Report: Thousands in Worcester Remain Uninsured

Saturday, March 30, 2013

Ashley Klann, GoLocalWorcester Contributor

A report from Blue Cross of MA Foundation reveals that staggering numbers of children and adults remain uninsured in Central Mass. despite the state's health report initiative.

The Bay State has lowest figures compared to other states in the nation, but pockets of uninsured residents are still slipping by the state’s healthcare program, creating concerns.

“Their lack of insurance places them at financial risk and, when they forgo needed care to avoid those costs, at risk for poor health outcomes,” the report reads.

Blue Cross of MA released the report earlier this month, which examines the circumstances of nonelderly uninsured persons in the state in recent years. The study, titled “Reaching the Remaining Uninsured in Massachusetts: Challenges and Opportunities,” suggests strategies to reach remaining groups, including those in our region.

Worcester’s Numbers

The study looked at two groups of the population, uninsured children (up to age 17) and uninsured non-elderly (ages 18 to 64).

In Worcester, the study revealed 341 uninsured children, the sixth highest number behind Springfield, New Bedford, Marlborough, Quincy, and Revere.

The number of uninsured non-elderly residents is even more staggering, with a total of 7,630 – making 6.4 percent of the city’s population. This number is the third highest amount of uninsured.

Other Towns in Central Mass.

Other towns in Central Mass. also came in with high numbers. In terms of uninsured children, Marlborough had a significantly high number – 389 or 4.9 percent of the city’s population. Milford’s number of uninsured children totaled to 242.

The number of uninsured non-elderly in Milford came out to 10.1 percent of the population, or 1,617 individuals. Marlborough came out with 1,099, or 4.3 percent.

“As with the uninsurance rate, the number of uninsured varied widely across places in the state, ranging from 0 to 1,659 for children and from 233 to 31,473 for non-elderly adults,” the group stated.

The five places with the largest numbers of uninsured children were Lynn (538), New Bedford (599), Brockton (657), Framingham (688), and Boston (1,659). For adults, the five places with the largest numbers of uninsured were New Bedford (6,415), Lowell (6,422), Worcester (7,630), Springfield (8,792), and Boston (31,473).

The highest based on percent was Revere with 14.5 percent of its population of adults, or 4,738.

The report says that these figures show those lacking health insurance coverage in Massachusetts after the 2006 reform initiative, to highlight the difficulties they face in accessing and affording health care.

Blue Cross of MA says that the data also takes into consideration new changes coming from the implementation of the Affordable Care Act.

Who’s Uninsured?

Trends evolved from the data, showing that many uninsured residents have low education levels and limited English proficiency. Predominantly, remaining uninsured are disproportionately younger, male, Hispanic, and non-citizens.

The majority (59.2 percent) of the uninsured were working, including 34.9 percent who were working full-time. However, less than one-third of those uninsured workers had access to employer-sponsored insurance.

Of those who did have access to employer-sponsored insurance, most did not take up that offer of coverage because of cost. Overall, the cost of coverage was the most common reason given for being uninsured.

According to the study, uninsured adults are more likely than insured adults to have difficulty getting a doctor’s appointment and to have problems accessing primary care. They are also more likely to use the emergency department for non-emergency care.

Uninsured adults are more likely than insured adults to have medical debt of $10,000 or more and to have trouble paying other bills.

To a large extent, uninsured adults and children are concentrated in a subset of communities

Challenges

The study also points out many challenges to reaching remaining uninsured residents in Massachusetts.

“Residents are once again facing changes in the available health insurance options, as implementation of national health reform begins under the federal Patient Protection and
Affordable Care Act of 2010,” the group says.

The ACA, which relied on the Massachusetts reform as a template, utilizes Medicaid expansions, subsidies for private insurance, health insurance exchanges, insurance market reforms, requirements for employers, and an individual coverage mandate, among other changes, in a push for expanded health insurance coverage for the nation

Family income is also a huge hurdle in aiding these families, according to the study. Nearly all of the uninsured are in families whose incomes are below 400 percent of the poverty level.

A Solution?

Due to this income gap in uninsured residents, and the fact that the majority are citizens, Blue Cross of MA says that these groups will most likely be eligible for Medicaid or subsidized coverage under the Affordable Care Act, and many may be eligible for MassHealth or Commonwealth Care now.

The key to getting the numbers down, however, remains outreach, something the group suggests using to target specific groups of uninsured individuals, including younger adults, males, and Hispanics, as well as including efforts that address literacy and language issues.

According to the group, efforts that reach out to low-income uninsured workers who, because of an offer of ESI, are not currently eligible for Commonwealth Care but appear likely to be eligible for Medicaid as part of the ACA expansion.

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