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Health Insurance Coverage and Access to Care for Communities of Color Presentation for the Health Disparities Council

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Health Insurance Coverage and Access to Care for Communities of Color Presentation for the Health Disparities Council Kate Nordahl Assistant Commissioner – PowerPoint PPT presentation

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Title: Health Insurance Coverage and Access to Care for Communities of Color Presentation for the Health Disparities Council


1
Health Insurance Coverage and Access to Care for
Communities of ColorPresentation for the Health
Disparities Council
  • Kate Nordahl
  • Assistant Commissioner
  • Division of Health Care Finance and Policy

2
Presentation Overview
  • Who are the uninsured?
  • Uninsurance rates by race/ethnicity and age
  • Type of insurance coverage by race/ethnicity and
    age
  • Access to and use of care
  • Usual source of care
  • Doctors visit in past 12 months
  • ER visit in past 12 months
  • Barriers to care due to cost

3
Uninsurance
Uninsurance Ratefor All Massachusetts Residents
  • Uninsurance was low among Massachusetts
    residents, with less than 3 (167,300 people)
    uninsured at the time of the survey (summer 2008).

Source Urban Institute tabulations on the 2008
Massachusetts HIS
Massachusetts Division of Health Care Finance and
Policy
4
Who are the Uninsured?
  • More likely to be
  • Male (57 of the uninsured are male vs. 48.2 in
    general population)
  • Young adult - 19 to 25 years of age (32.1 vs.
    15.2)
  • Hispanic (18.8 vs. 6.8)
  • Non-citizen (14.5 vs. 4.6)
  • Low-income
  • lt150 FPL (45.1 vs. 20.2)
  • 151-299 FPL (33.9 vs. 18.7)
  • With less formal education
  • Less than high school (12.0 vs. 3.9)
  • High school graduate or GED (55.6 vs. 40.0)
  • Non-working or working only part-time
  • If work, work for a small sized firm (lt51
    employees) and for a firm that doesnt offer
    employer-sponsored insurance (ESI)

5
Uninsurance
Uninsurance Rates by Race/Ethnicity, All Ages
  • Hispanic residents were most likely to go without
    coverage in Massachusetts, with an uninsurance
    rate more than twice as high as other
    non-Hispanic groups (7.2 versus less than 3).

Source Urban Institute tabulations on the 2008
Massachusetts HIS
Massachusetts Division of Health Care Finance and
Policy
6
Uninsurance
Uninsurance Rates of Non-Elderly Adults (ages
19-64) by Race/Ethnicity
  • Uninsurance was highest among non-elderly
    Hispanic adults in Massachusetts, with an
    uninsurance rate roughly three times that of
    other, non-Hispanic groups.

