This is the second entry in a series of posts highlighting GCO’s new report, Increasing Access to Quality Healthcare for Low-Income Uninsured Georgians. The first entry provided an overview of the report .
Unfortunately, 19 percent of Georgians lack health insurance, the sixth highest percentage in the country in 2012.[i] Of the nonelderly uninsured, 56 percent live in households that make less than 139 percent of the federal poverty level (FPL), which is $16,221 for an individual and $33,151 for a family of four.[ii]
While it can be difficult for uninsured individuals to find care – particularly those with low-incomes – some uninsured individuals access care through Georgia’s healthcare safety-net. These providers include community health centers, charity clinics, public hospitals, local health departments, and private office-based physicians who provide limited free care.[iii]
Community Health Centers
The state’s community health centers provide primary and preventive care to many uninsured individuals on a sliding fee scale based on patient or family income. In 2011, Georgia’s Federal Qualified Health Centers (FQHCs) – local, non-profit, community-owned healthcare providers – served more than 317,000 patients at 152 delivery sites across the state. Of the FQHC patients, 51 percent were uninsured. The National Association of Community Health Centers estimates that 13 percent of Georgia’s low-income uninsured population was served by an FQHC in 2011.[iv]
Uninsured individuals in 90 of Georgia’s 159 counties have access to a charity clinic as another option to help meet their primary care needs. In 2012, the state’s 96 nonprofit, independent charity clinics served 183,625 unique patients, and 62 percent of these patients were below the poverty level.[v] Due to their volunteer nature, clinics are able to provide an average of $7 worth of services for every $1 invested, and the average cost per patient visit is $29.[vi]The total value of the services provided by Georgia’s charity clinics in 2012 was over $200 million.[vii]
In addition to community health centers and charity clinics, many uninsured patients seek care in hospital emergency rooms. Since many low-income uninsured individuals can only afford a small portion of the care they receive and hospitals are required to provide emergency healthcare to anyone needing it, providers are often uncompensated for the services they provide. In 2012, Georgia hospitals provided $1.6 billion in uncompensated care, including $936 million in free, indigent, and charity care and $671 million in care for which the patient did not pay his or her bill and was not qualified for the hospital’s indigent or charity care programs.,[viii]
 Uncompensated care is an overall measure of hospital care provided for which no payment was received from the patient or insurer. It is the sum of care for which the hospital never expected to be reimbursed and care for which it is unable to obtain reimbursement for the care provided, called “bad debt.” Uncompensated care excludes other unfunded costs of care, such as underpayment from Medicaid and Medicare.
[i] The Henry J. Kaiser Family Foundation, “Health Insurance Coverage of the Total Population,” accessed March 12, 2014, http://kff.org/other/state-indicator/total-population/.
[ii] The Henry J. Kaiser Family Foundation, “Distribution of the Nonelderly Uninsured by Federal Poverty Level,” accessed March 12, 2014, http://kff.org/uninsured/state-indicator/distribution-by-fpl-2/?state=GA.
[iii] Mark A. Hall, “Health Care Safety Net Resources by State,” Robert Wood Johnson Foundation, February 2012, http://www.rwjf.org/en/research-publications/find-rwjf-research/2012/02/health-care-safety-net-resources-by-state.html.
[iv] National Association of Community Health Centers, “Georgia Health Center Fact Sheet,” http://www.nachc.com/client/documents/research/GA12.pdf.
[v] Georgia Charitable Care Network, “10 Years of Service,” http://www.house.ga.gov/Documents/CommitteeDocuments/2013/MedicaidReform/MEDICAREREFORM%20COMM%20flyer.pdf.
[vi] Georgia Charitable Care Network, “Georgia Charitable Care Network – Partners in Georgia’s Safety Net,” Handout provided by the Georgia Charitable Care Network.
[viii] Georgia Hospital Association, Hospitals 101: A Resource Guide for Elected Officials, Fourth Edition, February 2014, 3, https://publications.gha.org/Portals/4/Hospital101UpdatedApril2014.pdf; American Hospital Association, “American Hospital Association: Uncompensated Hospital Care Cost Fact Sheet,” January 2013, http://www.aha.org/content/13/1-2013-uncompensated-care-fs.pdf.