By RUTH LILJENQUIST
March is officially the “Month for the Uninsured,” the time of year when we remember the millions of Americans who lack health insurance. But the problem of more than 49 million uninsured Americans is not an issue we can afford to pay attention to for only one month of the year. It’s a daily challenge for millions of people across the country and people right here in Arizona. It’s also a daily concern for St. Elizabeth’s Health Center, an agency of Catholic Community Services which provides low-cost medical and dental care to uninsured and underserved people in our community.
Many more people in Arizona today are going without health care, said Dr. Mark Schildt, St. Elizabeth’s medical director. “In 2005, 15 percent of Pima County residents were uninsured. Today, that number is 23 percent. That’s roughly 71,000 people.”
The numbers have gone up for several reasons. Many have lost health insurance because of a job loss or because their employers have dropped coverage as a benefit. Others have lost coverage because they can no longer afford the premiums, which many employers have had to raise to stay in business. Other people have been cut from AHCCCS, the state’s Medicaid program, because of state budget cuts.
Even people who previously were uninsured and coming to St. E’s are no longer getting care. Prior to July 2010, Arizona Primary Care funds subsidized the cost of care for many patients, reducing costs for visits, lab work, and medications. When those funds were eliminated in 2010, the subsidy was eliminated, and many patients could no longer afford to come in for care.
Without health insurance, people suffer. They go without or delay care, which often makes medical conditions worse and results in more emergency room visits. Children who do not get health care for common childhood illnesses miss more school and fall behind in learning. Workers lose pay when sicknesses are prolonged. People with chronic illnesses cannot manage their diseases effectively.
To make it easier for uninsured people to get health care, St. E’s recently lowered its fees. As a result, more people are registering for health services and coming in for care. But lowering fees has required St. E’s to lay off staff and cut costs, maximize efficiency throughout the agency, and explore alternative funding sources and partnerships. It’s not been easy.
“We’ve definitely had to be more creative,” said Schildt. St. E’s had entered into new partnerships with health care providers, businesses, and notably, Mercy Care, which administers AHCCCS in some parts of the state. However, St. E’s is still heavily dependent on individual donations. “They are very important. We wouldn’t be open without them.”
With the economy improving, though ever so slowly, and the state starting to see a surplus in its budget, Schildt hopes that St. E’s will see a return of some of the Arizona Primary Care funds or an expansion of AHCCCS. Both would enable St. E’s to provide more care.
The uninsured rate in Arizona and around the country should go down as the job market improves, and later when the Affordable Care Act is enacted, many more Americans will have health coverage. But until then and even then, people will struggle daily without health care.
“This is not a short-term problem, which is why we have to continue advocating for people without health insurance,” said Schildt. And not just during the Month of the Uninsured.