Joyce Gantt said she never thought life would turn out this way.
Until September 2001, she had a comfortable life. She had a job in Phoenix as an accountant and lived in an eight-room house with a swimming pool. But then came the attacks on the World Trade Center and the Pentagon. Her employer went bankrupt, leaving Gantt and more than 400 of her co-workers jobless and without health insurance.
She sold her home and moved to the Washington area to look for work. Unable to find full-time employment, she works temporary jobs while trying to find a way to pay for her asthma and diabetes medicines, which cost $400 per month.
As Cover the Uninsured Week geared up, organizers drew on the plight of Gantt and others like her to focus on a problem that seems perpetually out of legislators' reach. From May 1-8, about 1,200 events are scheduled throughout the country to highlight different aspects of the uninsured problem. According to the latest figures from the U.S. Census Bureau, 45 million Americans went without insurance in 2003, representing 15.6% of the population.
In Washington, the Robert Wood Johnson Foundation, one of the organizers of the event, released a study last week ranking states by their percentages of uninsured. Texas had the highest rate of uninsured working adults at 27%, while Minnesota had the lowest at 7%, according to the report, prepared by the State Health Access Data Assistance Center at the University of Minnesota.
Researchers used data from the Centers for Disease Control and Prevention's 2003 Behavioral Risk Factor Surveillance System survey, a national telephone survey of preventive and health risk behaviors. More than 20 million working adults have no health insurance coverage, researchers found. In eight states, at least 20% of working adults were uninsured. In 39 other states, at least 10% of working adults were uninsured.
"Twenty million working adults without health insurance equals 20 million Americans unable to access healthcare services on a regular basis, including preventive care," John Nelson, president of the American Medical Association, said in a news release. "This is not a nameless, faceless statistic; these uninsured Americans are our neighbors, friends and families."
The American Hospital Association has placed the uninsured at the top of its lobbying agenda for this year, and last week AHA President Richard Davidson called for action.
"Too often, (hospitals) see what going without coverage means," he said in a news release. "Patients with chronic health issues often go without needed checkups and screenings. Patients seeking emergency care often could have been better served had they received preventive and wellness care."
Both the AHA and the Catholic Health Association are pushing for legislation that would expand coverage for children by extending eligibility for Medicaid and the State Children's Health Insurance Program. They also propose that small businesses be allowed to use tax credits to purchase insurance for their employees and that low-income residents be eligible for tax credits to purchase health coverage.
In Washington, solutions have been elusive. The last large-scale effort at attacking the problem was the Clinton administration's proposed government-run healthcare program, aimed at providing universal coverage. That effort collapsed under the weight of opposition from a broad coalition of providers, private insurers and business groups.
During the most recent presidential election, Democrats tried to make the uninsured a major domestic issue. But despite voter concerns, polls indicated that healthcare did not significantly influence election results.
The Bush administration continues to push for association health plans, health savings accounts and tax credits as ways to increase coverage. Meanwhile, a provision that was part of the Medicare Modernization Act of 2003 will bring the issue to the public. A 15-member working group established in February will hold town hall meetings throughout the country on ways to improve the health system. The group will then develop recommendations based on the meetings to present to Congress.
"I have always thought (the uninsured problem) is far and away the most important issue on the domestic front," Sen. Ron Wyden (D-Ore.), one of the bill's sponsors, said last week during a press event. "Uniting Americans to call for change is the first step toward getting real action from Washington."
Rep. Henry Waxman (D-Calif.) and Sen. John Kerry (D-Mass.) also have introduced legislation to expand health coverage for children. Under those bills, the federal government would fully match state spending to expand coverage through the Medicaid and SCHIP programs. The bills would cover children up to age 21 in families with income up to 300% of the federal poverty level. The legislation would also provide tax credits for parents to purchase coverage for their children.
Last week, a study conducted for HHS said the Census Bureau's estimate of 45 million uninsured Americans may be overstated by 9 million. Regardless, Risa Lavizzo-Mourey, president and chief executive officer of the Robert Wood Johnson Foundation, said the number of uninsured is still too high to ignore, and all indications show it is rising.
For someone like Gantt who lives with the consequences of not having insurance, the difference in numbers seems beside the point.
"If Washington could get some law to bring this down," she said, "I am willing to do anything to get that along."