Health Care Costs and Low Income Families

The Henry J. Kaiser Family Foundation recently published an article titled "Health Care Spending Among Low-Income Households with and without Medicaid" http://kff.org/medicaid/issue-brief/health-care-spending-among-low-income-households-with-and-without-medicaid/ This article takes a look at the amount of the total household income spent on medical costs. The affordable Health Care Act made it so that families are covered by Medicaid so long as they are at or below 138% of the federal poverty level, according to the article that means an income of $27,310 for a family of 3 in 2014.   For families that have an income this low, the priority for spending is on food and if the family does not qualify for Medicaid they may not be able to afford other kinds of health coverage.   The article looked at the differences in spending habits between families that have Medicaid benefits vs families that do not have Medicaid benefits. I have inserted the pie chart of their findings below 

The issue: In looking at this data you can see that low income individuals such as those who are on a fixed income or receive social security and those who are unemployed or single income families have to make decisions about how their money is spent. When the health care spending increases, there is less money that can be spent on food and housing. This also means that these families are probably prioritizing their medical spending on things that are medically necessary. The researchers also suggest that individuals that have no health coverage are more likely to postpone receiving health care as well as going without care because of costs, this could be incredibly detrimental to young children who are in need of early interventions because this could slow their entire developmental trajectory.

How can we fix this issue: Changes need to be made at a nationwide level affecting policy. Expanding the individuals who receive healthcare coverage for free or at a lower cost can lead to a decrease in medical spending by the family, ensuring that there is money for food and housing  as well as ensuring that there is money for interventions that are not only medically necessary but interventions that may improve their quality of life or improve everyday functioning such as Occupational Therapy.

In order to prove that this works there should be research done to see how the spending habits of families change after they receive health care, data can also be collected regarding the types of care individuals receive and the amount of preventative care that they receive as well as how long they go without care. While this data has been collected in a number of studies, as Medicare is expanded this information could be taken using the same families.

What does this mean for OT: Occupational Therapy is not always considered to be "necessary" this means  that this could be one of the services that families elect to go without when they are unable to pay. Expanding Medicare could expand the availability of Occupational Therapy. This also means that without Medicare coverage Occupational Therapy could be out of reach for many individuals who have low income.