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Entering the Final Stretch

Feb 3, 2015, 6:15 PM, Posted by David Adler

2015 Affordable Care Act ACA Enrollment Website

As we head into the final weeks of this year’s open enrollment season, we can all be proud of the progress that’s been made. New numbers released last week show 9.5 million Americans signed up for health coverage through marketplaces across the country. Behind each number is someone who now has quality, affordable health coverage with access to health care when they need it and protection from financial ruin if they get sick.

But there are still millions more who are eligible for coverage this open enrollment period. RWJF and our partners are doing all we can to get as many people enrolled as possible before the February 15 deadline. These collective efforts focus on breaking down the biggest enrollment barriers for people to get covered. Our research shows that consumers are more motivated to enroll when they understand the benefits of coverage, believe they can afford the cost, and know they can find enrollment support to complete the process.

Enroll America, an RWJF grantee, is addressing the need for in-person help head on—operating grassroots efforts in 11 states and connecting consumers to enrollment tools and help nationwide. Their connector tool, allows consumers to schedule appointments for in-person help right away. Drawing from lessons learned from the first open enrollment period we know this one-on-one support will be critical for many consumers during these final weeks.

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New Year, New Coverage for Millions

Jan 9, 2015, 2:51 PM, Posted by John R. Lumpkin

Health Care Dot Gov healthcare.gov

The beginning of a new year is a great time to reflect on progress toward longstanding goals. At RWJF, we’ve spent the better part of four decades advancing solutions to help everyone in our nation gain access to affordable, high quality health care—a goal we reaffirmed in 2014 when we announced our vision for a Culture of Health in America.

Happily, our country has made enormous progress toward this goal in 2014. Health coverage rates improved dramatically last year because of robust enrollment through the health insurance marketplaces, Medicaid, and CHIP. As we enter 2015, we continue to see strong coverage gains, with nearly 6.6 million consumers newly enrolled or renewing through HealthCare.gov.

But let’s not forget that more than 40 million people remain uninsured. There is still more work to be done to make sure all those who are eligible can get the coverage they need and deserve.

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What We Learned from the First Open Enrollment Period, and What to Expect from the Second

Nov 18, 2014, 10:32 AM, Posted by David Adler, Lori K. Grubstein

A man fills out an insurance application

It seems like just yesterday we were celebrating the victories from the first open enrollment period under the Affordable Care Act. More than 8 million consumers signed up for coverage through state and federal marketplaces, and millions more enrolled in Medicaid.

As the spring of success gave way to the summer of planning, we are once again in the autumn of enrollment. As work gets rolling for the second open enrollment period, it is an opportune time to reflect on lessons learned from the first open enrollment period, especially since the second one is shorter and there are fewer navigator resources available from the federal government.

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The Lucky One

Mar 21, 2014, 9:00 AM, Posted by Vanessa Grubbs

Vanessa Grubbs, MD, MPH, is an assistant professor at the University of California, San Francisco, School of Medicine, and a scholar with the RWJF Harold Amos Medical Faculty Development Program. She is writing a book about what she calls the “sometimes irrational use of dialysis in America,” which will include a version of this narrative essay.

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It is a Monday afternoon like any other and time to make my weekly rounds at the San Francisco General Hospital outpatient dialysis center. I push my cart of medical charts down the long aisle of our L-shaped dialysis unit and see Mr. Rojas, my dialysis patient for over a year now. He is in his mid-40s and slender, sitting in the burgundy-colored vinyl recliner. His blue-jeaned legs and sneakered feet are propped up on the extended leg rest. The top of his head shines through thinning salt and pepper hair. White earbud headphones peek through gray sideburns. He is looking intently at his Kindle, rarely glancing up at the activity around him.

I roll my cart up to his recliner, catching his eye. His right hand removes the earbuds as the left pauses his movie. He looks up at me, smiling. “Hola, Doctora. How are you?” he says with emphasis on the “are.”

“I am good. How are you doing?” I smile back at him as I grab his chart from the rack. I write down his blood pressure and pulse—both normal—and the excellent blood flow displayed on the dialysis machine. My eyes shift to his fistula, the surgically thickened vein robustly coursing halfway up his left forearm like a slithering garden snake. It is beautiful to me. Through it, Mr. Rojas is connected to the dialysis machine.

“I am good, Doctora. No problems. I feel healthy. Strong.” His brown eyes glint.

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Getting Ready for the Oscars: Three Things that the Movie “Gravity” Has in Common with Health Insurance Exchanges

Feb 18, 2014, 10:32 AM, Posted by Susan Dentzer

Gravity Publicity Still to Accompany Susan Dentzer Blog Post

The Academy Awards are just a few short weeks away, much as is the end of this year’s open enrollment period for the health insurance exchanges. We health policy geeks who also love movies can now give out our own award—for the film that most closely resembles the rollout of the marketplaces under the Affordable Care Act.

As far as I’m concerned, there’s only one real candidate: “Gravity,” the science-fiction space drama directed by Mexican-born Alfonso Cuaron and starring the actors Sandra Bullock and George Clooney.

The film wins because its big themes are the same ones reflected in the experience of the exchanges: the omnipresence of Murphy’s Law and human perseverance overcoming calamity. What’s more, gravity—the real star of “Gravity”—is a universal force that can’t be overcome (and is one of the few scientific aspects of the movie that the critics agree the filmmakers got right). Is it too much to see a parallel to the Affordable Care Act’s coverage expansion, which is inching forward despite the formidable odds stacked against it?

