsured?
Although the Affordable Care Act’s Medicaid expansion made it possible for more people to get coverage, black adults are still more likely than others to be uninsured.
Since the expansion process began in 2014, 38 states and the District of Columbia have opted for federal funding.
However, 12 states — mostly southern states with the largest black populations in the country — have yet to extend public health coverage to their residents.
Among them are Mississippi, Alabama and Georgia — states where black mothers die at disproportionately high rates and strokes are the leading cause of death.
“If these states expand, you’re going to see a big increase in coverage rates among black adults,” Collins says.
How can more black people gain access to coverage?
The Commonwealth Fund offers several policy recommendations that could support the coverage needs of the black community — including allowing states to maintain continuous Medicaid eligibility without needing to apply for a federal waiver.
Additionally, the organization is proposing that Congress provide a federal “backup” option for Medicaid-eligible residents living in non-expansion states. That could reduce uninsured rates for blacks in those states by 27 percent, according to the Urban Institute.
Collins says, “these are really minor adjustments that can really have significant effects, especially for black adults and children.”