The recession and the regression in healthcare access

The week brings yet one more report to underscore ways that healthcare (despite hiring through the recession) is vulnerable to the weak economy.

A report by the Commonwealth Fund surveyed adults about access to healthcare, insurance coverage and income during the second year after the Great Recession ended.

Responses, taken from more than 2,000 adults, found households living closer to poverty were less likely to be insured. And insurance made a significant difference in whether adults reported receiving basic health screening, such as cholesterol checks or mammograms. That's according to Sara Collins, vice president for affordable insurance at the Commonwealth Fund, who walked me through the maze of statistics that parsed answers by income and insurance coverage.

The recession that began in late 2007 eroded household income and access to healthcare. Unemployment climbed through the recession and has yielded little until recent months. Households abruptly delayed medical care, helping to slow the nation's health spending growth to historical lows. Median income during the first year after the recession was down more sharply after the Great Recession than each of the six prior recessions. Here's a comparison:

Collins and her colleagues wrote the recession's long reach has “substantially undermined the ability of low- and moderate- income families to maintain health insurance coverage.” That coverage makes a difference, according to the Commonwealth Fund survey results:

The Commonwealth Fund report also outlined ways that the coverage expansion under the Affordable Care Act would likely address the gap between low-income and wealthy households when it comes to timely and affordable medical care. Expanded Medicaid eligibility, subsidies for insurance, new insurance regulation, limits on how much households must spend on deductibles and other medical costs and the mandate for individual insurance will all contribute to expanded, affordable coverage, the authors said.

However, the law may not address all barriers to access, the report said. Low-income adults found doctors would not always accept their insurance. Regardless of insurance, low-income adults were more likely to visit an emergency room on nights and weekends and more often said they did so for a prescription or because other options were too expensive.

You can follow Melanie Evans on Twitter: @MHmevans.



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