There are numerous ongoing and emerging threats to health equity, such as climate change, artificial intelligence, lack of access to insurance, and disparities in exposure to adverse childhood experiences which can impact health for a lifetime. The P4HE Collaborative emphasizes the importance of understanding these threats to health equity and addressing them through cross-sector collaboration. This blog examines health insurance coverage and explores how various stakeholders can collaborate to address challenges related to achieving adequate coverage and promoting health equity.
In the United States, health coverage is administered through a combination of employer-based private coverage, public Medicare for retirees, and Medicaid for lower-income Americans. Despite these systems, an estimated 8% of the U.S. population remains uninsured. This inconsistent coverage leads to worse health outcomes for Americans, such as delayed diagnoses, untreated chronic conditions, and higher mortality rates. Insurance coverage is a key health equity issue, with disparities observed among marginalized socioeconomic and racial groups, including Black, Brown, low-income, immigrant, and disabled populations. Access to insurance and variations in coverage contribute to these inequalities. For instance, insurance affects access to services like preventive and mental health care, often requiring separate optical and dental plans. Without adequate coverage, individuals may forgo necessary treatments, leading to exacerbated health issues. Access to insurance and variations in coverage contribute to these inequalities.
In the U.S., many low-income communities and individuals lack insurance or are underinsured, limiting their access to quality health care and leading to health disparities. The Medicaid expansion enabled by the Affordable Care Act (ACA) has helped address these disparities. The literature reflects improved health outcomes with the expansion of insurance under the ACA, including millions of people insured who would not have had coverage otherwise. In cancer care, uninsured individuals and those from racial and ethnic minority groups are more likely to present with advanced disease, less likely to receive definitive treatment, and have higher mortality rates.
Individuals with preexisting conditions often encounter significant obstacles in obtaining insurance. Prior to the ACA, many insurance companies could deny coverage or charge higher premiums based on a person’s health history, further exacerbating health inequalities. Ensuring that those with preexisting conditions continue to have access to affordable insurance is essential for achieving health equity, as it allows them to receive necessary medical care without facing financial hardship.
Disaggregated data, data that are broken down into smaller categories, is crucial for identifying disparities in health care access and outcomes within marginalized communities. Changes in federal policies are working to assist in improving data quality to more effectively identify and address disparities in health outcomes. For example, the collection of more detailed demographic data can help pinpoint specific areas where health inequities are most pronounced, allowing for targeted interventions.
Addressing health insurance coverage is vital for promoting health equity. By understanding and mitigating the disparities in insurance access, stakeholders can work together to ensure that all individuals have the opportunity to achieve optimal health outcomes. Cross-sector collaboration, improved data collection, and policy changes are key strategies in overcoming the threats to health equity and ensuring a healthier future for all.
Here are several ways different sectors can work together to address the insurance gap and improve health equity:
- Advocates can support policies such as Medicaid expansion and other initiatives that increase insurance coverage by ensuring everyone has access to affordable healthcare.
- Philanthropists can fund programs that provide free or low-cost insurance to underserved populations.
- Communities can create support networks to help individuals navigate the insurance system.
- Researchers can study the impact of insurance coverage on health outcomes.
Together, these sectors can address the insurance gap and improve health equity.
Interested in learning more?
- Check out our resources on Promoting Healthcare Equity through the Medicaid Program.
- Visit our partner organization, SIMPCO Foundation, to learn about their developments in insurance as a managed care organization (MCO).
- Subscribe to our P4HE Collaborative Newsletter to get notified when we post our resources from the webinar, Overcoming Threats to Health Equity: Today and Tomorrow.
- Stay tuned to our Learn page for updates on our upcoming programming.