People who do not have health insurance struggle to lead healthy and comfortable lives. They cannot get relevant medical attention in institutions whose services are exemplary but expensive. According to Kominski et al. (2017), most uninsured or underinsured individuals are low- and middle-income earners. The high cost of insurance forces them to live without medical cover. Therefore, problems like unaffordable medical bills accompany them when they seek care. America experienced changes in the population of uninsured and underinsured individuals when the Affordable Care Act (ACA) started to apply.
The provisions of ACA filled gaps that hindered people from accessing quality public insurance and affordable private coverage. For instance, under ACA, Medicaid coverage is available to adults whose income is as low as 138% of the federal poverty level (FPL) (Garfield et al., 2019). Those with incomes from 139 % to 400 % of FPL can apply subsidies when acquiring insurance plans at the health insurance marketplaces (Kominski et al., 2017). Such benefits are only present in states that adopted the expansion of health insurance coverage. Thus, millions of low-income earners acquired medical covers due to expanding Medicaid and establishing insurance marketplaces.
Despite ACA’s historic gains, some Americans remain uninsured or underinsured due to political and financial reasons. Garfield et al. (2019) indicated that those who lack coverage are individuals of all ages, races, and ethnicities. Some of them are ineligible for financial assistance because they reside in states that are yet to adopt the provisions of ACA. Others do not afford to settle the amount of money that remains after receiving financial assistance from the government. Also, some individuals choose to forgo or drop health plans because of efforts to limit Medicaid coverage for some groups (Garfield et al., 2019). They disregard ACA’s provisions and benefits because they desire to see equality and fairness. Therefore, millions of Americans are still struggling to acquire health insurance.
The insured can access better health services than those who lack insurance. Tolbert et al. (2020) explained that individuals who cannot acquire medical plans do without needed care due to cost. They gave an example of 2016 when at least one in five adults without medical cover skipped essential treatment. Some of them died from illnesses that would not have become worse if they could afford preventive care. ACA shielded such people against medical debts by making healthcare affordable.
When many people access medical services, various resources in hospitals undergo strain. As the patient population increases, health workers, hospital beds, and medical equipment become scarce. Therefore, some specialists or hospitals may reduce the number of patients by receiving those whose health insurances belong to specific companies. Williams et al. (2019) indicated that patients who use Medicaid struggle to get appointments with specialists and travel long distances to access care. Those with Medicare and private insurance are likely to land opportunities in hospitals that offer specialized care. The rising number of insured individuals leads to overcrowding, thus forcing hospitals and health workers to change how they operate.
There will be a rapid increase in the population of sick people when health centers refuse to receive some patients. According to Kominski et al. (2017), at least 20 million uninsured individuals have taken advantage of ACA to get health insurance. The majority of them have enrolled in Medicaid because they cannot afford the services of other insurance companies. They are the ones who rarely get the attention of specialists in private hospitals. When they go to public hospitals, their chances of contracting infectious diseases are high because of overcrowding. The government should initiate more policies to ensure that the insured access treatment in private and public hospitals.
How policy has affected the rate of underinsured and uninsured individuals
The ACA has led to notable differences in the rates of underinsured and uninsured individuals. Wippold and Roncoroni (2019) discovered that the rate of uninsured individuals in the country rises. According to them, it rose from 12.7% in 2016 to 15.5% in 2018. These figures show that millions of people lose coverage annually. On the contrary, Tolbert et al. (2020) indicated that the rate of uninsured and underinsured individuals dropped to a historic low under the ACA. Therefore, health insurance data in the country keeps changing from time to time. The changes impact those who have health insurance positively or negatively.
The impact underinsured and uninsured individuals have had on insured individuals’ cost, access to care, and resources
Underinsured and uninsured individuals have increased the time and cost that the insured need to access medical care. Many hospitals prefer admitting patients without health insurance because they pay early (Garfield et al., 2019). Therefore, the insured have to deal with congestions or incur more transport costs to get excellent services. Also, the insured may have to chip to offset medical debts that uninsured and underinsured accumulate in hospitals. If they do not assist, hospitals may close down due to financial crises. The insured should find ways to facilitate other people’s insurance, thus avoiding extra costs to get care.
Millions of previously uninsured individuals got insured and gained access to health services when the United States implemented the ACA. The uninsured population had limited options before the ACA because they could not afford expensive insurance services. Those who have health insurance will enjoy it better if the government provides enough hospitals and other facilities.
Garfield, R., Orgera, K., & Damico, A. (2019). The uninsured and the ACA: A primer – Key facts about health insurance and the uninsured amidst changes to the affordable care act. The Henry J. Kaiser Family Foundation.
Kominski, G. F., Nonzee, N. J., & Sorensen, A. (2017). The Affordable Care Act’s Impacts on Access to Insurance and Health Care for Low-Income Populations. Annual Review of Public Health, 38(1), 489–505.
Tolbert, J., Orgera, K., & Damaco, A. (2020). Key facts about the uninsured population [Fact sheet]. The Henry J. Kaiser Family Foundation.
Williams, D. V., Liu, T. C., Zywiel, M. G., Hoff, M. K., Ward, L., Bozic, K. J., & Koenig, K. M. (2019). Impact of an integrated practice unit on the value of musculoskeletal care for uninsured and underinsured patients. Healthcare, 7(2), 16–20.
Wippold, G. M., & Roncoroni, J. (2019). Hope and health‐related quality of life among chronically ill uninsured/underinsured adults. Journal of Community Psychology, 48(2), 576–589.