Medical Debt Problems Plague Massachusetts Residents

The Access Project & Blue Cross Blue Shield of Massachusetts Foundation | September 18, 2008 | Link to article

Andrew Cohen, Susan Ryan-Vollmar

FOR IMMEDIATE RELEASE

SEPTEMBER 18, 2008
CONTACT:
Andrew Cohen, The Access Project
617.654-9911 ext. 231 / acohen@accessproject.com
Susan Ryan-Vollmar, Blue Cross Blue Shield of Massachusetts Foundation
617.246.2404 / susan.ryanvollmar@bcbsma.com

While solutions exist, new report documents need for greater awareness of available programs to ease the burden of medical debt

BOSTON ¯ A new report from The Access Project finds that medical debt continues to be a problem for lower- and middle-income residents of Massachusetts, even though hundreds of thousands of state residents now have health insurance under the landmark health reform law. The findings were published today in “In Debt But Not Indifferent: Chapter 58 and The Access Project’s Medical Debt Resolution Program.”

Between September 2006 and April 2008, the Medical Debt Resolution Program worked with 187 people with an aggregate medical debt of more than $2 million. The program helped people to resolve medical debt by informing them about insurance appeal rights, eligibility standards for public programs, and strategies to negotiate payment arrangements with medical providers.  The Access Project identified patterns of policies and problems that caused these clients to accrue medical debt and helped retire more than $1 million of that debt.

“It’s a tragedy that many clients in our program had medical bills that should have been paid by a private insurer or public program, but they did not know about available resources to help them secure payment or coverage,” said Andrew Cohen, coordinator of the Debt Resolution Program and report co-author.  Cohen said that this lack of awareness caused particular problems for people who learned too late about the Healthy Safety Net, which can cover past bills, and the Office of Patient Protection, which can review denied insurance claims.

Many of the people assisted under the Medical Debt Resolution Program were insured when they sought care—approximately 40 percent of program clients—but ended up with medical debt due to unaffordable out-of-pocket costs.  One program client, Rob Peck, found himself with $2000 in medical debt because of the deductible under his health plan.  Rob is self-employed and purchased insurance on the individual market.  “I never would have gotten the preventative test that my doctor recommended had I known that it wouldn’t be covered,” said Peck.  His insurance also refused to pay another $2000 for cancer screening because they said that the provider was out-of-network.  Peck only learned that he could appeal the insurer’s decision when he sought help from The Access Project.  After a review of his case by the state’s Office of Patient Protection, the insurer finally agreed to cover the cost.  “I was so happy about the outcome,” said Rob.  “$2000 doesn’t seem like a lot of money to some people, but it was really expensive for a self-employed person like me.”

“We need more programs like The Access Project’s Medical Debt Resolution Program,” said Jarrett Barrios, President of the Blue Cross Blue Shield of Massachusetts Foundation.  “Health reform continues to insure record numbers of state residents, but we still see uninsured and under-insured people who have accumulated medical debt and are now putting off needed care for fear of accruing more bills.”

The Blue Cross Blue Shield Foundation of Massachusetts provided funding for The Access Project’s Medical Debt Resolution Program.

Key report findings include the following:

Even modest medical bills, especially for program clients with low- and moderate-incomes, created health access and financial problems.
 
For many program clients, a significant percentage of their medical debt was, or could have been, paid by private insurance or public programs had they known about existing protections.
 
Retroactive coverage under public safety net programs was vital for program clients, particularly since medical bills often took many months to process.
 
Barbara Anthony, Executive Director of Health Law Advocates, stated, “The work of the Access Project shows that providers have to do a much better job of screening and counseling patients and providing information to patients about financial assistance to help pay medical bills. Even with health insurance, many consumers are underinsured, and end up owing huge sums to providers for health care treatment.”  Anthony added, “This gap results in consumers not seeking treatment when they need it, an outcome that is counter to all our health reform efforts.”

The report also offered recommendations to diminish the incidence and consequences of medical debt in Massachusetts.  Included among them are improving efforts to educate the public and providers about existing resources to ensure payment of medical bills and increasing the retroactive period for public safety net programs

“Far too many people struggle in silence trying to pay off medical debt,” said Mark Rukavina, Director of The Access Project.  “If existing programs and consumer protections were more widely known, millions of dollars in medical debt could be resolved for Massachusetts residents, which would free up sorely-needed dollars to pay for other vital needs like food, fuel, and housing.”

Visit www.accessproject.org or www.bcbsmafoundation.org to download the full report.

More About The Access Project

The Access Project works to strengthen community action, promote social change, and improve health, especially for those who are most vulnerable. By supporting local initiatives and community leaders, The Access Project is dedicated to strengthening the voice of underserved communities in the public and private policy discussions that directly affect them.

More About The Blue Cross Blue Shield of Massachusetts Foundation

The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to expand access to health care. Through grants and policy initiatives, the Foundation works with public and private organizations to broaden health coverage and reduce barriers to care. It focuses on developing measurable and sustainable solutions that benefit uninsured, vulnerable and low-income individuals and families in the Commonwealth, and served as a catalyst for the pioneering Massachusetts health care reform law passed in 2006. The Foundation was founded in 2001 with an initial endowment of $55 million from Blue Cross Blue Shield of Massachusetts; the endowment has since grown to $108 million. The Foundation operates separately from the company and is governed by its own 18-member Board of Directors. It is one of the largest private health philanthropies in New England and in 2007 was awarded the Paul Ylvisaker Award for Public Policy Engagement by the Council on Foundations.