A 2019 study by the Blue Cross Blue Shield of Massachusetts Foundation identified that over 25,000 Bostonians and over 200,000 Massachusetts residents did not have health insurance. This was despite the 2006 universal health care law that was passed in Massachusetts making health care a right statewide and the 2009 affordable care act that brought universal health care access nationwide. What was incredibly important as part of these laws were provisions that dropped the most significant barrier to accessing health care- pre-existing conditions. Prior to these laws, health insurance companies could deny coverage to someone based on a pre-existing condition like chronic illnesses such as asthma, diabetes, hypertension, and obesity. With higher rates of asthma and diabetes prevalent in communities of color, and the denial of those with preexisting conditions, access to health insurance was yet another barrier for communities of color. Think of health care redlining.
Despite these transformative laws being passed by the Romney and Obama Administrations, respectively, lack of access and mistrust in the system still persist. However this crisis presents us with an opportunity to remove mistrust, and bring families and individuals into the healthcare system by getting them insured while they’re receiving COVID-19 testing.
The City of Boston’s Food Access program has delivered food and meals to over 25,000 families weekly since the state of emergency began in early March. With correlation between food insecurity, poverty, and chronic illness. Data suggests correlation between these families and the 25,000 uninsured population in Boston. This makes closing the gap on the uninsured even more critical as these families are more susceptible to contracting the coronavirus and with the presence of chronic illness more vulnerable to worst outcomes.
Since the city of Boston’s Resiliency Fund has helped increase Covid-19 testing at community health centers across Boston, more accessing to testing is available. In addition, in partnership with the Commonwealth of Massachusetts, Partners in Health is leading a groundbreaking contact tracing initiative, with over 1,000 tracers who will follow up with patients who have tested positive with the goal of containing the virus. It is unprecedented. But in order to go a step even further, the Department of Public Health should authorize contact tracers to sign up the uninsured through MassHealth.
For the uninsured, like many of the patients being offered testing at Codman Square and Whittier Street Community Health Centers, and hopefully more broadly if the state adopts our call to allow the Massachusetts National Guard to blanket test senior, low income and public housing, taking the step to enroll into health insurance plan will change their interaction with healthcare for the better.
While dedicating our efforts to address this historic crisis, there is an opportunity to address other systemic issues like healthcare reform – by scaling up the system to cover everyone, cutting wasteful spending, managing chronic illness and shifting the focus to preventive care, which will improve future outcomes and ultimately lead to higher life expectancy. A reinvigorated commitment to expanding access to health insurance hopefully will prevent the disparities we are seeing play out the next time our society is faced with a public health crisis of epic proportion.
State Senator Nick Collins represents the First Suffolk District which includes Dorchester, Mattapan, Hyde Park and South Boston. He is Also the Vice Chair of Public Health in the Massachusetts Legislature.