Health Resource Capacity Assessment for Danielson, Connecticut, June 2003

Health Resource Capacity Assessment for Danielson, Connecticut

June 2003

Danielson Description

Health Needs and Barriers to Care

Health Needs and Barriers to Care: Uninsured

One in ten Connecticut residents lacks health care coverage.³⁸ Town specific measures of the uninsured are not available, but it is likely that Danielson's rate is above the state average. Low income is the most closely correlated indicator with lack of insurance. Half of Connecticut's uninsured live in households with incomes below $30,000/year³⁹. In 2000, Danielson's median annual income was $31,969, compared to Connecticut's median of $53,935⁴⁰. Day Kimball Hospital's costs of uncompensated care (for the entire region, including Danielson) grew by 25% from 1999 to 2001 to reach $1,925,444.⁴¹

Connecticut's uninsured are 3.7 times less likely to have a regular source of primary care, are 6.5 times as likely not to get care for a medical emergency, and 6.7 times less likely to receive care for an injury or illness⁴².

Communities with high rates of uninsured suffer along with the individuals and families directly affected. Many uninsured residents cause strains on health providers and institutions including fewer hospital beds and fewer services such as trauma centers. Half of all bankruptcies are caused by high medical bills, creating an economic burden touching entire communities. Public health risks increase in proportion to uninsured populations. When uninsured patients delay early detection and preventive care, they are forced to access care at later stages of disease, when problems are more difficult and costly to treat. These increased costs are shifted onto private and public payers causing a cycle of rising health care costs and more uninsured⁴³.

Virtually all key stakeholders noted the rising number of uninsured and skyrocketing health care costs as significant barriers to the health of Danielson residents. Many gave this as their first and only response as the greatest barriers to health in Danielson. Focus groups also strongly emphasized the uninsured and health care costs. Most felt the problem was likely to grow worse. One commented that Danielson didn't fully share in the good economic times of the late 1990s but is suffering disproportionately from the current recession. Another sees a gradual "dilution of wages" in the area. Many felt that the growing number of uninsured and underinsured residents will significantly undermine the healthcare infrastructure and cause irreparable harm affecting all the region's residents, including those with and without coverage⁴⁴.

Businesses noted the huge burden of double-digit inflation on companies during an economic downturn. The Chamber of Commerce receives calls "every day" from individuals and business owners looking for affordable insurance⁴⁵.

Consumers and community leaders noted difficulty in paying for basic services - rising co-payments and premiums. Many emphasized dramatically rising drug prices and the effects on the elderly. The ACCESS homeless shelter in Danielson reports an increasing number of uninsured working poor seeking shelter. Several noted that rising medical costs combined with rising numbers of residents without coverage are forcing people to forgo preventive care and check ups that could detect problems early. One also noted that people are forced to seek care in the Emergency Dept. for problems that could have been avoided or should have been seen in a doctor's office. Several predicted that this will eventually lead to even higher medical costs⁴⁶.

Providers noted, often with great emotion, personal conflict between their obligations to pay their staff and meet their business costs with an ethical obligation to provide care to the growing number of patients who cannot afford it. Safety net providers are feeling an increasing level of pressure -from rising caseloads, soaring costs and reduced government funding (see Funding and Healthcare Costs). Day Kimball Hospital reported a significant increase in the number of uninsured patients. There is concern that this will lead to reductions in services or availability, making matters even worse just as the demand grows, creating a downward cycle. "You're only as strong as your weakest link⁴⁷."

Others noted the public health risks posed by a growing segment of the population who do not regularly access preventive and primary care.

One bright spot for the uninsured according to stakeholders, is the HUSKY program - Connecticut's Medicaid and SCHIP combined program. Significantly expanded in 1999, the HUSKY program covers uninsured citizen and legal immigrant uninsured children at any income level and parents up to 150% of the federal poverty level⁴⁸. Not surprisingly, since the economic downturn that began in 1999, HUSKY enrollment has grown - statewide and in Killingly⁴⁹. Stakeholders report that the HUSKY program has been a critical safety net for the increasing numbers of newly uninsured in Danielson. There is a great deal of support for HUSKY in Danielson⁵⁰.

Note: HUSKY Part A is Medicaid coverage - covering children up to 185% of the federal poverty level. Source: Children's Health Council

Note: HUSKY Part B is SCHIP coverage - covering uninsured children above 185% of the federal poverty level. Source: Children's Health Council

Despite the progress of the HUSKY program, stakeholders were very concerned that the state has made significant cuts to the HUSKY program and is planning more⁵¹. 27,000 Connecticut HUSKY consumers were scheduled to lose coverage as of April 1, 2003. Legal advocates were successful in securing a temporary restraining order to delay those cuts, but on May 30, 2003 a federal court ruled that the state may go forward with those cuts. Consumers are expected to lose coverage beginning July 1st⁵². As of this writing, state budget negotiations have included varying levels of further cuts in services, increases in premiums and co-payments as well as the potential loss of SAGA, a state-funded coverage program serving 25,000 Connecticut residents⁵³. Stakeholders predict that those cuts will fall heavily on Danielson residents forcing many to delay care and check ups, leading to higher costs for all payers, including the state. One characterized the cuts as "very foolhardy⁵⁴."

Next: Health Needs and Barriers to Care: Transportation

Footnotes