Cover the Uninsured Week 2009
MedSave.com is participating in national "Cover the Uninsured Week" (March 22 - 28, 2009) with a consumer education campaign designed to emphasize the simplest and most affordable solutions that are readily available to more than half of the 46 million people the U.S. who lack health coverage. Cover the Uninsured Week is a national event drawing upon the efforts of a large number of public and private entities involved in health care. Other major national participants include Aetna, Kaiser Foundation, Robert Johnson Wood Foundation and the Magic Johnson Foundation. While MedSave.com focuses on private health insurance solutions, many of the organizations at CovertheUninsured.org focus on public solutions.
Our mission is to raise awareness that more than 20 million people can choose to be part of the solution to our nation's health care crisis. Eight out of ten uninsured Americans come from working class families that feel they cannot allocate any money toward health insurance and gamble that they will not get sick or injured. Almost half of the nation's uninsured, about 22.5 million people, could be immediately covered by insurance they can afford if they knew about existing insurance and resolved to make this a financial priority in their household budget. Unfortunately, too many of the uninsured choose to ignore the problem because they believe that it is too complicated, too expensive and that someone in government will address the problem.
The focus of "Cover the Uninsured Week" will be on identifying possible solutions for the four unique groups that make up the majority of our nations' unemployed. The five groups are: 1) working class families, 2) students and recent graduates, 3) small business employees, 4) high risk individuals. The final segment draws attention to the fact that an estimate 80% of our national health care costs are attributable to behavioral factors that can be prevented through modification of lifestyle habits. This approach may offer the best long term strategy for resolving our national health care crisis.
(Part 1 of 5, Monday March 23, 2009)
SCHIP programs for working class families
The brightest stars in the battle to expand health care coverage over the past year were the state children's health insurance plans (SCHIP). These SCHIP plans were largely responsible for the overall decline in the number of people without health insurance, dropping form 47 million to 46 million over the past year. These health plans are available for free or very low cost yet millions of Americans eligible for coverage have not enrolled. Last year Aetna's "Plan for Your Health" Foundation found that 63% of Americans are unaware of their state's programs to help the uninsured. This Aetna Foundation teamed up with the Magic Johnson Foundation to educate uninsured Americans about free or low cost health insurance. The program brochure featured a photo of the basketball legend "Magic" Johnson with a quotation "Did you know you may qualify for free or low cost health insurance programs". An estimated 11 million uninsured Americans, many of them children, qualify for free or low cost SCHIP programs. Ongoing consumer education programs are believed to be the most effective approach to reducing the number of uninsured within this population. The inclusion of a celebrity spokesperson is a welcome addition to the efforts.
What can I do? Talk to parents working in fields that do not usually offer employer-paid health benefits like retail, small businesses, agriculture and domestic employees. Refer them to the nurses' office of a local elementary school; they almost always have information about local SCHIP programs. Mention that an increasing number of these health plans now also cover adults, especially the parents of eligible children. Do not assume that these plans are for low income families; many are available to families making more than $50,000 per year.
(Part 2 of 5, Tuesday March 24, 2009)
Student & graduate health insurance
College students, especially part-time students, and recent graduates run a very high risk of going without health insurance. MedSave.com has reported that those in this age group who do purchase health coverage increasingly buy the wrong type of insurance. While high quality insurance is usually available and affordable, there is only a small probability that a person in this age group would choose to enroll in coverage. In response, an increasing number of schools now require students to have health coverage and many specify the coverage limits that must be carried. MedSave.com publishes specific guidance on student health insurance for many the nation's 20 largest universities.
What can I do? Parents should to be directly involved in their children's health insurance purchases. In the event that major medical treatment is required, the financial risk will fall on the family so it makes sense for the family to ensure that the coverage is adequate. In cases where health insurance is not required for students, OnlineAdviser reports that in the majority of households it appears to be the mother's influence that dictates that the student carries health insurance. Without that parental influence and financial support, their is little likelihood of students remaining covered.
(Part 3 of 5, Wednesday March 25, 2009)
Self-employed and small business coverage
Despite ongoing efforts in many states, we are losing the battle for affordable health insurance for small businesses. Small group insurance plans are so overburdened with expensive regulatory requirements that the employees of small businesses are more likely to be chronically uninsured than any other segment or the population. The percentage of employers who offer coverage declines each year and this trend is unlikely to reverse under the current legal environment.
Self-employed individuals and owners of businesses typically buy insurance from specialty commercial insurance companies like UnitedHealthcare (Golden Rule Insurance) and Celtic Insurance that offer specific coverage benefits that appeal to entrepreneurs.
Employees may be unaware of the affordable health plans in their area so an employer's indirect help and guidance in this area can be especially valuable. A 2008 report from the National Institute of Health Care Management (NIHCM) indicates that 25% of the uninsured working-class Americans - about 12.5 million - would enroll in coverage at their own expense if they only knew that affordable insurance was available.
What can I do? Small businesses with high deductible major medical insurance plans can offer supplemental insurance to employees on a voluntary salary-deducted basis. If you have employees or sub-contractors but have no group health plan then offer to reimburse the cost of their individual health insurance up to a specified dollar amount. This strategy often makes more sense and stretches the available health care dollars further than an employer-sponsored group plan. More information is available under the term "Health Reimbursement Arrangements". Direct these employees to the listing of low cost health plans available in their area.