Source Urban Institute tabulations on the 2008
Massachusetts HIS
Massachusetts Division of Health Care Finance and
Policy
7
Uninsurance
Uninsurance Rates of Children (lt18) by
Race/Ethnicity
Uninsurance was highest among Hispanic children
in Massachusetts, with 2.6 uninsured. Note
there was not large enough sample size to report
Black, non-Hispanic and Asian, non-Hispanic
separately
Source Urban Institute tabulations on the 2008
Massachusetts HIS
Massachusetts Division of Health Care Finance and
Policy
8
Type of Coverage
Type of Health Insurance Coverage by
Race/Ethnicity, All Ages
Employer-sponsored insurance was more common
among white, non-Hispanic residents of
Massachusetts (71) than among other race,
non-Hispanic or Hispanic residents (63 and 45,
respectively).
Insurance coverage is based on the hierarchy
Medicare, employer-sponsored insurance, public or
other coverage. Public and other coverage are
combined because of the survey respondents
difficulties in reporting type of coverage. For
lower-income residents, public or other coverage
is mostly MassHealth or Commonwealth Care, while
for higher-income residents it is non-group
coverage and, to a lesser extent, Commonwealth
Choice. Source Urban Institute tabulations on
the 2008 Massachusetts HIS
Massachusetts Division of Health Care Finance and
Policy
9
Type of Coverage
Type of Health Insurance Coverage of
Non-Elderly Adults by Race/Ethnicity
Employer-sponsored coverage was most common among
white, non-Hispanic adults (83), compared to
other race, non-Hispanic adults (73) and
Hispanic adults (54).
Insurance coverage is based on the hierarchy
Medicare, employer-sponsored insurance, public or
other coverage. Public and other coverage are
combined because of the survey respondents
difficulties in reporting type of coverage. For
lower-income residents, public or other coverage
is mostly MassHealth or Commonwealth Care, while
for higher-income residents it is non-group
coverage and, to a lesser extent, Commonwealth
Choice. Source Urban Institute tabulations on
the 2008 Massachusetts HIS
Massachusetts Division of Health Care Finance and
Policy
10
Type of Coverage
Type of Health Insurance Coverage of Children
by Race/Ethnicity
Employer-sponsored coverage was most common among
non-Hispanic, white children (79), compared to
other race, non-Hispanic children (56) and
Hispanic children (42).
Insurance coverage is based on the hierarchy
Medicare, employer-sponsored insurance, public or
other coverage. Public and other coverage are
combined because of the survey respondents
difficulties in reporting type of coverage. For
lower-income residents, public or other coverage
is mostly MassHealth or Commonwealth Care, while
for higher-income residents it is non-group
coverage and, to a lesser extent, Commonwealth
Choice. Source Urban Institute tabulations on
the 2008 Massachusetts HIS
Massachusetts Division of Health Care Finance and
Policy
11
Non-Elderly Adults
Non-Elderly Adults with a Usual Source of Care by
Race/Ethnicity
Other, non-Hispanic adults were less likely to
have a usual source of care than white adults and
adults reporting other race/ethnicities.
Source 2008 Massachusetts Health Insurance Survey
Massachusetts Division of Health Care Finance and
Policy
12
Non-Elderly Adults
Non-Elderly Adults with a Usual Source of Care by
Insurance Status
Compared with the insured, uninsured non-elderly
adults were much less likely to have a usual
source of care (42 versus 91).
Source 2008 Massachusetts Health Insurance Survey
Massachusetts Division of Health Care Finance and
Policy
13
Children
Children with a Usual Source of Care by
Race/Ethnicity
Hispanic children were least likely to have a
usual source of care, compared to other
race/ethnicity groups.
Source 2008 Massachusetts Health Insurance Survey
Massachusetts Division of Health Care Finance and
Policy
14
Non-Elderly Adults
Non-Elderly Adults with a Doctor Visit in Past 12
Months by Race/Ethnicity
Among non-elderly adults, those who reported
other, non-Hispanic race/ethni-cities were less
likely than white, non-Hispanic or Hispanic
adults to have had any doctor visits or a
preventive care visit.
Source 2008 Massachusetts Health Insurance Survey
Massachusetts Division of Health Care Finance and
Policy
15
Children
Children with a Doctor Visit in Past 12 Months by
Race/Ethnicity
Hispanic and other, non-Hispanic children were
less likely than white, non-Hispanic children to
have had any doctor visit or a preventive care
visit in the past 12 months.
Source 2008 Massachusetts Health Insurance Survey
Massachusetts Division of Health Care Finance and
Policy
16
Non-Elderly Adults
Non-Elderly Adults with an ER Visit in the Past
12 Months by Race/Ethnicity
Among non-elderly adults, Hispanics were much
more likely to have had an ER visit overall and
an ER visit for a non-emergency than other
race/ethnicity groups.
A non-emergency ER visit is one that the
respondent says could have been treated by a
regular doctor if one had been available. Source
2008 Massachusetts Health Insurance Survey
Massachusetts Division of Health Care Finance and
Policy
17
Children
Children with an ER Visit in the Past 12 Months
by Race/Ethnicity
Hispanic children were much more likely than
non-Hispanic children to have had an emergency or
non-emergency ER visit.
A non-emergency ER visit is one that the
respondent says could have been treated by a
regular doctor if one had been available. Source
2008 Massachusetts Health Insurance Survey
Massachusetts Division of Health Care Finance and
Policy
18
Non-Elderly Adults
Non-Elderly Adults Not Getting Needed Care Due to
Cost in Past 12 Months by Race/Ethnicity
Among non-elderly adults, one-quarter of white,
non-Hispanic adults skipped needed health care
due to cost, compared with 29 of other,
non-Hispanic adults and 35 of Hispanic adults.
Source 2008 Massachusetts Health Insurance Survey
Massachusetts Division of Health Care Finance and
Policy
19
Children
Children Not Getting Needed Care Due to Cost in
Past 12 Months by Race/Ethnicity
Unmet need for health care due to cost was
highest for Hispanic children, at 22.
Source 2008 Massachusetts Health Insurance Survey
Massachusetts Division of Health Care Finance and
Policy
20
Non-Elderly Adults
Non-Elderly Adults in Families with Problems
Paying Medical Bills in Past 12 Months by
Race/Ethnicity
Among non-elderly adults, black, non-Hispanics
were more likely to report problems paying
medical bills than were white, non-Hispanic
adults.
Source 2008 Massachusetts Health Insurance Survey
Massachusetts Division of Health Care Finance and
Policy
21
Children
Children in Families with Problems Paying Medical
Bills in Past 12 Months by Race/Ethnicity
Other, non-Hispanic and Hispanic children were
most likely to live in families that had trouble
paying medical bills (22).
Source 2008 Massachusetts Health Insurance Survey
Massachusetts Division of Health Care Finance and
Policy
22
Summary
  • While Massachusetts has made great strides to
    reduce uninsurance and improve access to care the
    Hispanic population is more likely to
  • be uninsured
  • use the emergency department in the past 12
    months
  • have sought care in the ER for a non-emergency
  • have not sought needed care due to cost
  • The Hispanic, non-elderly adult population is
    less likely to have a usual source of care
  • In addition, Black, non-Hispanic non-elderly
    adults were more likely to
  • have not sought needed care due to cost
  • have problems paying medical bills
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