Health care law may not cover all

Many people in Chautauqua County find themselves uninsured and in need of accessing care.

According to Ann Abdella, executive director for the Chautauqua County Health Network, people who are uninsured tend to receive less medical care and less timely care.

However, if someone is uninsured, many hospitals and providers are still obligated to provide some level of care to people who are in need.

“You can only provide so much of that charity care or free care before you can’t keep your doors open,” Abdella said. “The insurance reimbursement is much-needed revenue into a depleted system already. It keeps the lights on, it keeps the staff paid, it keeps the computers operating and the tests running. On the human side, it provides access and security for people who have the insurance. But it’s also part of the economic engine that keeps the system moving.”

According to a 2011 American Community Survey by the U.S. Census Bureau, 24.2 percent of the population in Chautauqua County is age 60 or over. Additionally, it is reported that 17.7 percent of people in the county fall below the poverty level.

“We are a high-poverty county, there’s no question about it, which impacts mostly the Medicaid population. The Medicare comes along with the older population,” Abdella said. “We have a rapidly aging residence base in this area, and we are a high-poverty county. You put those two together, you have Medicaid, Medicare and the government is paying for a lot of services. And, we still have a fair amount of people who are uninsured. It’s just too expensive right now.”

The Chautauqua County Health Network runs a Get Covered! Campaign, which helps people within the county find affordable health care coverage and gives access to needed health care services.

However, there are some groups that still fall through the gaps when it comes to insurance.

“One of the groups that we see fairly frequently is what we call the Medicare-Stranded Spouse,” Abdella said.

She explained that often, there will be a husband and wife, where the wife has not worked outside the home and is covered by her husband’s insurance. When the husband retires, although he is eligible for Medicare, the wife is no longer insured. And, often, Abdella said, there will be an age gap between the couple, so the wife may not be covered by insurance for several years.

In a case such as this, there is simply nothing that can be done to provide coverage, as income is limited and health care may not be affordable.

“So, the health reform bill, in that regard, is going to be nice,” Abdella said. “It’s certainly is still not going to cover everybody, there will be a number of people who will remain uncovered, even with this new wave of the health exchange and all that. But, it will pick up for some people for sure.”

The Patient Protection and Affordable Care Act was signed into law by President Barack Obama in 2010. The act is aimed at decreasing the number of uninsured Americans, while reducing the costs of health care. It has a number of provisions, which will be gradually introduced until the year 2020, when the act takes full effect.

Although many doctors, including Dr. Patrick Collins of Jamestown Primary Care, don’t feel that the way they provide care under the Affordable Care Act will change, they do believe methods of reimbursement will be changing. However, only time will tell as each provision falls into place over the next seven years.

The Get Covered! Helpline is available between 9 a.m. and 4 p.m., Monday through Friday. It can be reached by calling 1-888-753-7315.