Survey: Large gap exists between insurance coverage, access to care

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A survey of 1,022 Michiganders revealed a gap between insurance coverage and access to healthcare, and those from the Center for Healthcare Research & Transformation (CHRT) suggest that lawmakers must focus on closing this gap and providing better access to care.

The survey aimed to create a comprehensive picture of healthcare coverage in the state of Michigan and the U.S. by reporting on self-perceived health status, insurance coverage and receiving medical care. Results showed that many have trouble paying healthcare costs, and insurance coverage doesn't always guarantee care.

Of the 1,022 respondents: 58 percent were female and the average income was between $50,000 and $60,000. Forty percent were employed full time, 13 percent were employed part time, 8 percent were unemployed and 16 percent were retired.

Eighty-eight percent of participants said they have insurance coverage: 20 percent through Medicare, 63 percent through their employer/union, 6 percent from Medicaid and 9 percent purchased coverage individually.

Twelve percent of respondents reported having no insurance. Of that group, 29 percent said their lack of insurance spawned from not being able to afford it, 19 percent attributed it to job loss, 14 percent said they had lost employer or state coverage and 4 percent said that they were in good health and it was not necessary.

When asked to self-report their health status, 18 percent viewed their overall health as “excellent,” 31 percent reported it as “very good,” one-third rated their health as “good," 14 percent as “fair” and 5 percent as “poor.”

Survey results showed that social factors can influence healthcare coverage and access to care. Of those who self-reported health status, 14 percent of respondents who made less than $10,000 per year placed themselves in the “excellent” or “very good” categories. In comparison, 72 percent of participants who had incomes of $150,000 or more annually reported themselves within the same categories.

Additionally, 65 percent of respondents with a graduate degree reported themselves as having "excellent" or "very good" health compared to 39 percent of respondents with a high school diploma or GED who reported the same.

"Factors beyond medical care--such as income and education--must be considered if the focus is on achieving the ultimate goal: improved health status for all Michiganders," the report urged.

The survey also asked how respondents would pay for insurance if they for some reason lost coverage. While 44 percent said that they would pay out of pocket, 21 percent said they would not be able to pay for coverage and 10 percent said they would turn to Medicare or Medicaid.

Twenty-one percent of those surveyed said that in the past six months they required medical care but did not seek it—35 percent said they could not afford care while 23 percent said the reason was because they didn’t have insurance or the costs were too high.

"These findings paint an important picture for those seeking to expand access to care in Michigan and the U.S. While health insurance coverage for all is an important goal, this survey reveals that coverage alone will not guarantee access to care," the report stated.

Forty percent of persons without insurance coverage admitted that they did not seek needed medical care in the past six months compared to only 17 percent with insurance coverage.

"Other barriers to access--such as cost and availability of providers--must be addressed by policy makers in all sectors in order to close the gap between coverage and care," the report concluded.