Millions of Americans live below the federal government's poverty line. Millions more do not strictly meet federal poverty guidelines yet do not make enough money to afford health insurance. A staggering "60 percent of all American adults will experience at least one year of living below the poverty line, whereas one-third will experience dire poverty," according to a study published in the journal "Social Work." The nonprofit public policy Brookings Institution in 2009 reported that private health insurance coverage has fallen in every age group since 2000. Such sobering statistics point to a situation where countless numbers of America's poor are living with little or no access to health insurance and health care.
Every year in August or September, the U.S. government issues a report on income, poverty and health insurance. Its latest report, "Income, Poverty and Health Insurance Coverage in the United States: 2008," states that 39.8 million people were living in poverty in 2008, up from 37.3 million in 2007. During the same period, the number of people with no health insurance rose from 45.7 million to 46.3 million.
With mass layoffs in difficult economic times come drops in health insurance coverage. In the U.S., where a majority of workers gain access to health insurance through their employers, being terminated from a job can mean a double loss of both income and access to group health insurance. For the unemployed, finding an affordable health-care plan is a challenge. About 57 percent of people who try to purchase health coverage outside a group plan find it difficult or impossible to afford the premiums.
One option for the newly unemployed is the federal government's COBRA benefit. COBRA guarantees continued access for a period of 18 months to group health insurance plans offered by a displaced worker's former employer. In 2009 and 2010, COBRA provided substantial monetary subsidies for enrolled individuals making ongoing health plan payments. With COBRA costs eating up to 84 percent of unemployment benefits, the temporary subsidies provided welcome respite for cash-strapped families. Even at deeply discounted prices, however, many of the poorest laid-off workers still could not afford to buy into COBRA plans. What's more, workers laid off as of June 1, 2010, are no longer eligible for the temporary COBRA subsidies.
Government Agency Relief
Local, state and federal agencies offer access to health-care coverage for many people who could not otherwise afford it. Each program has its own eligibility guidelines. The Medicare program from the U.S. federal government provides coverage for the elderly and the disabled, two populations vulnerable to poverty. At the state level, programs like California's Medi-Cal and New Jersey's FamilyCare provide low- or no-cost health insurance for low-income families with children and certain other individuals. However, single adults often do not qualify for such state-run programs, leaving many with no option but to go without health insurance.
For those who cannot afford health insurance and do not qualify for government assistance, community or county free or low-cost clinics often act as a last resort. For low-income women and men, Planned Parenthood offices all over the U.S. offer access to reproductive and general care services such as physical exams, annual gynecological exams and testing for STDs. Patients at these clinics often pay based on what they can afford. Local community outpatient clinics sometimes also act as health-care providers for adults who otherwise have no access to health insurance. Some nonprofit hospitals may provide urgent care and emergency services to indigent adults, including the homeless and others who live in dire poverty.
Prescription Drug Coverage
The high price of prescription drugs is the constant subject of alarming news reports. Some folks on fixed incomes, like the elderly, report not being able to afford their prescription drugs, even with assistance from government programs. Without health insurance, many who live in the direst poverty are often forced to choose between paying their rent or utilities and paying for their monthly supply of prescription medicine. Some of the hardest hit may qualify for prescription subsidy programs from local and state health agencies; as well, drug manufacturers sometimes offer discounts to qualifying individuals without health coverage.
- U.S. Census Bureau: Summary Poverty and Health Insurance
- The Brookings Institute: 2008 Health Insurance Statistics
- "Social Work"; The Likelihood of Poverty across the American Adult Life Span; M. Rank & T. Hirschl; Vol. 44, 1999.
- ABC News: Millions Can’t Afford Health Insurance
- U.S. Department of Labor: COBRA
Lilo Trill has published articles on health care, nature and education topics since 2004. Her writing is found in reference and educational databases subscribed to by The San Francisco Public Library and other leading information access providers.