It also helps if an employer is familiar with a few key issues that are especially important to their own employees. A business that hires immigrants, for example, can help by pointing out the unique advantages of Inbound Immigrant over most other insurance for these employees. Companies that hire Mexican or other Spanish-speaking workers who are not U.S. citizens can point out that both Inbound Immigrant and Amigo Medical offers full customer support in Spanish language and do not require citizenship. Farmers can be familiar with the inexpensive emergency accident coverage that is most popular with migrant farm workers. Although this is not full medical coverage, it does ensure that emergency care can be paid.
Finally, employers can help become "part of the solution" by encouraging workers to take action to enroll in an affordable insurance option that is available now rather than stay on the sidelines waiting for a perfect health care plan to be provided for them.
(Part 4 of 5, Thursday March 26, 2009)
High risk coverage
Public awareness and lobbying events are being held nationwide this week by other organizations to raise awareness of the need for solutions for the remaining portion of Americans who do not have readily available coverage opportunities. Unfortunately, those who need the most health care resources are those lest likely to be able to afford insurance. Those with chronic health conditions that contribute to lower lifetime economic resources are most at risk. The toughest and most costly health care problems are presumed to take the longest to address.
It is important to realize that our nation's current health care policy does provide universal coverage to all without regard to pre-existing medical conditions - but with a catch. Medicaid plans are only available after almost all personal financial resources have been exhausted. Americans increasingly question why it is necessary to become bankrupt in order to gain entrance to free universal health care, yet that is the system that governs our health care today. While the term "Medicaid planning" is no longer in use today, it is still true that raising public awareness of the rules for coverage for high risk individuals can be an effective way to reduce the financial pain of these individuals and their families.
With the recent expansion of temporary COBRA eligibility and government subsidy of its costs on a short term basis, it appears likely that our national policy for covering high-risk individuals will continue to force these people out of mainstream health plans and into more restrictive managed care plans. While this is a politically delicate and controversial topic, financial planning for chronic health care requires recognition of this national trend. The fact is that health coverage is available for all, regardless of medical conditions, but not necessarily under the terms we would prefer. Health care reformers are unlikely to change this fact. Consider that supplemental health insurance can be used to provide cash for care that is not paid under most high risk plans, since these benefits are paid to the insured separately and in addition to the major medical plan.
What can I do?
If you or a family member has a chronic health care problem then order an carefully review the open eligibility high risk plan in your state now, even if this coverage is not needed immediately. Remember that health care costs rise as we get older and that most expensive and financially devastating medical treatment comes in the final years of life. This inevitably means that our most challenging health care battles lie ahead in the future. The longer we wait, the harder it is to find affordable health insurance.
One recent innovation by UnitedHealthcare offers individuals the ability to ensure that they can buy full major medical insurance regardless of any future decline in health condition. When health insurance is not needed (for example, when covered by an employer plan) then the individual pays only for the guaranteed insurability feature rather than the full cost of health insurance. This option is now available under a wide range of plans offered under the name Golden Rule Insurance. This approach may eventually evolve into the national solution for dealing with our current problems with insuring pre-existing conditions.
(Part 5 of 5, Friday March 27, 2009)
Prevention through behavioral modification
About 80% of our nation's health care costs are directly related to five behavioral issues including smoking, obesity, lack of stress management, lack of exercise and poor nutrition. These five issues are likely to remain a long term health care policy challenge for the United States but small changes can yield significant changes to the affordability of care for all. Health care policymakers are increasingly aware that we cannot sustain a system where the world's best health care resources are universally available to all without some public effort to contain and minimize utilization of these resources.
A similar finding was reached with regard to middle income Americans who lack health insurance. MedSave.com promotes low cost health insurance solutions for individuals who do not qualify for government-assisted coverage or employer-provided group health insurance. This group included the temporarily unemployed, part time workers, students, recent graduates, and recent immigrants. MedSave.com stresses that while full coverage may not be available or affordable, at least some type of affordable entry-level commercial health insurance is available to almost everyone. A key to solving the uninsured problem is to motive those without insurance to take some action to obtain coverage, no matter how minimal, in order to reduce the burden that uninsured segment is posing on our entire national health care system. The two most promising approaches are 1) public education through efforts like this promotion of "Cover the Uninsured Week" events, and 2) laws requiring everyone to carry health insurance. The first approach is obviously easier, less controversial and less expensive than the second and so this is the focus of our efforts. Eventually, however, we see the likely need for a universal health insurance mandate. This topic is covered in more detail "Covering the Uninsured: a plan for 2009".
"Cover the Uninsured Week" efforts have shifted in recent years to emphasize the unique solutions that are available to each sub-group within the uninsured population rather than trying to address the problem as a single issue. Increasing awareness that the issues that cause a lack of insurance vary widely from one demographic sector to another is seen as a first step to reaching effective solutions. Through ongoing partnerships of public and private efforts, along with increased media attention, we expect to continue to increase public awareness of health insurance possibilities.