Why Healthcare Reform Remained a Central Concern During the Election

JSI investigating barriers to care and supporting affordable healthcare access

By Natalie Truesdell, JSI consultant

In the tumultuous last months of the U.S presidential election the economy has undeniably been the central concern of voters—but this has not shifted the public's interest and concern over healthcare. Despite the economic crisis, health care cannot be separated from the concerns for the economy.

A Kaiser Family Foundation poll in October found that one third of Americans have had trouble paying for their medical bills in the last year. The rising costs of health care are being felt by a large and growing majority of Americans, and with the economic downturn the numbers will only increase. The growing number of uninsured and underinsured are contributing to the concern over out-of-pocket health care costs for Americans. For some, just a single office visit (with $10 co-pay for the visit, $5 in transportation costs, and $5 for medication) is a struggle. [Read more]

Health insurance is a critical component to facilitating health care access, but it is not the only component. JSI works to address these and other issues around health care reform to understand the challenges of costs and other health access barriers for families and support affordable access to health care. JSI has worked in several states including Western New York, Maine, and Massachusetts in the last year to comprehensively identify what the access barriers are for low-income families, and recommend solutions based on best practices, available state and federal programs, and the policy environment.

In the Western New York region, JSI distributed a survey to 600 low income families and interviewed close to 100 key informants to understand the access barriers in an eight county region. The work culminated in a series of recommendations to the Community Health Foundation of Central and Western New York on how to strengthen the safety-net in the region and improve health care access to low income families and children. [Read more]

In Maine, JSI is working with the Maine Health Access Foundation to understand how Federally Qualified Health Center (FQHC) expansion in the state has improved access to medical, dental and behavioral health services in rural and urban areas. This project again used a patient survey to identify how many of the health center patients did not have access to services previously and how their access has improved once becoming an FQHC patient. In addition to investigating patient access, JSI investigated the impact of FQHC expansion on the local provider community, and the fiscal impact for the state Medicaid budget. [Read more]

In Massachusetts, JSI recently began working with the Blue Cross Blue Shield Foundation of Massachusetts on their initiative "Care Beyond Coverage: The Next Generation of Health Reform." The Massachusetts health care reform enacted in 2006, known as Chapter 58, is landmark legislation that has reduced the number of uninsured by 439,000 people as of October 2008. However, insurance alone does not guarantee access and there are many potential barriers to access which are not addressed by Chapter 58. As part of "Care Beyond Coverage," JSI is developing a comprehensive framework to understand access barriers, identifying a set of indicators to track health care access in the state over time, and helping to evaluate potential policy initiatives that will become "the next generation" of health reform. [Read more]

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