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Growth in Enrollment Slowing at Nursing Schools

Jan 24, 2014, 9:00 AM

Enrollment in registered nurse (RN) programs has increased for the 13th consecutive year, according to preliminary data from the fall 2013 nursing school enrollment survey conducted by the American Association of Colleges of Nursing (AACN). But with a 2.6 percent enrollment increase from 2012 to 2013, entry-level baccalaureate nursing programs saw their lowest growth rate in five years.

Though interest in nursing careers remains strong, AACN said in a news release, many qualified individuals seeking to enter the profession can’t be accommodated in nursing programs. The preliminary data show that 53,667 qualified applications were turned away from 610 entry-level baccalaureate programs in 2013, and AACN expects that number to increase when final data are released in March.

The primary barriers to accepting all qualified nursing school applicants continue to be a shortage of faculty, clinical placement sites, and funding, AACN reports.

The 2013 survey shows stronger growth rates for RN-to-BSN programs, at 12.4 percent, as well as master’s programs (4.4 percent) and doctor of nursing practice programs (21.6 percent).

See more survey findings and analysis from the American Association of Colleges of Nursing.

 

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.

New Infographic, Premium Payment Extension Will Help People Signing up for Health Insurance Coverage

Dec 27, 2013, 11:00 AM

Americans Health Insurance Plans, the trade association of many of the U.S. health insurance companies, has released a very easy to understand new infographic that helps simplify the steps for buying health insurance on the federal or state exchanges under the Affordable Care Act.

The new infographic is not the only bonus from the trade association this season. Last week the group announced that most insurers are extending the deadline for people purchasing coverage to pay their premiums to January 10, so long as signup for the plan is before January 1. Coverage for those signups will be retroactive to January 1.

This commentary originally appeared on the RWJF New Public Health blog.

Engaging Communities of Faith to Help Americans Gain Health Insurance

Nov 13, 2013, 2:46 PM, Posted by John R. Lumpkin

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With the opening of health marketplaces and the Affordable Care Act’s partial expansion of Medicaid, our nation has an opportunity to substantially expand health insurance coverage for all Americans, and ultimately, to significantly reduce racial disparities in access to affordable coverage.

But to achieve that goal, communities of color must attain robust enrollment gains. That’s why RWJF is working with religious leaders and their congregations to help make sure that all who are eligible enroll.

The Problem

According to United States Census data for 2012, approximately 48 million Americans are uninsured. It is a problem that cuts across all racial and ethnic groups, but is most acute in two, resulting in 19 percent of African Americans and more than 29 percent of Hispanics living without health insurance.

In 2009, the Institute of Medicine documented what many suspected: The uninsured are much less likely to obtain preventive care; get timely diagnoses for illnesses, including cancer; receive treatments for chronic illnesses such as diabetes and asthma; and take prescription medications as recommended by physicians.

Beyond the health consequences of uninsurance, there are steep costs for our economy. We all pay the bill for indirect fiscal burdens associated with the uninsured—including illness and injury, decreased workforce productivity, developmental and educational losses among children, and shorter life spans, costing the U.S. economy between $100 and $200 billion each year.

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Twentysomething? Have We Got an Affordable Care Act Story For You

Oct 18, 2013, 2:00 PM

Alarmed at recent surveys that show only about ten percent of young Americans who say they are very familiar with the Affordable Care Act (ACA), staff reporters at Kaiser Health News (KHN) have crafted a clever article—winsome graphics included—aimed at getting the attention of millennials about the new health law in time for them to sign up before looming deadlines.  

Getting the attention of millennials on the state or federal health insurance exchanges, recently launched and going through overhauls, is crucial for two key reasons. One is that young adults no longer on their parents' plan (now allowed until age 26 under the ACA) often don’t bother with health insurance because they believe they’re invincible, so why shell out hundreds to thousands in premiums and deductibles? That works fine unless an accident or illness ensues, which can cost hundreds of thousands or more.  

file Kaiser Health News graphic aimed to appeal to "young invincibles"

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The Exchanges Marathon Begins: Improving Health Care Quality and Lowering Cost

Oct 4, 2013, 4:37 PM, Posted by Susan Dentzer

Peter Lee Peter Lee, director of Covered California

When the starting gun went off this week for the nation’s health insurance exchanges, millions of Americans began shopping  for coverage. For those running the exchanges, or marketplaces, it was the start of a marathon.

That’s the conclusion that emerged from a Health Reporters’ Roundtable that the foundation sponsored in Washington recently. As top officials overseeing three of the state-based exchanges told reporters, signing people up for health insurance is just one of their tasks. Over time, the officials plan to use the power of their exchanges to help drive broader changes to improve the quality and value of U.S. health care.  

The foundation-funded State Health Reform Assistance Network is providing technical support to 11 states. Two of those states, Maryland and Rhode Island, were represented at the roundtable—the former by its exchange director, Christine Ferguson, and the latter by Maryland’s secretary of health and hygiene, Joshua Sharfstein, who chairs that state exchange’s board. A third state, California, isn’t receiving help from the network, but was represented by Peter Lee, the director of its exchange, Covered California.

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