Who We Are

Problem: Lack of Access to Health Insurance Coverage/Medical Care: Impact on the Health of Children, Latinos, Women, Young Adults.
Source: "California Perspectives: Govening California in the 21st Century," The Irvine Quarterly, Vol. 4, No. 13 (Winter 2005): "More than one in five Californians lacks health coverage . . . " http://www.irvine.org/publications/iq/iq.shtml
Source: Quantum Foundation, 2002 Palm Beach (FL) Community Health Assessment: Assessing the Health Needs of Palm Beach Country: "20.2% of Palm Beach/Riviera Beach adults 18 to 64 do not have any type of health insurance coverage, representing about 25,000 residents. . . . The 'working' poor is the group that has the most trouble. . . . these are the people who are trying to stay off Medicaid who are actually encouraged to go back into the workplace, and then they don't have good access to medical care." http://www.trustedpartner.com/docs/library/000004/2002PBCHealth Assessment.pdf
Source: Pear, "States Forfeit Unspent U.S. Money for Child Health Insurance," New York Times, October 14, 2002.

"Large amounts of federal money intended to provide health insurance to children are going unused, federal officials say, even though 8.5 million children are uninsured. On Oct. 1, states lost $1.2 billion that had been appropriated by Congress to provide health coverage for low-income children. The money, unclaimed after four years, reverted to the Treasury and can now be used for other purposes — anything, including law enforcement, military pay, farm subsidies or the fight against terrorism."

"The Bush administration estimates that states will lose $1.6 billion more next year if Congress takes no action, in addition to the $1.2 billion lost in the current year."

"Twenty-five states forfeited money at the beginning of this month. New York lost more than any other state, $397 million, about one-third of the total. . . . Indiana and North Carolina each lost $100 million of federal money on Oct. 1. South Carolina lost nearly $90 million. Arkansas lost $44 million, and Washington State lost $35 million. . . . Texas received an allotment of $502.8 million for the fiscal year 2000, Mr. Cooke said, but $285 million remains unspent and would, under current law, be redistributed to other states."

Source: Connolly, "Health Coverage for Kids Low-Cost But Little Used," Washington Post, June 1, 2001, A3.

"At least 7 million children find themselves . . . eligible for free or subsidized health coverage but not receiving it. The reasons range from the bureaucratic to the cultural. In Portland, Ore., homeless teenagers cannot sign up for care without a mailing address. Immigrants across the country fear that applying for government assistance would result in deportation. And . . . many working adults simply don't know their children qualify." (A3)

". . . more than 42 million Americans still lack health insurance coverage." (A3)

"In 1997, Congress approved the Children's Health Insurance Program (CHIP), a $42 billion matching program that helps states provide health insurance for children whose parents earn too much for Medicaid but cannot afford private insurance. . . . In most states, however, the results have been disappointing. By late last year, fewer than 2 million of the 10 million uninsured children have been registered for CHIP, and 40 states were in jeopardy of losing hundreds of millions of dollars in federal aid because of low enrollment figures." (A3)

"The barriers to care range from lack of information to application procedures that intimidate many low-income families. More than two dozen states require parents to come in for interviews, list any assets they hold and produce a month's worth of pay stubs in order to enroll children. Other states run the health program out of welfare offices even though the two are not connected. Lawmakers in Texas and Mississippi initially set such low income levels for participation that few working families qualified. Across the country, state social workers know little about the new program. In Southhill, VA, for example, Thelma Pierce was told she earned too much money to qualify for Medicaid. But the single mother was not told about the state's CHIP, even though her income was below the program's $21,500 threshold and her child was eligible for it." (A3)

"In New Haven, CT about 100 students from Yale Medical School filled out the application forms as part of their training to enroll families . . . Not one was able to complete the form adequately. . . . When CHIP began in Illinois, 70 percent of applicants were rejected by caseworkers who were rewarded for speed rather than enrollments . . . After trimming the application form from seven pages to two and hiring and additional 200 people to process applications, the acceptance rate jumped to 85 percent." (A3)

Source: "Health Coverage Level Up in 2000, Report Says," Washington Post, September 28, 2001, A36:

"The number of people in the United States without health insurance declined in 2000 for the second year in a row, the Census Bureau estimated yesterday, and it ascribed the drop to a rise in work-based coverage. But after the agency recorded the increase in employment-based coverage, the economy cooled and the labor market softened, so analysts say recent changes are probably already pushing many people into the ranks of the uninsured. . . . The Census Bureau estimated that 38.7 million people, or 14 percent of the population, were without health insurance in 2000, down from 39.3 million people, or 14.3 percent, the previous year."

According to the Center for Disease Condrol's National Center for Health Statistics, however, in 1999, there were 38.5 million people under age 65 in the U.S. with no health insurance. Almost 12% of the children under 18 years of age lacked health insurance coverage in that year. (Thus, it is apparent that Census Bureau figures and NCHS figures are similar, but not identical.)

