1.8 Million New Yorkers
Without Health Insurance

One in four New York City residents under the age of 65 is without health insurance. That’s 1.8 million people. Most are low-income, working adults. The consequences for those with no health coverage do not end with medical problems. They radiate out to every facet in the lives of low-income families. In New York City, nearly two-thirds of low-income families are African American or Latino.

The Kaiser Commission on Medicaid and the Uninsured reveals that while people of color constitute 34 percent of the nation’s population, they account for 52 percent of the uninsured. A major reason for this discrepancy is the greater employment of African Americans and Latinos in low-wage jobs, where insurance coverage is often unavailable or unaffordable.

Our annual survey of low-income New Yorkers, “The Unheard Third,” (PDF) confirms that holding a job no longer guarantees a worker benefits such as health insurance. The survey reveals that 40 percent of full-time workers living below the poverty line don’t get health coverage for themselves through their employer. Fifty-eight percent don’t get health insurance for their families.

A recent job-related barrier to health care coverage is a scheme where employers offer their workers a fixed contribution for a number of benefits. Rather than guaranteeing benefits, this forces workers to pick and choose, often reducing or eliminating health coverage for other benefits. Young workers, in particular, tend to omit health insurance coverage from their package of benefits.

Health Care Security Act

A bill introduced in the City Council – the Health Care Security Act – would expand health care coverage to more than 400,000 working New Yorkers and their families. It targets five industries where employers can provide health care benefits and still remain competitive. The bill would apply to construction, building services, industrial laundry, medium/large groceries, and hotels. It would give employers a choice: either offer their workers the industry’s prevailing level of health care or pay into a fund to provide uninsured workers with coverage.

Currently, many low-wage workers are not even offered a health insurance benefit on the job. And even if they are, low-income workers often cannot afford it. A worker earning $25,000 a year isn’t likely to spend approximately $4,000 of it to cover the employee share of the premium for family health coverage.

So our survey findings about health care are not surprising: among low-wage workers holding full-time jobs, 31 percent weren’t able to fill needed prescriptions and 23 percent postponed or were unable to get medical care in the last year.

The numbers of uninsured workers are creeping up as the price of health insurance rises and employers shift more of its costs onto their employees. The financial implications for the uninsured can be catastrophic. In the last few years, nearly half of bankruptcies filed were because of medical bills.

Half of the poor families in our survey say they have less than $500 in savings to fall back on. One in three has less than $100. In these circumstances, and forced into making a choice, food and rent come before health insurance.

Crisis for the City

The problem of workers without health insurance is also a crisis for New York City. The food preparer in the hotel – the grocery worker in the local food market – do we really want these people to be without access to adequate health care?

Uninsured patients who go to public health facilities cost money. The uninsured can’t pay; and the state never reimburses the city’s public hospital system and local health facilities at a reasonable rate. The result is that the taxpayers pick up a large slice of the bill while the medical facilities teeter on the edge of bankruptcy.

Access to quality health care is an issue that should be of concern to all New Yorkers. Having nearly two million people going around without sufficient access to health care constitutes both a public health crisis and a financial crisis.

The Health Care Security Act is especially vital at a time when public health programs are being slashed in Washington and Albany. The Council should pass this legislation and Mayor Bloomberg should sign it into law.

From the New York Amsterdam News
April 7 - 13, 2005