The recently passed Affordable Care Act was created to reduce the ranks of America’s uninsured and, while some Americans are unsure whether the legislation will ultimately achieve its goals, what’s not in question is that many of America’s uninsured don’t have to wait for new legislation to pass to get coverage.
For many Americans, getting off the rolls of the uninsured is a simple matter of getting information about coverage that’s already available to them. And, while state governments and health care advocacy groups are making concerted efforts to direct the uninsured to coverage, efforts by ordinary citizens can also help reduce the rolls of the uninsured.
The growing problem
According to “State of the States,” a 2009 publication by the Robert Wood Johnson Foundation, the number of Americans without health insurance rose to 46.3 million in 2008 – or 15.4 percent of the population. Even working adults – 26.9 million of them – are increasingly uninsured.
The growing number of uninsured Americans is driven in part by a continued rise in premiums which, according to the report, have increased by 131 percent over the past decade. During the health reform debate, both the media and the Obama Administration expressed outrage over proposals to increase health insurance rates by double digits in 11 states – and as much as 39 percent for some policy holders in California.
As a result, the percentage of Americans with private health insurance is dropping while the number of individuals with employer-sponsored insurance rates also continues a long-term decline.
The consequences of not having insurance are numerous for the uninsured – and for the insured. A report from the Institute of Medicine on the consequences of not having insurance noted that
- uninsured Americans “experience worse health and die sooner” than their insured counterparts;
- families suffer emotionally and financially when a family member is uninsured;
- the uninsured cause instability at the community level for health care providers and institutions and for the services and programs accessible to residents; and
- the nation suffers economically due to the “poorer health and premature death” of uninsured Americans.
Where the uninsured turn
As Americans lose their private health insurance and their employer-sponsored coverage, more and more people are turning to public programs to find whatever affordable coverage they can secure. Many states, in response to increasing demand, are making their own efforts to expand access to programs.
Eighteen states have passed or enacted legislation to expand Medicaid and CHIP programs. And last year, Congress provided funding to states so they could expand eligibility for Medicaid and CHIP.
Some individuals – including many who can actually afford insurance – have been denied coverage because of pre-existing conditions. Those individuals are increasingly looking to high-risk insurance pools, state-sponsored pools of individuals who have been denied coverage by private insurance companies.
Historically, not all states offered risk pools – and when they do, the pools are often markedly more expensive, which still puts coverage out of reach for many individuals. With the passage of the Affordable Care Act, states are now moving to enroll citizens in temporary high-risk insurance pools.
Communities offer help
But even with increased funding and promotion of these programs by the states, millions of families continue to go without insurance because they’re not aware that they’re eligible for publicly administered health insurance programs. And sadly, many Americans aren’t aware of how easy it is to help the uninsured.
“During the debate about reform, Americans sent loud, clear messages to Washington about their desire for legislation that would cover more of the uninsured,” says Charles Smith-Dewey, founder of the Health Insurance Resource Center. “But their voices can accomplish as much, if not more, in their own communities.”
Smith-Dewey says that more and more, communities are witnessing grassroots efforts to raise awareness of affordable coverage options for the uninsured. “It may be as simple as using your school or community group newsletter, bulletin board or Web site to post directions to insurance resources,” he says.
For CHIP and Medicaid assistance, the most convenient resource is often a state’s department of insurance. For Web sites and phone numbers of each state’s department, start here. Individuals seeking coverage through state high-risk pools can find contact information for participating states here.
Beyond posting the information, an increasing number of community groups are hosting insurance enrollment drives, Smith-Dewey says. Well-organized initiatives such as Cover the Uninsured (discontinued), a project of the Robert Wood Johnson Foundation, give individuals the information and tools they need to learn about insurance options in their states and to start their own community drives.
“Through the reform debate, we all learned that a lack of health coverage can have catastrophic consequences,” Smith-Dewey says. “Fortunately, we’ve also learned that Americans genuinely want to help solve the health care crisis – and that they’re willing to take steps in their own communities.”
For more information about health coverage resources – both public and private – available in your state, check out our state health insurance guides.