THE ACCESS PROJECT It's Everyone's Loss: The Ripple Effect of the Uninsured Thursday January 26, 200

1
THE ACCESS PROJECT It's Everyone's Loss The
Ripple Effect of the UninsuredThursday January
26, 2006

• Mark Rukavina, DirectorThe Access Project30
  Winter Street, Suite 930Boston, MA 02108Phone
  [phone] Fax [phone] E-mail
  rukavina_at_accessproject.orgWeb-site
  www.accessproject.org

2
What Do We Know About Medical Debt?

• Medical Debt is a problem for the uninsured and
  those with health insurance
• Medical Debt influences peoples healthcare
  access
• Medical Debt influences peoples lives in other
  ways
• Medical Debt broadens the base for health reform

3
How widespread is the problem of medical
debt?
4
Commonwealth Fund Biennial Health Insurance
Survey

• Six out of ten adults under the age of 65 who
  were uninsured any time during previous year had
  problems related to medical bills or accrued
  medical debt
• Four out of ten adults under the age of 65 had
  problems related to medical bills or accrued
  medical debt
• Health Insurance Survey 2003 The Commonwealth
  Fund

5
Sicker and Poorer Adults Harder Hit by Medical
Bill Problems Debtpercentage of adults ages
19-64
Health Insurance Survey 2003 The Commonwealth Fund
6
Kaiser Commission on Medicaid and Uninsured2003
Health Insurance Survey

• Estimates 58 million adults are at risk of
  incurring medical bills they may not be able to
  afford includes those uninsured for all or part
  of previous year, as well as those underinsured.
• One in six adults with private insurance - 17.6
  million adults report having substantial
  problems paying their medical bills
• Among privately insured, those with medical debt
  more than twice as likely to report poor or only
  fair health status.

7
Does medical debt influence peoples healthcare
access?
8
Access Project Community Research

• Getting Care But Paying the Price How Medical
  Debt Leaves Many in Massachusetts Facing Tough
  Choices
• Nearly 60 said medical debt caused them to delay
  getting needed health care
• 73 delayed care because uncomfortable about the
  bills
• 30 said they were asked to pay cash upfront
• 14 said denied care altogether
• Pryor Gurewich, The Access Project February
  2004 funded thru Blue Cross Blue Shield of
  Massachusetts Foundation

9
Access Project Community Research

• Playing By The Rules But Losing How medical debt
  threatens Kansans healthcare access and
  financial security
• OF RESPONDENTS WITH MEDICAL DEBT
• Nearly half (48) delayed a doctors visit
  because of the debt
• 39 delayed a dental visit
• 29 delayed filling a prescription
• 25 changed primary care doctors because of money
  they owed for care
• 13 refused an appointment because of debt
• Pryor Prottas, The Access Project January
  20064 funded thru W. K. Kellogg Foundation and
  United Methodist Health Ministry Fund

10
Commonwealth Fund Biennial Health Insurance
Survey

• Health Insurance Survey 2003 The Commonwealth
  Fund

11
Kaiser Commission on Medicaid and Uninsured2003
Health Insurance Survey

• Privately insured with medical debt have
  care-seeking behavior similar to uninsured

12
Kaiser Commission on Medicaid and Uninsured
2003 Health Insurance Survey
2003 Health Insurance Survey Kaiser Family
Foundation
13
Kaiser Commission on Medicaid and Uninsured
2003 Health Insurance Survey
2003 Health Insurance Survey Kaiser Family
Foundation
14
Does medical debt influence peoples lives in
other ways?
15
Problems Resulting from Medical Bills Adults
ages 19-64 with medical bill problems or accrued
medical debt

• Health Insurance Survey 2003 The Commonwealth
  Fund

16
Medical Debtors Struggle to Pay Bills

• Health Insurance Survey 2003 The Commonwealth
  Fund

17
Access Project Community Research

• New Report, Home Sick, uncovers link between
  medical debt and housing problems

18
Access Project Community Research

• Home Sick How Medical Debt Undermines Housing
  Security
• Nearly half (46) reported having medical debt.
• More than one-quarter (27) of respondents with
  debt said housing problems resulted from the
  medical debt
• Relatively small debts had far-reaching effects
• One out of six respondents (16) with medical
  debts less than 500 said that the debt had
  harmed their credit.
• Twelve percent (12) of respondents with this
  level of debt reported having housing problems.
• Health insurance did not provide thorough
  protection
• One out of five respondents who had health
  insurance said their medical debt had led to
  housing problems.
• Seifert, The Access Project November 2005
  Funded by the W.K. Kellogg Foundation, the Annie
  E. Casey Foundation, the Quantum Foundation and
  the Missouri Foundation for Health

19
Access Project Community Research

• Home Sick How Medical Debt Undermines Housing
  Security
• Bad credit was a frequent result of medical debt
  
• Most people did not know whether their medical
  debt was on their credit reports,
• Of of those who did know, three in five (39)
  said it had damaged their credit.
• Seifert, The Access Project November 2005
  Funded by the W.K. Kellogg Foundation, the Annie
  E. Casey Foundation, the Quantum Foundation and
  the Missouri Foundation for Health

20
What Do We Learn From the Medical Debt Issue?

• Medical debt is a widespread problem and has the
  potential to bring new allies into health reform
  discussion
• Focusing on the number of uninsured, while
  important, isnt enough!
• Medical Debt is a good handle for organizing and
  connecting low and middle income Missouri Story