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Uninsured Unaware of Options for Affordable Care

Many of AFSCME's health care worker members work for "safety net" providers — providers that care for many uninsured patients. Although research has shown that uninsured Americans receive more than half of their care through emergency rooms, most don't identify hospitals as a safety-net provider, according to a study by the Center for Studying Health System Change (November 2004). Among those who were aware of safety-net providers in their community, only 8.3 percent cited the hospital ER. Almost 45 percent cited a clinic and 26.1 percent cited a doctor's office.

Among all uninsured people, awareness of a local safety-net provider varies by income, race/ethnicity, health status and proximity to community health centers. Poor and lower-income uninsured people — those with incomes under 200 percent of the federal poverty level — were more likely to know of a safety-net provider in their community than uninsured people with higher incomes. More than half of uninsured African-Americans (57%) and Latinos (53%) knew of a safety-net provider in their community compared with about 40 percent of uninsured whites.

As the number of uninsured increases, the reliance on the health care safety-net becomes ever more critical. Uninsured people who live in areas without safety nets are especially vulnerable to inadequate medical care. But even when safety-net providers are present, a large number of uninsured people are unaware of them as places to receive affordable medical care. The study's authors summarize, "If uninsured people are unaware of safety-net providers, they may be at higher risk of going without needed medical care or incurring large, out-of-pocket expenses and medical debt to obtain care." (Source: Center for Studying Health System Change Issue Brief, November 2004)

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