Health Coverage
Access to timely, quality medical care is vital for a person’s well-being. In fact, medical care accounts for about 20% of a person’s overall health outcome.
Health insurance coverage is one of the main ways a person can access quality care. However, 1 in 10 U.S. adults lack health insurance. Similarly, data shows that 7% of Hoosiers do not have health insurance.[1]
People who lack health insurance are less likely to have a primary care provider or be able to afford care and medications. When people are uninsured or underinsured, maintaining overall health becomes a struggle. These barriers contribute to worse health outcomes, deepening the divide in health equity.
Here’s what you’ll learn:
How Healthcare Access and Quality Impacts Olivia
Meet Olivia—artist, part-time barista, and resilient teenager. After experiencing homelessness and battling depression and a substance use disorder, her chosen family helped her heal and thrive.
Get to Know OliviaHow Healthcare Access and Quality Impacts The Jackson Family
Meet Evelyn—an immigrant grandmother struggling to prioritize her health after a lifetime without consistent care. Cultural differences, a language barrier, and past trauma make her hesitant to seek medical help, and she often relies on home remedies. Now, with mobility issues and diabetes, Evelyn faces the challenge of trusting the health care system.
Get to Know The Jackson FamilyHow Healthcare Access and Quality Impacts The Garcia Family
Meet Elena—a widowed mom experiencing grief and PTSD. She is navigating managing her family’s medical needs while living in a rural town with limited health care access.
Get to Know The Garcia FamilyHow Healthcare Access and Quality Impacts Chris
Meet Chris—a blind substitute teacher with high health literacy but constant barriers to accessible care. From being denied braille materials to microaggressions at clinics, Chris faces struggles within the system while managing his arthritis and other health care needs.
Get to Know Chris
Terms to Know
Public or private insurance companies which pay for some or all of a person’s medical expenses. A person is considered uninsured when they have no health insurance and must pay all their medical expenses out of pocket, exposing them to financial risk.
Medicaid is a joint state and federal program that provides health coverage to eligible people. In Indiana, Medicaid is available for people based on income, financial assets, or certain disabilities.[1]
Medication adherence means taking medications as prescribed by a health care provider. The main barriers are high costs, low health literacy, and limited pharmacy access. People who don’t take drugs as prescribed have worse health and higher death rates.
Health care services such as routine check-ups that help prevent and manage illness, chronic conditions, and any other health issues.
Health care providers and practitioners who treat common medical conditions, coordinate patients’ long-term health, and are the primary way patients are referred to additional, specialized care.
People are underinsured if their health insurance doesn’t provide adequate coverage. Their medical expenses, such as high deductibles and out-of-pocket costs, are more than they can afford.
Key
Facts
- 64% of uninsured U.S. adults (ages 18–64) lack coverage due to the high cost of insurance.
- 20% of uninsured U.S. adults reported they have gone without needed care due to cost.
- 18% of Hoosiers collectively have more than $2 billion in outstanding medical debt in collections.
- Across the U.S., Indiana has the 11th-highest percentage of residents with medical debt in collections.
Impact of Health Insurance
Having health insurance coverage is linked to having better access to health services and preventive care. Before the enactment of the Affordable Care Act in 2010, more than 48 million Americans younger than age 65 years lacked health insurance. About 1 in 3 Hispanic Americans and 1 in 5 Black Americans were uninsured. In 2024, the number of uninsured Americans younger than 65 decreased to 26 million.
Despite these strides, inadequate health care coverage continues to impact people’s financial well-being, their access to quality care, and overall health. Further, these disparities are persistent in groups who have low income, a disability or belong to a racial or ethnic minority group.
More and more health care providers choose to locate in neighborhoods with higher economic status where most residents have health insurance.[1] For example, Black and Hispanic residents have higher rates of Medicaid coverage or lack insurance altogether. Few office-based health care providers decide to locate in Black and Hispanic neighborhoods due to concerns about being able to be reimbursed by Medicaid or their patient’s ability to pay out-of-pocket costs.[2]
Similarly, some providers don’t accept public insurance such as Medicaid. Further, Medicaid beneficiaries have reported discriminatory interactions with their providers. These individuals are less likely to receive preventive health services.[3]
[1] U.S Department of Health and Human Services
Quality health care refers to individuals receiving appropriate health services to increase the chances of achieving favorable health outcomes.[1] Having health insurance can determine the type of care people seek, regardless of whether that type of care is the most appropriate or effective for their needs.[2] For example, people without insurance have higher mortality rates and receive fewer diagnostic and therapeutic services while hospitalized compared to people with insurance.[3]
Medical bills are often unaffordable for uninsured or underinsured people. These high costs can lead to medical debt since many uninsured people have low or moderate incomes and minimal savings. Uninsured adults ages 18–24 are nearly twice as likely to struggle with health care costs compared to those with insurance. For these and other reasons, uninsured people often delay or do not get treatments recommended by their health providers.[1]
Early detection saves lives, but uninsured people are less likely to receive regular preventive screenings for chronic illnesses like diabetes, cancer, and cardiovascular disease. They’re less likely to have regular blood pressure checks and screenings for blood sugar, cholesterol, and cancer screenings like breast, cervical, and colon. Being uninsured can result in delayed treatment, which leads to poorer health outcomes and higher mortality.
