Friday, December 11, 2009
Addressing Disparities in Health Coverage
As the national health care reform debate progresses in Congress,
states continue to focus on ensuring broader access to care that is affordable
and cost-effective. Public Welfare Foundation grantees in Texas are taking multiple approaches to reach
these goals.
A recent report by the Center
on Public Policy Priorities, based in Austin,
found that the cost of health insurance, particularly for employees in the
private sector and for small businesses, is escalating at disturbing rates. From
1998 to 2008, premiums for employer-sponsored health insurance doubled and they
are projected to double again by 2020.
Generally, the average out-of-pocket share of premiums paid
by private sector employees in Texas is about 32
percent, compared to 27.6 percent in the U.S. as a whole. The state’s
smallest businesses – those with fewer than 10 employees – pay $13,032 per year
for family premiums, compared to the national average of $11,650.
Such increasing costs are a key reason why Texas has the highest rate of uninsured – 25
percent, compared to the national rate of about 15 percent, according to state
health reform advocates.
Nearly 60 percent of the uninsured in Texas
are Latinos, reports grantee La Fe
Policy Research and Education Center, based in San Antonio. Even after adjusting for
non-citizens, the uninsured rate among Latinos is twice that of whites, 29
percent to 15 percent. As of 2008, La Fe found that 21 percent of Latino
children and 14 percent of African-American children were uninsured, compared
to 12 percent of white children.
The disparities persist, La Fe reports, regardless of educational
level or employment status. Expanding health insurance coverage by targeting low-income
working families, who are disproportionately minority, could help reduce some
of the disparities.
“These are the families who struggle the most to meet the
basic costs of living,” says a recent La Fe study on affordability of coverage.
Many have no or inadequate health insurance because it is unaffordable, not
available through their employer or they do not qualify for public insurance
programs, the study notes. “As a result, their access to health care is limited
and their health and financial insecurity risks increase.”
Texas
is trying to tackle some disparities and inequities through reforms to the state’s
Medicaid and Children’s Health Insurance Program (CHIP), as well as through
efforts such as a state-subsidized high risk pool for people with pre-existing
and other conditions that make it difficult for them to find insurance in the
private market. But advocates say that issues of eligibility and affordability remain.
That helps explain why another grantee, Texas Impact Education Fund, a religious
grassroots network, also in Austin,
recently sponsored a statewide sermon contest on health justice. The contest,
which ran for 12 weeks, drew sermons by clergy, lay preachers and seminary
students from several religious denominations.
Texas Impact executive director Bee Moorhead said that, “As
our nation struggles with the issue of health care reform, it’s especially
important that the voices of faith communities be firmly grounded in theology
and scripture, and not simply reflect partisan rhetoric.”
Contestants submitted videos of their sermons up to 10 minutes
in either English or Spanish. Among the criteria that a panel of preaching
experts used to judge the entries were sermon structure, theology, audience
engagement and delivery.
The winning English language sermon, by Rev. Kathryn Ransdell, was delivered
at First United Methodist Church of Dallas. The winning Spanish language sermon was delivered by Rev. Margarita Arroyo at St. James Episcopal Church in Austin. To view these and all the other
entries, click
here.
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