For week 2, we’ll focus on how, in order to promote access to care, we must advocate for policies that expand care to the under and uninsured

COVID-19 has had a devastating impact, shedding light on the barriers to accessing quality and affordable health care, gainful employment, and safe and affordable housing.

We know all too well how social determinants of health — such as the lack of transportation and broadband across our rural communities — play a role in our patients’ ability to access our services.

We also know that the cost of care can be a huge barrier, especially when people may have to choose between feeding their family or paying rent. 

That’s why we must work to ensure that people without insurance, and those who have a health plan but find themselves underinsured, can actually afford the care they need.


The Affordable Care Act (ACA), landmark legislation enacted in 2010, reduced the number of uninsured Americans by more than 20 million. In fact, uninsured rates across our nation dropped to a historic low in 2016. 

But beginning in 2017, some of those gains were lost, with the country’s uninsured rate increasing overall the next three years in a row. 

The number of uninsured individuals increased once again in 2020, amidst a global pandemic that threatened the health and safety of all Americans — regardless of insurance status. 


The cost of health care insurance is the main reason that someone may be uninsured. In 2019, 74% of uninsured adults said that it was because of high cost. And many Americans do not have any option to retain coverage through their employer.

Other Americans who are lower-income live in states that did not expand Medicaid and therefore remain ineligible for financial assistance for coverage. Undocumented immigrants also remain ineligible for Medicaid or Marketplace coverage.

Although they are unable to afford a health care plan, most uninsured households have at least one worker in the family. They are also more likely to be lower-income, adults rather than children and a person of color — and go without the care they require.

In 2019, three out of every 10 uninsured adults went without medical care because of the cost.

This means uninsured households not only often face huge hospital and/or provider bills following a medical emergency, but they are also much less likely to receive preventive care such as annual exams and other recommended screenings to maintain their overall health and wellness.

In New York State our uninsured rate is around 6%. Compared to states like Texas at 21% and Oklahoma at 17.6%, that number seems very low. 

However, it is important to note that 6% means that 1,167,000 in New York State are still without insurance coverage — and nearly 17,000 of those live right here in Broome, Chenango, Cortland, Delaware, and Otsego counties.


We know Americans are more likely to have insurance since the passing of the ACA. But many who do have health care plans find themselves “underinsured.”

So what does underinsured mean? 

Those who are underinsured have high deductibles and out-of-pocket medical expenses relative to their income. In 2018, it’s estimated that 29% of all Americans were underinsured. 

These households are not just more likely to struggle to pay their medical costs — but are also more likely to skip care altogether.

In fact, more than 40% of those who are uninsured delay care because of the cost and almost half find it difficult to pay their medical bills. 

But it’s not just the under and uninsured. Some one-in-four households with adequate insurance coverage delay receiving medical care because of concerns over the costs, while also finding it difficult to manage the medical bills they already do have.


Here’s what we know: having continuous coverage, even if it is not entirely adequate, makes a significant difference in access to care, including preventive care. 

That’s why we will continue to advocate for policies and programs that expand affordable, compassionate care to all those who find themselves underinsured or without any health care insurance at all.

Here at FamPlan, no one is ever turned away for care — regardless of insurance, income, or immigration status. Our doors are open and welcoming to all.