HOUSTON – (March 8, 2016) – Approximately 25 percent of Texans say they lack confidence in understanding some of the most basic terminology about health insurance plans, according to a new report released today by Rice University’s Baker Institute for Public Policy and the Episcopal Health Foundation (EHF). The report found uninsured, low-income and Hispanic Texans were least likely to understand health-plan terms like “premium,” “copayment” and “provider network.”
The survey asked Texans about their confidence level in understanding seven terms that describe various features of health insurance plans. While one-quarter of all the respondents lacked confidence in their understanding of the terminology, there are significant differences among various subgroups.
Researchers found at least half of those who are uninsured said they didn’t fully understand five of the seven terms. In fact, the rates of lack of confidence for uninsured Texans were nearly double that of those with health insurance.
“This research shows that understanding the key parts of a health insurance plan can be tough, especially for the uninsured,” said Elena Marks, EHF’s president and CEO and a nonresident health policy fellow at the Baker Institute. “These numbers illustrate the continuing need to offer education and outreach targeting the uninsured so they can better understand their health insurance options.”
Local health departments (LHDs) can play pivotal roles in U.S. communities by helping to link people with medical services and assuring access to care when it is otherwise unavailable. However, a new study in the American Journal of Preventive Medicine finds that many LHDs aren’t able to meet these goals, which could spell trouble for the uninsured and underinsured.
“Our report shows that in 2010, about 28 percent of LHDs had not conducted any of the three targeted activities in our study,” which looked at how LHDs assessed gaps in care, increased access to health services and used strategies to meet the health needs of the underserved, said lead author Huabin Luo, Ph.D, former research fellow with the Centers for Disease Control and Prevention and assistant professor in the department of public health at the Brody School of Medicine at East Carolina University.
In recent years, deep funding cuts have impacted local health departments. For example, between 2008 and 2009 alone, over 23,000 LHD jobs were eliminated. This combined with an increase in demand for health care services can mean an increase in health disparities for those who rely on community health care.
The study found that LHDs with larger budgets in bigger population centers were more likely to provide access to health services compared to smaller LHDs with fewer financial resources, where they may be needed more.
Hanen noted that as health insurance coverage becomes more widespread, LHDs will continue to identify and link people without health insurance to programs that provide health care services. “It cannot be overstated enough that poor housing, education, low income, unemployment and lack of transportation in a neighborhood are all interconnected and are all factors that determine health.”
- Cuts to Local Health Departments Hurt Communities (publichealthwatch.wordpress.com)
- Health cuts hurt inspections, but flu programs OK (news-journalonline.com)
- Health department warns of scam targeting restaurants (wkyt.com)
- Erie County Council discusses merging health, human services departments (goerie.com)
Whether one is for or against all or parts of Obamacare, surely, we as a country can do better in providing needed health care to the poor, especially the poorest of the poor.
…For many of our patients, poverty alone limits access to care. We recently saw a man with AIDS and a full-body rash who couldn’t afford bus fare to a dermatology appointment. We sometimes pay for our patients’ medications because they are unable to cover even a $4 copayment. But a fair number of our patients — the medical “have-nots” — are denied basic services simply because they lack insurance, and our country’s response to this problem has, at times, seemed toothless.
In our clinic, uninsured patients frequently find necessary care unobtainable. An obese 60-year-old woman with symptoms and signs of congestive heart failure was recently evaluated in the clinic. She couldn’t afford the echocardiogram and evaluation for ischemic heart disease that most internists would have ordered, so furosemide treatment was initiated and adjusted to relieve her symptoms. This past spring, our colleagues saw a woman with a newly discovered lung nodule that was highly suspicious for cancer. She was referred to a thoracic surgeon, but he insisted that she first have a PET scan — a test for which she couldn’t possibly pay.
However unconscionable we may find the story of Mr. Davis, a U.S. citizen who will die because he was uninsured, the literature suggests that it’s a common tale. A 2009 study revealed a direct correlation between lack of insurance and increased mortality and suggested that nearly 45,000 American adults die each year because they have no medical coverage.1 And although we can’t confidently argue that Mr. Davis would have survived had he been insured, research suggests that possibility; formerly uninsured adults given access to Oregon Medicaid were more likely than those who remained uninsured to have a usual place of care and a personal physician, to attend outpatient medical visits, and to receive recommended preventive care.2 Had Mr. Davis been insured, he might well have been offered timely and appropriate screening for colorectal cancer, and his abdominal pain and obstipation would surely have been urgently evaluated.
