By Dr. Kimberly McDermott MD
Access to health care has seen major ups and downs over the past several years. After a series of painful cuts to our state’s healthcare safety net, coverage finally started to improve with the expansion of Medicaid in 2013. Because of this expansion more than 500,000 Washingtonians are newly insured, with 26 percent of them in King County. We celebrate this progress, but there is still more work to be done.
The fact that the state’s uninsured rate has decreased significantly is no comfort if you’re one of the many still uninsured. At HealthPoint, a network of non-profit community health centers with 11 locations throughout East and South King County, we see the great relief for people who have recently gained health insurance. But we also see the frustration of those who fall through the cracks – with incomes too high to qualify for Medicaid, but too low to afford coverage, even with subsidies.
When the open enrollment period was supposed to end on February 15, enrollment numbers didn’t meet expectations of the Washington Health Benefit Exchange. The nearly 160,000 people who had signed up for qualified health plans was lower than the previous year and their goal of 213,000 customers. We’ll see if a special enrollment window until April 17 increases the numbers significantly.
Neither the Exchange nor the state can say why enrollment is below expectations. Community health centers like us have a pretty good idea. Many people are staying uninsured, even if it means a tax penalty, because the cost of coverage is too expensive for them.
A family of four earning less than $47,700 a year will pay up to $3,000 of their income on premiums alone, with co‐pays and deductibles on top of that, which is unaffordable for a family trying to keep a roof overhead and food on the table. Our enrollment specialists, who are working hard to get people enrolled during the sign-up period, are seeing roughly 75 percent of people declining to purchase an insurance plan because they can’t afford it.
Health centers are asking our state legislature to get to the bottom of this by funding a study over the next year to better understand the barriers to coverage, examining coverage gaps and opportunities to improve. You can’t solve a problem unless you know exactly what’s wrong. And this is a problem worth fixing.
Dr. Kimberly McDermott lives in Bellevue and is a pediatrician at HealthPoint Redmond. HealthPoint is a community-based, community-supported and community-governed network of non-profit health centers in King County dedicated to providing expert, high-quality care to all who need it, regardless of circumstances. healthpointchc.org
