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A Calexico firefighter treats a patient while on the way to the El Centro Regional Medical Center emergency room Friday. About 20 percent of uninsured U.S. residents note that their usual source of care is the emergency room, according to the National Coalition on Health Care. (ALEJANDRO DAVILA PHOTO / January 25, 2013) |
It’s been years since Graciela Hernandez had health insurance and although she has diabetes, the last time she saw a doctor was two years ago.
The Brawley resident does qualify for Medi-Cal, but her share of cost came out to be almost $1,000 a month. “So there’s no way I could afford that. … I might as well go without insurance,” said Hernandez, a 51-year-old customer representative who lives on minimum wage.
Being without insurance for three years “has been difficult, it (has), I mean, I’m sick and I need medication. So what I started doing is getting my medication across the border,” said Hernandez, who follows the prescription she was given years ago. “I don’t know where I stand really, health-wise,” she added.
But Hernandez has another problem incurred by her lack of health-care coverage: emergency room hospital bills. Since Hernandez doesn’t have insurance, she waits until she is very sick before she seeks care. “I do have some bills in collections,” she said and estimated she owes around $14,000 in medical bills.
“I’m sure my mom is not the only one,” said Jesse Macias, while referring to Hernandez. “I’m sure there are many, many residents who are experiencing the same thing my mother is.”
Macias is correct. His mother is one of some 48.6 million people who were uninsured in the United States as of 2011, according to U.S. Census Bureau figures. She is also part of the 26 percent of women who had problems paying medical bills in the country in 2009-2010, according to a 2012 report by the Commonwealth Fund, a nonprofit that supports the Affordable Care Act approved in 2010.
A health care problem
The Affordable Care Act, mostly upheld by the U.S. Supreme Court last summer, hopes to address the problems that people like Hernandez have. Not everybody may be politically on board with the particulars of the act, widely referred to as “Obamacare,” but nonetheless research suggests the country has numerous health-care systemic problems that need to be addressed.
To begin with, the United States is the only developed nation without a form of universal health care coverage and it also has the most expensive health-care system in the world. Moreover, costs are projected to increase with health spending rising by about 5.8 percent each year from 2010 to 2020, according to 2011 actuaries from the Centers for Medicare and Medicaid Services.
These high costs, another Commonwealth Fund study notes, are likely caused by higher prices, more readily accessible technology and greater rates of obesity. A number of other studies also suggest administrative costs related to health care in the United States are higher compared to other nations.
And of course, a high number of U.S. citizens don’t have health-care insurance. Many employers don’t offer it and while some people can’t afford private insurance, others are denied coverage over pre-existing conditions. As a result, people like Hernandez tend to visit the emergency room instead of visiting a primary care physician, incurring debt that many can’t pay.
A health care solution
Uncertainty about the Affordable Care Act is ongoing, with some questioning the mandate that requires — with various exceptions — that individuals buy health insurance or pay a penalty. On the other hand, many approve of the health-care reform in that it expands Medicaid and Medi-Cal eligibility for millions of people.
“The Affordable Care Act expands eligibility to all lawfully present adults who have incomes of $15,000 a year for a single person or $32,000 for a family of four,” said Laurel Lucia, policy analyst at the University of California, Berkeley, Center for Labor Research and Education.
For people with incomes of up to $45,000 for a single person and $90,000 for a family of four, they could be eligible for subsidized coverage provided by a private insurance company. Companies would offer their plans through a somewhat government controlled health insurance market being set up by the end of this year called Covered California.
So if a person doesn’t have access to base coverage by an employer or if they are not eligible for a public program, Lucia said that depending on their income level, “they can get this private health insurance that the federal government will pay part of the premium.”
Above that income level, the main benefit of Obamacare is that starting in 2014 insurers have to provide insurance to anyone that applies, regardless if they have a pre-existing condition, she said.
“I think it (Obamacare) will stabilize the health-care system because more people will get coverage and there will be more predictability in terms of where the payment is coming from,” said Lucia.
A phase-in process
The Brawley resident does qualify for Medi-Cal, but her share of cost came out to be almost $1,000 a month. “So there’s no way I could afford that. … I might as well go without insurance,” said Hernandez, a 51-year-old customer representative who lives on minimum wage.
Being without insurance for three years “has been difficult, it (has), I mean, I’m sick and I need medication. So what I started doing is getting my medication across the border,” said Hernandez, who follows the prescription she was given years ago. “I don’t know where I stand really, health-wise,” she added.
But Hernandez has another problem incurred by her lack of health-care coverage: emergency room hospital bills. Since Hernandez doesn’t have insurance, she waits until she is very sick before she seeks care. “I do have some bills in collections,” she said and estimated she owes around $14,000 in medical bills.
“I’m sure my mom is not the only one,” said Jesse Macias, while referring to Hernandez. “I’m sure there are many, many residents who are experiencing the same thing my mother is.”
Macias is correct. His mother is one of some 48.6 million people who were uninsured in the United States as of 2011, according to U.S. Census Bureau figures. She is also part of the 26 percent of women who had problems paying medical bills in the country in 2009-2010, according to a 2012 report by the Commonwealth Fund, a nonprofit that supports the Affordable Care Act approved in 2010.
A health care problem
The Affordable Care Act, mostly upheld by the U.S. Supreme Court last summer, hopes to address the problems that people like Hernandez have. Not everybody may be politically on board with the particulars of the act, widely referred to as “Obamacare,” but nonetheless research suggests the country has numerous health-care systemic problems that need to be addressed.
To begin with, the United States is the only developed nation without a form of universal health care coverage and it also has the most expensive health-care system in the world. Moreover, costs are projected to increase with health spending rising by about 5.8 percent each year from 2010 to 2020, according to 2011 actuaries from the Centers for Medicare and Medicaid Services.
These high costs, another Commonwealth Fund study notes, are likely caused by higher prices, more readily accessible technology and greater rates of obesity. A number of other studies also suggest administrative costs related to health care in the United States are higher compared to other nations.
And of course, a high number of U.S. citizens don’t have health-care insurance. Many employers don’t offer it and while some people can’t afford private insurance, others are denied coverage over pre-existing conditions. As a result, people like Hernandez tend to visit the emergency room instead of visiting a primary care physician, incurring debt that many can’t pay.
A health care solution
Uncertainty about the Affordable Care Act is ongoing, with some questioning the mandate that requires — with various exceptions — that individuals buy health insurance or pay a penalty. On the other hand, many approve of the health-care reform in that it expands Medicaid and Medi-Cal eligibility for millions of people.
“The Affordable Care Act expands eligibility to all lawfully present adults who have incomes of $15,000 a year for a single person or $32,000 for a family of four,” said Laurel Lucia, policy analyst at the University of California, Berkeley, Center for Labor Research and Education.
For people with incomes of up to $45,000 for a single person and $90,000 for a family of four, they could be eligible for subsidized coverage provided by a private insurance company. Companies would offer their plans through a somewhat government controlled health insurance market being set up by the end of this year called Covered California.
So if a person doesn’t have access to base coverage by an employer or if they are not eligible for a public program, Lucia said that depending on their income level, “they can get this private health insurance that the federal government will pay part of the premium.”
Above that income level, the main benefit of Obamacare is that starting in 2014 insurers have to provide insurance to anyone that applies, regardless if they have a pre-existing condition, she said.
“I think it (Obamacare) will stabilize the health-care system because more people will get coverage and there will be more predictability in terms of where the payment is coming from,” said Lucia.
A phase-in process