Source: "1 Million More Lacked Health Coverage in ’98, U.S. Study Finds," Washington Post, October 4, 1999, A1, A10:

"The number of Americans who lack health insurance continued to increase last year ['by about 1 million" in 1998], climbing to 44.3 million in spite of a prosperous economy and recent government efforts to expand coverage."

". . . figures released by the Census Bureau . . . show the proportion of people in the United States without coverage was still one in six."

"And the pool of uninsured children remained undiminished, despite a major new federal insurance program, launched in 1997, that was predicted eventually to reach half the 11 million U.S. youngsters who lack coverage."

"Taken together, health analysts said, the patterns suggest that the country’s unparalleled economic growth, while enabling some people to find better jobs and health benefits, has been unable to reverse a decade-long trend in which more and more people have no help in paying medical bills."

"The new figures . . . show that the lack of coverage remains concentrated in certain groups—people with relatively little education and immigrants. More than one-third of all Latinos are uninsured, far more than any other racial or ethnic group. Lack of coverage remains prevalent among young adults—who may have jobs without coverage or decide not to take it."

"The figures also showed that the number of women who are uninsured increased, but not the number of men. . ."

Since 1987, the number of uninsured Americans has increased from approximately 31 million to 43.5 million or more than a 40% increase.

"In a new survey conducted by Harvard researchers for the Robert Wood Johnson Foundation, 79 percent of those interviewed said it was ‘very’ or ‘extremely’ important that the federal government pass a law providing coverage for the uninsured. . . . [but] only half favoring a broad attempt to provide insurance to nearly everyone."

"What is clear is that people who lack health insurance get substantially less medical care. One recent survey of U.S. women conducted for the Commonwealth Fund, for instance, found that one in four without coverage said that they had forgone treatment they needed in the previous year, compared with one in 17 women who were insured."

Rising costs of medical care could threaten gains in employer-provided health insurance.

Sources: Commonwealth Fund; Robert Wood Johnson Foundation; Paul Fronstein, Senior Research Associate, Employee Benefits Research Institute.
For more information on women's risk of diabetes and how it is affected by in low income and incomplete education, click here.
Solutions:

For an example of a statewide grassroots advocacy effort to expand access to health care, see Health Care For All, a Massachusetts-based organization. For an example of a local effort to provide expanded health care services, see Health Care Access, Inc., a Lawrence, KS initiative.

Information on a federal grant program to expand health care access in underserved areas may be found at www.hhs.gov.

Simplifying Enrollment Paperwork. See Russakoff, "Out of Tragedy, N.Y. Finds Way to Treat Medicaid Need: Streamline Post-Crisis Process Draws Record Enrollment Through a Multilingual Grapevine," Washington Post, November 26, 2001, A2: "With little official publicity, a temporary Medicaid program created after the World Trade Center attack has enrolled more than 75,000 low-income individuals and families in New York City in the last six weeks--what Medicaid experts and officials call the biggest one-time enrollment increase in Medicaid history. While the program was designed largely to speed assistance to people who lost jobs and income because of the Sept. 11 attack, many men and women interviewed at packed Medicaid offices in recent days said they had been poor for years but had not applied for Medicaid until now because they didn't know they were eligible or couldn't assemble the required documents. Out of the tragic necessity, experts and advocates say, New York has demonstrated that radical simplification could overcome one of the more vexing problems in health insurance: the millions of poor people who remain uninsured even though they are eligible for Medicaid. . . . In normal times, New York's Medicaid application fills eight pages, requires extensive documentation and can take up to six weeks to process. By contrast, Disaster Relief Medicaid requires only a single page of income and household information, Social Security number, a valid photo ID and a signed vow that the answers are true. City Medicaid workers review applications as people wait . . . and those deemed eligible receive coverage instantly."

Grants to Increase Coverage of the Uninsured. Through the Los Angeles Access to Health Coverage Initiative, the [California] Endowment will provide $11 million to help community-based organizations expand their efforts to inform and enroll uninsured residents of Los Angeles County in health plans. The Endowment will also provide $3 million to support local policy and advocacy activities, $1 million to help employers increase their coverage options for uninsured low-income workers, and $1.5 million for a public awareness campaign to encourage the uninsured to seek public assistance. An additional $3.5 million will be used for other projects that fit the objectives of the initiative. More than a third of the 9.5 million residents in Los Angeles County lack health insurance -- a number that includes half of California's uninsured children. The initiative will focus on enrolling people from East, Central, and South Los Angeles; the El Monte area; and the East San Fernando Valley into government-funded programs such as Medi-Cal and Healthy Families. "This initiative is designed to...enable Los Angeles County residents to receive needed health-care services by increasing enrollment and retention into these programs, and promoting understanding among these communities about the availability and importance of health insurance options," said Robert K. Ross, president and CEO of the Endowment. "Los Angeles will serve as a model for our initiative which we hope to replicate statewide." California Endowment Press Release, "New Initiative Aims to Boost Enrollment of Low-Income Uninsured Residents in Health Coverage Programs; Los Angeles County Has Highest Rate of Uninsured Children in Nation." April 18, 2002. www.calendow.org/news/NewsReleases/2002/special/press041802/press0418 02.htm

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