Uncovering Health Care in Orange County: Is it as accessible as they say it is and is there a connection to house pricing and homelessness?

By: Ira Adnaik

(Jeff Gritchen/OC Register)

By Ira Adnaik

September 8 - October 19, 2023

Health care, as defined by Oxford languages, is the “organized provision of medical care to individuals or a community.” It can be considered as the improvement and maintenance of health, through certain aspects of medicinal care and treatment. According to OC Health Care Agency, “services are provided to all residents of Orange County who meet the criteria regardless of financial status.” However, what has failed to be addressed is whether all health

related concerns will be met and served. Are certain treatments not covered under the health care provided to all?

Because of the implementation of the ACA, or the Affordable Care Act, many Americans have been able to receive health insurance; Medicaid eligibility has been further expanded for

those with low incomes, as Weighed Down: Californians and the Financial Burden of Health Care Coverage by State Health Access Data Assistance Center (SHADAC) explains. Regarding

the ACA, as SHADAC further depicts, there are 2 paths for those with low to average income to follow in order to receive health insurance. To start off, the ACA gave states the authority to expand Medicaid/Medi-Cal to US citizens along with specific immigrants who met the 138% income requirement, in relation to the federal poverty guidelines. Moreover, the law made it possible for those with incomes in the range of 139% and 400% to receive government provided subsidies to make it easier for monthly bills. For those with 139% to 250% of FPG, they are also able to obtain “cost-sharing subsidies to reduce their out-of-pocket medical expenses, such as

deductibles and copays,” according to SHADAC. People could as well purchase individual-market health insurance.

(CHCF.org/US Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, “Poverty Guidelines,” January 8, 2020)

This table shows the FPG levels discussed above, as provided in 2020 by the US Dept. of Health and Human Services.

While the ACA makes it seem incredibly easy for those with even low incomes and high FPG to receive health care, the concern surrounds how easily those people can pay off their bills.

In fact, SHADAC states that “in 2018, 10% of Californians reported having trouble paying medical bills, although that varied across population subgroups,” with almost 20% of those people having a FPG in the range of 139% to 249%. Of course, those with a higher income were able to easily pay off said bills and reported the least amount of trouble. 1 in 10 people is a large portion of people, considering the amount of people that are eligible to obtain health care in California. This is an issue that should be addressed, as not paying medical bills in a timely manner or at all can result in consequences regarding credit card debt and debt in general adding

up.

Struggles to pay medical bills can most likely also have a connection with the increasing rate of homelessness in Orange County. Due to the shortage of affordable housing in Orange

County, homelessness has become more common. However, there are also many other factors to take into account. According to a poll conducted by UC Irvine, 36% of the surveyed demonstrated a concern for the lack of jobs that pay well enough to thrive in such an expensive and demanding city. Additionally, the Orange County register discusses in their article, UC Irvine poll: Homelessness, affordable housing top concerns in OC, how when the surveyed were asked “to identify the “most serious” problem, more than 1 in 3 (37%) said affordable housing, and more than 1 in 4 (26%) said it is homelessness” (OC Register).

These days, in Orange County, many people have been struggling to obtain a well-paying job and get back on their feet after the COVID-19 pandemic. The lack of such jobs also does not help the case, along with housing being incredibly expensive. The concern lies in the safety and wellbeing of these people who are struggling to get shelter. Several cities have looked into make-shift/temporary shelters and places for these people to stay. Majority of these people are also in the group of people who struggle to pay medical bills, as they have a relatively low

income and cannot afford to pay their bills in a timely manner. Overall, the issues regarding difficulty to pay medical bills intertwine with income related problems and the struggle for finding affordable housing in Orange County, as those with lower incomes are unable to pay off medical bills and get shelter.