Two decades ago, infectious disease experts warned that our country was uniquely vulnerable to epidemics because, unlike every other affluent nation, the United States has millions of residents without health insurance. Many who lack health coverage cannot afford to seek medical attention, even if they feel sick. A highly contagious virus “left undetected” because a person chose to forego care could “spread to family, neighbors, and other contacts,” making health insurance gaps “a risk to the nation’s health.”
The tragedy took as many forms as the novel coronavirus itself. An uninsured nursing home aide who feared the cost of a COVID test unknowingly brought the virus to seniors whom that aide served and loved. An uninsured server who felt sick but couldn’t afford to skip work or get medical care did not realize she infected her customers with every cough. The British Medical Journal concluded, “in the past when people avoided tests and treatments because of cost they endangered only themselves. Now, they risk everyone else’s health as well.”
Regrettably, the glaring health disparities that have long existed but became so evident during the pandemic led to significantly more sickness and death in communities of color — not only because those disparities left people of color more vulnerable to severe illness from COVID, but also because people of color are more likely to lack the coverage they need to seek care. All of us need affordable health care that can never be taken away. But for some of us, that goal is particularly distant.
To be fair, Maryland has done better than many other states. We cover 94% of our residents — that’s above the national average and far more than before President Obama signed the Affordable Care Act.
But 94% isn’t good enough anymore. It leaves more than 347,000 people without coverage. With so many lives needlessly lost to the pandemic, we can longer afford gaps in access to essential health care. Our goal must be 100%.
We can reach that goal. Here’s how: We should automate and streamline enrollment into coverage whenever possible. Maryland took important steps in this direction by creating the nation’s first Easy Enrollment program that lets people sign up for health care when they file state tax returns or claim unemployment benefits, but we can take this effort to the next level. More than 230,000 Maryland residents without health insurance — almost 70% of our state’s uninsured — now qualify for Medicaid or federal help buying private health insurance. It’s time to sign them up.
We must also address the glaring health disparities which impact particularly communities of color in our state. I commend the Maryland General Assembly for creating a new Health Equity Resource Communities program this year to improve health care in disadvantaged communities and we must do all we can to fully implement and strengthen this program.
Maryland should also join the handful of other states that guarantee health care to hardworking immigrants, regardless of their status. During the pandemic, these front-line workers have cared for our sick, grown and prepared our food, and delivered goods to our doors. They are taxpayers, and they contribute to Social Security with every paycheck, just like the rest of us. Woven into the fabric of our community, our undocumented friends and neighbors should never be turned away when they get sick and need help.
Denying them health care is not only wrong — it is foolish. If someone avoids the doctor because they can’t get health insurance, we pay far more when they turn to the hospital emergency room, where the unaffordable costs get passed to the rest of us.
And let’s never forget the pandemic’s bitter teaching: All of us are at risk if some of us are denied care.
Half a century ago, Martin Luther King Jr. observed, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” We have made major progress since then, but our work remains incomplete, and there’s no time to waste. Let’s start the next chapter in America’s quest for health care progress right here in Maryland.
Tom Perez (Twitter: @TomPerez) and his family live in Montgomery County. Until January, he served as chair of the Democratic National Committee. He has also served as U.S. secretary of labor for President Barack Obama, assistant attorney general for civil rights at the U.S. Department of Justice, secretary of the Maryland Department of Labor, Licensing and Regulation and on the Montgomery County Council.