Medication Adherence
The main barriers to taking medication as prescribed are high costs, low health literacy, and limited pharmacy access. About 75% of Americans have trouble taking their medication as directed.[1] When people don’t take drugs as prescribed, they have worse health and higher death rates.
[1] Medication adherence: helping patients take their medicines as directed.
People with low health literacy often don’t understand how to take their medications or why they need them. This can lead to dangerous health outcomes.
- Missed doses: They may forget to take their medication on time.
- Confusing instructions: They may not understand instructions if they are complex or unclear.
- Side effects: They might avoid medications because they fear potential side effects.
- Lack of trust: They might not believe they need the medication unless it’s clearly explained.
- Complex regimens: They might find managing multiple medications with different schedules challenging.
A pharmacy desert is when someone lives far from a pharmacy, affecting medication access. While almost 90% of people live within five miles of a pharmacy, not everyone can get there due to transportation issues or inconvenient store hours. A 2021 study showed that 60% of Indianapolis neighborhoods were in a pharmacy desert.[1] It was even worse for predominantly Black neighborhoods, at 80%. Nationwide, Hispanic and Black people have disproportionately low access to pharmacies.
Prescription drug shortages happen when manufacturing problems, delays, or discontinuations occur. These supply problems raise health care costs, stress staff, and increase the risk of medication errors. Further, pharmacies in poor communities are 24% more likely to be out of stock or have limited stock of the 13 most prescribed medications.[1] These same pharmacies are more likely to have limited hours of operation, making it harder for people to get their medication.
[1] Medication deserts: survey of neighborhood disparities in availability of prescription medications.
Key
Takeaways
- Adequate health insurance coverage is crucial for accessing necessary medical care, preventing financial hardship due to high medical expenses, and achieving better health outcomes.
- High costs, low health literacy, and limited pharmacy access are major barriers to taking medications as prescribed, resulting in worse health and higher mortality rates.
- Low-income and minority populations are disproportionately underinsured and uninsured.
Other
Healthcare
Topics
Behavioral Health & Mental Health
Addressing behavioral health supports people in their daily lives and helps prevent or manage other serious health conditions.
Health Literacy
Clear, culturally tailored information empowers informed health choices, improving health equity and outcomes.
Employment: Some uninsured workers can’t afford their employer-sponsored health insurance premiums. But some employers don’t offer insurance at all. In 2022, 61% of uninsured workers ages 18–64 were employed by an employer who did not offer them health insurance.[1] Further, not all employer-sponsored insurance is the same. The quality and affordability of health insurance can vary by employer.
Lost wages or unemployment: If people can’t afford to treat their chronic conditions or illnesses, they might miss work and lose their wages or jobs. This makes it harder for them to pay off medical debt, stay insured, or manage their chronic conditions because they may skip doses or go without necessary medications.
[1] KFF
Health literacy: People with low health literacy might not understand medication and its use or be convinced of the need for treatment. Better provider-patient communication can help patients make informed decisions about their care.
Insurance coverage: People without health insurance are more likely to go without medical care, including preventive screenings. Children without insurance might not receive dental care, immunizations, or well-child visits that track developmental milestones. They are less likely to get treatment for conditions like asthma.
Built environment: Some communities—especially rural areas or poor communities—don’t have easy access to medical services or pharmacies. Additional barriers like lack of transportation options or supply shortages can prevent people from getting the care and medications they need in a timely manner.
Environmental factors: Exposure to pollutants and poor living conditions can make certain health problems worse. This can increase dependency on medications and health care services.
Support networks: Communities with strong support networks can better navigate health care and advocate for group benefits, including access to necessary medications.
Culture: Cultural norms within communities can influence attitudes toward health care, affecting how individuals use medication and engage with health care services.