Utah’s uninsured have significant barriers to coverage, education needed to ‘bridge the gap’

The Utah Health Policy Project (UHPP) recently held their annual conference, which brought together panelists to discuss Utah’s uninsured population and how it relates to inequities in our health care system. The conference touched on the many barriers to coverage for those who are uninsured and the investments needed to address those barriers. 

 

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One panel, ‘Addressing Utah’s uninsured rate through an equity framework’, included Shireen Ghorbani, director of Community Health at Intermountain Healthcare, Sarah Woolsey, director of the Family Health and Preparedness Division at the Utah Department of Health (UDOH), Diximar Paredes Bolli, CHIP and Medicaid Coordinator at Alliance Community Services, and Daryl Herrshaft, health access assister at UHPP. 

The panel first highlighted the importance of coverage to overall community health. Woolsey said access to health care only comes with coverage. She said this is true in the general population and in those with complex conditions who need more resources. 

“When we get people covered, even in the most complex patients, then we get the best outcomes.”

The panelists said children are in the greatest need for coverage. Ghorbani said there are 82,000 uninsured kids in Utah, and 40% of those kids come from Hispanic/Latinx communities. She said this “incredible disparity” is the most pressing issue that needs to be addressed through funding and legislative action.  

She explained that when more people are covered and access preventative care, it saves money for the system by reducing  higher acute care costs. Those savings can then be used for those with complex conditions to allocate more monetary resources to their treatment. 

However, the panelists highlighted many barriers that stand in the way of underserved people accessing coverage. Bolli said many do not know where to get coverage and how to navigate the system. This is due to both language and education barriers. 

Bolli also highlighted the technology barriers to access care, such as finding the right websites and physical locations. She said these uninsured people tend to feel hopeless in their attempts in finding coverage, leading to the uninsured giving up on finding coverage. 

“When you are hopeless because you have tried for so long, and in different aspects of your life you just have doors closing out on you with no understanding [as to why], you just don’t feel like someone hears you, all while people are not getting the right information [for needed services].”

Herrshaft said the administrative process of applying and receiving coverage through Medicaid is not culturally competent. He also said the Department of Workforce Services’ (DWS) eligibility staff are “not particularly empowered to make decisions that affect health insurance.” 

He said this particularly affects those with substance use disorder (SUD) since the delays in eligibility confirmation through DWS increase the amount of time an SUD goes untreated. This can lead to more relapses and a perpetuation in their barriers to coverage. 

Woolsey then discussed the unique challenges facing rural communities in the state. She said the reduced number of marketplace choices to rural citizens make it challenging for rural citizens to find clinics in network. She also said employer-sponsored health insurance is also greatly limited, which brings up issues of affordability. 

Bolli’s solutions to these barriers include increased education and outreach to isolated and rural communities. She said churches are important in accessing these people, and can be used as meeting spaces to educate rural folks about their insurance options and how to navigate the insurance marketplace.

“There is no relationship based in trust. So it takes us time to build those relationships with distance, technology, and language barriers. So I think that we can bridge the gap if we are persistent and get to work with different players. Altogether, I think that would be a way for those who offer resources and those who need it to get together.”