By Paul W. Hamann, MA, MNA
President & CEO
The Affordable Care Act (ACA) has increased health care coverage to approximately 670,000 low- and moderate-income Illinoisans through the expansion of Medicaid and 400,000 more through the marketplace. Yet significant gaps in health care access remain. Barriers such as affordability, transition between jobs, immigration status, enrollment period cutoffs, and a shortage of Medicaid providers outside of metropolitan areas prevent many Illinois residents from obtaining quality health care services.
Despite the increase in the number of insured, Illinois has the eighth highest uninsured population in the country. An estimated 1,120,000 Illinois residents were uninsured in 2017. More than half are employed, and 22% are unemployed. This is just one way that Illinoisans can fall through the gaps of our health care system.
Even when a family has insurance, the healthcare system can be difficult to navigate. Only 12% of adults have proficient health literacy, meaning 9 out of 10 adults may not understand information crucial to managing their health. This is a particular challenge for patients managing chronic conditions such as hypertension and diabetes.
Unfortunately, on July 19, the Centers for Medicare & Medicaid Services dramatically cut funding for the ACA Navigator program to $10 million for all 34 participating states, bringing funding for the program 80% below the 2016 funding level. Navigators help people learn about their health insurance options and assist them with enrollment in their state marketplace. This is yet another way that people may fall through the gaps, unable to use the insurance they have.
August is Free and Charitable Clinics Month in Illinois, when we celebrate and support the clinics, like The Night Ministry, that help bridge these gaps by providing a safety net for those who have difficulty accessing the mainstream medical system, for any reason. The Night Ministry's Outreach and Health Ministry Program provides basic health care in several underserved Chicago neighborhoods via a customized mobile health unit, staffed by nurse practitioners, HIV testers, case managers, and specialized outreach workers. Additionally, we provide mobile health care on foot via our street medicine team at several dozen additional locations throughout the city including under viaducts and in encampments where people experiencing homelessness build makeshift communities.
Every year, Illinois' 48 free and charitable clinics provide comprehensive primary care and chronic disease management to around 100,000 patients who otherwise have no access to quality medical care. The Night Ministry's Outreach and Health Program provided healthcare to 1,430 patients in fiscal year 2018. With thousands of uninsured individuals in Chicago, The Night Ministry's outreach and health services are important to those who have difficulty accessing traditional health services. Many of our patients find it challenging to seek services elsewhere.
Funding cuts to Medicaid and Medicare, and further threats to the provisions within the Affordable Care Act put tremendous pressure on our health care system, and especially free and charitable clinics, by leaving more of our neighbors without access to insurance, preventive care, important treatment for illnesses, and ultimately sicker. In short, we are moving backward and leaving more of our fellow Illinois residents behind in our mission toward stronger, healthier communities.
What can you do? Find your local free and charitable clinic and support them! Free and charitable clinics rely on a mix of funding sources, primarily private, in order to keep their services free to patients. We also rely on thousands of hours of volunteer support and in-kind donations to keep our doors open. For more information, visit www.illinoisfreeclinics.org.