- With no insurance, he used enemas to treat colon cancer. Now he’s going to die. (americablog.com)
- Healthcare Costs Driven By High Device, Drug Prices: Researchers (huffingtonpost.com)
18.3 million baby boomers could benefit from the Affordable Care Act
Affordable health insurance, comprehensive benefits and stronger financial protections will be available to 8.6 million currently uninsured adults ages 50 to 64, and 9.7 million who have inadequate health insurance
December 14, 2010, New York, NY—18.3 million men and women ages 50 to 64 stand to benefit from provisions in the Affordable Care Act that expand access to affordable health insurance, assure that all health insurance provides a standard comprehensive benefit, prevent insurers from denying coverage or charging higher premiums to people with pre-existing conditions, and eliminate lifetime and annual limits in health insurance policies, according to a new Commonwealth Fund report released today.
Adults ages 50-64 are currently suffering the highest rates of longtime unemployment among working-age adults, and millions are without health benefits. Of the 8.6 million currently uninsured in this age group—4.3 million men and 4.2 million women—3.3 million with incomes under $29,000 for a family of four will gain Medicaid coverage, 3.5 million with incomes up to $88,000 for a family of four will be able to gain subsidized private coverage through the new health insurance exchanges, and 1.4 million with higher incomes will gain new coverage with consumer protections.
In addition, an estimated 9.7 million older adults who have health insurance but have such high out-of-pocket costs relative to their income that they are effectively underinsured, will gain improved coverage through the implementation of essential benefit standards, limits on out-of-pocket spending, and elimination of lifetime benefit limits.
Uninsured adults in this age group face serious difficulty with access to needed care: three-quarters (75 %) report forgoing needed health care and medications because of costs and nearly half (46%) report not getting recommended preventive care. More than half of uninsured women in this age group had not had a mammogram within the past two years. Nearly 70 percent of uninsured and underinsured baby boomers report that they have problems paying medical bills or are paying off medical debt.
“A loss of employer health benefits can be devastating to men and women in this age group since their older age and higher rates of chronic health problems places them at risk of facing exorbitant premiums, having a condition excluded from their coverage, or being denied insurance altogether if they try to buy it on their own,” said Commonwealth Fund Vice President Sara Collins, lead author of the report. “The Affordable Care Act will change all of that. Once its provisions are in full effect, older adults who lose their employer health insurance will have access to affordable and comprehensive health benefits regardless of their age or health.”…..
Additional Benefits for Baby Boomers in the Affordable Care Act
The Affordable Care Act includes many additional features that will improve health insurance coverage for adults ages 50 to 64:
- Beginning in 2010, adults in this age group with chronic health problems who have been uninsured for more than six months can join new plans for people with pre-existing conditions.
- A ban on lifetime limits on insurance benefits beginning in 2010 will help an estimated 102 million people who currently have these limits on their plans; older adults are at greater risk than younger adults of exceeding their limits and being saddled with a crushing debt load as a result.
- Requiring coverage of preventive care and immunizations without cost-sharing will assure access to services such as mammograms and colorectal cancer screenings for baby boomers beginning in 2010.
- Requiring health plans to insure all who apply, preventing health plans from charging higher premiums to sicker people, and limiting how much premiums can rise by age will remove many of the barriers baby boomers face when they have to buy coverage on their own beginning in 2014.
Two lesser-known ACA provisions will also provide significant benefits to baby boomers, the report finds:
- The Early Retiree Health Benefits Reinsurance Program for Employers helps public and private sector employers pay for health benefits for employees who retire before age 65. This $5 billion temporary program has already enrolled 3,600 employers and will run through 2014, when people who retire before age 65 will be eligible to purchase health insurance through the new insurance exchanges.
- The Community Living Assistance Services and Supports (CLASS) Program will provide employers and their workers as well as self-employed individuals the option of participating in a national long-term care insurance program aimed at providing better access to affordable long-term care insurance.
This report is part of a series of Fund issue briefs that examines the way the Affordable Care Act of 2010 will benefit different populations and groups, as well as improve insurance coverage and change the delivery of care. For more information, please visit: http://www.commonwealthfund.org/Content/Publications/Issue-Briefs/2010/Sep/A-New-Series-of-Briefs-on-the-Affordable-Care-Act.aspx
- In Its First Year, The Affordable Care Act Has Brought Health Care Benefits To Millions Of Americans (medicalnewstoday.com)
- Commonwealth Fund: Unemployment has made another 9 million uninsured (dailykos.com)
- Survey: Nine Million More Americans Added to Ranks of Uninsured in Recession (crooksandliars.com)
- The Affordable Care Act’s First Year: A Few Disappointments, Lots of Progress [The Pump Handle] (scienceblogs.com)
- “Who Will Be Uninsured After Health Insurance Reform?” and related posts (healthcare-now.org)
- Nearly 4 Million Medicare Beneficiaries Receive Help with Prescription Drug Cost under Affordable Care Act
- Health reform essential to young adults: Nearly half can’t afford needed health care (eurekalert.org)
- The Affordable Care Act is Working (economistsview.typepad.com)
- Affordable Care Act Helps Fight Unreasonable Health Insurance Premium Increases (medicalnewstoday.com)