Most Massachusetts residents are covered by health insurance, either through their employer or through a government-supported program, a point of pride here in the Commonwealth. But we could do more to listen to the remaining uninsured who may want health insurance but face enrollment hurdles.
A new report from the Blue Cross Blue Shield of Massachusetts Foundation confirms what we’ve known all along that uninsured residents tend to live in poorer communities and have historically faced racial discrimination or persistent challenges with accessing health care. The report offers new information and recommendations on how to remove coverage barriers and increase health coverage for the individuals and families who could benefit most.
Why is it so important to have health insurance? We know that uninsured people are much more likely to postpone or forgo annual checkups, prescription medications, and doctor appointments. Not having insurance actually has a negative effect on people’s health, especially people with a chronic condition like asthma or high blood pressure or diabetes. Being uninsured has been linked to a higher risk of death, particularly among the elderly.
And, not surprisingly, not being insured places financial stress on families and individuals who may fear falling ill or having to dip into their savings or go into debt to pay for urgent medical care or hospital care for themselves or their children.
Health insurance is the key that opens the door to our country’s health care system. Lack of health insurance is harmful and costly to individuals, health care professionals and the community as a whole. And we know that having health insurance is good for the individual and good for the community.
So who in Massachusetts is uninsured, despite living in the state with the lowest uninsured rate in the nation?
The report found that, at the time of the survey, the group numbers about 200,000 people, or about 3 percent of the state’s population. (But the percentage is much higher if you look back more than a year. For example, a 2019 survey found that more than 500,000 people, or 7 percent of the state’s population, had a health coverage gap in their previous 12 months due to changed circumstances such as job loss or eligibility.)
There were significantly higher levels of uninsured among Hispanic and black residents than among white residents. For example, in Massachusetts, Hispanic residents make up 12% of the population but make up 23% of the uninsured population.
People born outside the United States, who often face language barriers and other barriers to coverage, were also more likely to be uninsured: Nearly 4 in 10 uninsured residents were born outside the United States, and about 3 out of 10 uninsured residents were born outside the United States. 10 were not US citizens.
In addition to people of color and immigrants, the uninsured are very likely to be historically marginalized groups, whether economically, racially, ethnically or linguistically.
Most uninsured residents want coverage, but face many types of hurdles in getting it. Many are unaware that they can benefit from affordable public and subsidized options. For example, some who no longer qualify for the MassHealth program may be eligible for other subsidized programs but not know it. Others may be reluctant to apply for benefits due to their immigrant status. Many people had health insurance at one time but lost coverage when they lost or changed jobs. And unsurprisingly, given the complexity of healthcare, many people find it difficult to understand the different types of coverage or how to apply.
Even if you have insurance, getting the health care or treatment you need can still be difficult because of discrimination based on race and ethnicity, languages spoken, age, disability, sexual orientation, or national identity. type. A lack of primary care providers or specialists practicing in your area can also be a barrier.
The report outlined these barriers and made a number of policy recommendations aimed at reducing the uninsured rate and improving eligibility and affordability. The report also featured several voices of the uninsured in a video.
We can proudly point to Massachusetts’ leadership in dramatically expanding health coverage, but we need to take additional steps to secure even more people, especially those who can’t afford to go without.
Audrey Shelto is president and CEO of Blue Cross Blue Shield of the Massachusetts Foundationa private non-profit organization whose mission is to ensure equitable access to healthcare for all who are economically, racially, culturally or socially marginalized in the Commonwealth.
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