Insured, Uninsured and Underinsured: Decoding Access to Healthcare and the Affordable Care Act
For 25-year-old Devri, life was pretty normal until a series of odd events such as her knees buckling and her vision temporarily leaving forced her to see the doctor. At the time, Devri was 21 years old and learned that the series of odd events were not a coincidence. Instead, she was diagnosed with an auto-immune disease that affects 1 in 100,000 people per year.
Devri maintains that life has been anything but simple following her diagnosis.
“Doctors talk to me like I’m a case or a story out of a science textbook” she says. “It’s something you have to get used to.”
Fortunately for Devri, her parents connections to other medical professionals helped her secure a “front row pass” to getting doctors’ appointments scheduled.
“This [access] made my diagnosis and treatment process relatively easy compared to others,” Devri says. But she also has seen the plight of those who do not have
“I have witnessed the frustrations and complications that other people deal with when it comes to getting the proper health care attention they need. I can’t wait for the day that healthcare is more accessible to the masses, despite who or how much a person knows.”
Some would argue that the day where healthcare was made more accessible to the masses was the day the Patient Protection and Affordable Care Act–better known as the Affordable Care Act and unofficially known as “Obamacare”–was passed. The Affordable Care Act mandates that everyone not covered by an employer-sponsored health plan, Medicaid, Medicare or other public insurance programs must secure approved private insurance.
According to Jocelyn Triplett, an M.P.H. student at the University of Texas Houston, the Affordable Care Act emphasizes disease prevention over medicine with a focus on three main areas:
• The individual experience of healthcare (i.e. the patient experience)
• Improving health outcomes
• Reducing costs
“We [as a nation] spend the most money on healthcare to have some of the worst outcomes,” Triplett said.
According to National Health Expenditure data, the cost of healthcare in the U.S. ballooned to $2.8 trillion in 2012, or $8,915 per person. Of that $2.8 trillion, 33% was covered by private health insurance, 39% was covered by public health insurance programs and the remaining amount fell into out-of-pocket expenses, investments or public health activities.
But, while the Affordable Care Act seeks to make healthcare more, well, affordable, occupational therapist and blogger Brenda Fadeyibi has seen otherwise when it comes to some of the black women she has worked with.
“It’s just not that affordable. I have a lot of patients who have said it’s too expensive for them,” Fadeyibi said. “The Affordable Care Act is still missing a great number of individuals who may not make enough to qualify. It doesn’t cover some of the specialized things.”
In fact, the Black Women’s Health Imperative reports that more than 34 percent of the 45 million Americans who lack health insurance are black women. For many who are uninsured and for even more who are hit with astronomical bills due to unforeseen medical expenses, crowdfunding has provided a new alternative to insurance.
Emergence Community Arts Collective executive director Sylvia Robinson recently established a GoFundMe campaignafter she opted for an alternative holistic treatment to treat breast cancer. In only five days, Sylvia raised $7,000 of the $48,000 required for her treatment. On Sylvia’s GoFundMe page, it reads, “Sylvia will be so grateful for any contributions we can provide as she moves through this life-changing process.”
Access to healthcare in America, particularly for black women, is a multi-layered debate, laced with the complexity of policies, jargon of biostatistics and icy reality that we simply do not live forever. Perhaps Sylvia’s story is a testament to the power of community in spite of burdening and difficult-to-navigate healthcare policies. Maybe sometimes the most reliable form of healthcare is the support of a sympathetic and understanding tribe.
Next page: Infographic: State of Health–Black Women in America and Part 4 conclusion