Let’s finish the job on health care reform

Chuck Sheketoff

Thanks to health care reform efforts, there are now more Oregonians with health insurance than at any time in recent history. And yet many Oregonians are still left out. It’s time to finish the job.

Some 383,000 Oregonians — roughly one out of 10 people in the state — still lack health insurance, according to a report released today (PDF) by the Oregon Health Equity Alliance (OHEA). The Oregon Center for Public Policy contributed analysis for the report.

Among those who have health insurance coverage, many are not able to see a doctor because of barriers that prevent them from accessing the health care system. Those barriers include high costs despite insurance, discrimination and geography.

The lack of health insurance or barriers to accessing health care affects some Oregon communities more than others. The OHEA Mend the Gap (PDF) report explains the gaps in coverage and the disproportionate impacts on rural Oregonians, communities of color, immigrants, women, LGBTQ people, people with chronic conditions and low-wage working families. For example, while 8 percent of non-Hispanic whites were uninsured in 2014, the rates were 22 percent for American Indian/Alaska Natives, 21 percent for Latinos and 18 percent for Native Hawaiians/Pacific Islanders.

Many lack health insurance because it remains too expensive. Others are uninsured because federal law continues to exclude low-income people from basic public services, including Medicaid, due to their citizenship status and other factors, the report says. For example, 17,600 Oregon children cannot sign up for the Oregon Health Plan or obtain subsidized marketplace insurance because of their immigration status. Therefore, they are less likely to have health coverage and to grow up healthy, factors that are linked to higher earnings and wealth in adulthood.

The report recognizes that while having health insurance is no guarantee of actually receiving care, it is a primary driver of good health outcomes. The report examined a list of barriers that specific groups of Oregonians encounter in trying to access health care. For instance, many rural Oregonians face challenges seeing a doctor, struggling with long travel distances. The report explains how women and transgender persons needing abortion care can face high costs and few providers. And transgender people face discrimination and administrative obstacles that can result in denial of care.

The report makes clear why it’s in Oregon’s interest that everyone has access to quality health care:

When families have affordable, comprehensive health coverage, they are able to devote more of their resources to meeting other important needs. Having to spend less on health care helps families get ahead.

Healthier people also tend to be more productive and better able to contribute to the economy. They miss fewer days of work, are less likely to become disabled. They participate longer in the workforce. Health is also linked to educational achievement. Indeed, affordable, comprehensive coverage for all Oregon children would help ensure that every child succeeds in school, improving their success as adults.

The report offers 10 policy recommendations for how to increase health insurance coverage and remove barriers to access.

I invite all Oregonians — especially lawmakers — to read and act on this report. Let’s move forward on mending the health care gap that remains in our state.

Oregon Center for Public PolicyChuck Sheketoff is the executive director of the Oregon Center for Public Policy. You can sign up to receive email notification of OCPP materials at www.ocpp.org.

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