The Complexities of Living in the “Coverage Gap”

Under the Affordable Care Act, also known as Obamacare, nearly all low-income individuals with an income less than 200 percent of federal poverty level ($48,600 for a family of four or $23,760 for a single person) qualifies for health insurance, which has been a great boon for those struggling to afford healthcare. However, there are many nationally who live in a kind of “dead zone” that do not qualify, either because they make too much money for Medicaid or not enough income to be able to use the healthcare exchanges. These “coverage gaps” are complex and often rise because some states limited Medicaid coverage that would help the uninsured. Washington State expanded its Medicaid coverage which helped limit the coverage gap within Washington. However, there are still a significant percentage of the population that are uninsured.

How many are in the “coverage gap”?

Nearly two and a half million poor uninsured adults fall into the coverage gap many of whom are white non-hispanics, though that varies by state. Nationally, 46 percent of uninsured adults in the coverage gap are white. In Washington State, hispanics continue to have a high uninsured rate at about 19.2 percent. In Washington,almost 600,000 people still remain uninsured, approximately 38,000 of those within Clark County.

 

How does a “coverage gap” affect the uninsured?

Many of those who are without health insurance are also past middle age, making those who are struggling into their 60s and 70s with health issues more likely to not have insurance to cover their increasing health costs.

Untreated health issues often become more serious the longer they are left untreated. Those in the coverage gap tend to have higher percentages of late-term cancer diagnosis, chronic health conditions, untreated diabetes and other major health issues that have been ignored, burgeoning into critical health issues that often expand into costly emergency room visits that are unaffordable and create medical bills that go unpaid.

Many people, struggling under the burden of medical bills, find their tenuous health compromised even further as they face daily choices of what bills to pay, what medications to buy or not buy, and how to buy groceries or pay for housing.

How does the “coverage gap” affect communities?

Unpaid medical bills have to be absorbed by someone and often those bills are paid by hospitals or state and federal agencies, but they also can get passed on in rising medical costs. Since 2000, hospitals have provided more than $502 billion in uncompensated care to patients. Additionally, lost work time to sick employees cost billions to employers annually. That lost money affects communities at the most basic levels: productivity, happy communities, thriving businesses.

How do free clinics help?

Since the 1960s about 1,200 free and charitable clinics have been filling in the medical gaps for those who cannot afford health coverage. By helping people who cannot afford healthcare, free and charitable clinics help people, families, employees, employers and the larger community thrive and be productive. Free clinics can help stop the vicious cycle of uninsured people using medical resources inefficiently, such as emergency room visits for non-urgent care, which raises costs for everyone. Preventive care also helps the uninsured stop potential health issues before they reach a crisis point, which in turn helps reduce overall costs by keeping the employee at work and productive, reducing the strain on the community who would absorb the unpaid medical costs for critical care. Keeping people well and in the workforce has a significant impact on the local economy. And a healthy community attracts and retains businesses looking for employees who will enhance their company.

Why give to Battle Ground Healthcare

Battle Ground HealthCare believes in the value of health and strives to meet the health and dental needs of the uninsured and underinsured in our community so that our community can thrive! Consider partnering with us and giving a gift to your community.