By Aaron AllenThe Seattle Medium
America is the only major industrialized country without universal health insurance and the consequences are increasingly well known – inequities in access to care, avoidable mortality, poor quality care, financial burdens for the uninsured or under- insurance and loss of economic productivity.
Even though there has been a significant decrease in the number of uninsured people in America, there are still disparities in ethnicity and income. According to data from the Common Wealth Fund, the percentage of uninsured adults (19-64) in the United States has fallen from 20.8% in 2012 to 12.1% in 2021. However, the percentage of African- Uninsured Americans in 2021 is 13.5% compared to 8.2% for whites, and it should also be noted that the percentage of African Americans uninsured in 2021 (13.5%) is only slightly lower than the percentage of uninsured whites in 2012 (14.8%), just a few years after the Affordable Care Act (ACA or Obamacare) was signed into law.
Since the implementation of the ACA in Washington State, the number of African Americans without health insurance has been cut in half, from 22.4% in 2012 to 11% in 2021. However, 12, 3% of African Americans had no health insurance due to cost in 2021 compared to 7.2% for whites, and 17.2% of all residents who earned less than 199% of the federal poverty level were without health insurance due to cost, compared to 3.9% who earned more than 400% of the federal poverty level.
According to Daphne Pie, public health services administrator at Seattle-King County Public Health, the number of people without health insurance is not just about barriers, but also about lack of information and understanding of different health insurance options. insurance available. in underserved communities.
“The only thing I can say is that it’s not about whether people understand the importance of health insurance and access to health care services, they do” , says Pie. “What we’ve seen is a lack of understanding of what programs they may potentially be eligible for and the cost. So in marginalized communities, if they think the only programs available to them are, for example, Apple Health or Medicaid, and they know they don’t qualify for Medicaid, they go without insurance.It’s a lack of knowledge and it’s because the information isn’t reaching them.
In an effort to better inform underserved communities, Pie says outreach efforts/programs to educate the general public about enrollment, access and cost of insurance have been a top priority for the health department. these last years. This is especially true in areas that lack an adequate number of health care providers for the population they serve.
“We’re very strategic in that we create sign-up events within our communities every year,” says Pie. “Last year we held over 200 events.”
“Another hurdle we see, for lack of a better word, is the vendor desert,” Pie continued. “We have areas in King County where we lack providers that people want to go to. If you look at an area code like 98118 that is mostly made up of people of color who live there, what kind of providers do they have? There really is a lack of service providers there.
“People want to be able to see a doctor in their community and find the provider they want,” she added. “So those are the main issues we’re seeing, the lack of knowledge about what’s available to them and really helping customers understand the cost and find them the right supplier.”
Danny Colombara, epidemiologist for King County Public Health Evaluation, Policy and Evaluation Unit, says it’s important that people who don’t have health insurance through the through their employer be proactive when it comes to acquiring health insurance for themselves and their families. .
“If you don’t get your insurance from an employer, you have to be very proactive and try to get on an exchange, which may not be very expensive,” says Colombara. “You could be eligible for Medicaid which would also require a lot of initiative.”
“Unlike more affluent or affluent communities where cost is not an issue, there are just additional hurdles and a lot more initiative that needs to be taken. if you weren’t born in the United States, there are eligibility issues that may impact their citizenship,” Colombra added. “So there are other additional concerns among immigrants who don’t do not exist for native-born populations.”
Data experts like Colombra say you can clearly see the impact of ACA when adopted and properly implemented at the local level. When you look at the numbers for Washington and Oregon compared to other states like Texas and Georgia that rejected key elements of the ACA upon passing it, there is a stark difference in the pass rate. reduction in the number of uninsured Americans. Texas and Georgia still have relatively high numbers of uninsured people in their states, at 24.3% and 18.2% respectively, while the rates in Washington and Oregon are 9.2% and 8.8 %, respectively.
“If we look at the data after the ACA and when the ACA went into effect, these were pretty dramatic improvements across the board,” Colombra says. “For Washington and the region, there have been dramatic declines in all demographics. It was universal and a success.
As their efforts to reduce the number of people without health insurance continue to be successful, Pie says access to qualified health insurance options is only half the battle, the other half is to ensure that people have the necessary knowledge to be able to take advantage of all the options available to them.
“After doing polls, we found out what people think,” says Pie. “People say ‘we need the information brought to us directly, we need to know what we are entitled to’. So when we sit down with clients, we actually delve into what a qualified health plan is and what it costs, and that makes a difference.
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