Boston has striking disparities in health insurance coverage, particularly in communities like East Boston and Dorchester, which have nearly double the rate of uninsured people compared to the rest of the city.
Ahead of the Nov. 1 open enrollment date, Massachusetts Health Connector workers and volunteers have set out on a series of walks through those communities, popping into businesses along in Dorchester Thursday to drop off information about how to enroll.
At Namel’s Barber Salon on Washington Street, owner Derrick Marshall looked up from his work on a young man’s fade to gesture over to organizer Valentina Amaro, letting her know where to drop a pile of Health Connector pamphlets.
The rate of people without health insurance in Marshall’s neighborhood dwarfs that of the city: Dorchester’s uninsured rate is 6.8%, compared to Boston’s 4.7%.
The 53-year-old barber has owned his shop for 30 years. He says health insurance, for many people, is a consideration that comes later in life.
“When you get older, those types of things become more important,” Marshall told GBH News. “When healthy, you don’t think so much about insurance. It’s like having windshield wipers on your car: as long as it’s not raining, you don’t think much about it.”
“Most people don’t think about insurance until sickness comes,” Marshall continued, “and that’s when the problems start.”
Racial disparities are striking among adult residents who can’t afford a doctor, according to a report from the Boston Public Health Commission: Latino residents make up 16% of that group, and Black residents represent 13%, as compared to 5% for white residents.
Young men, especially in Black and Latino communities, represent the largest group of uninsured people across the state, according to Jason Lefferts of the Mass. Health Connector.
“We have known for a long time that the young ‘invincibles’ are the toughest to persuade,” Lefferts told GBH News. “We go about that through a number of different ways: we try to get signage up in the barbershop where they're going; we've created messaging for moms and girlfriends, knowing that moms and girlfriends are a powerful voice to young men to try to get them to put pressure on to sign up.”
Despite an abundance of healthcare resources, “vulnerable populations continue to experience persistent barriers to care,” according to the Boston Public Health Commission report. Key groups include immigrants, non-English speakers and people below the poverty line.
“The population in this state is growing, and there are immigrants and people coming into the state on a constant basis, and they're signing up for health insurance,” Lefferts said. “But there are people who haven't done it, and you know, we want to chase every single one of them down.”
As of this year, under the federal American Rescue Plan, people already enrolled in Marketplace insurance can qualify for more tax credits and lower health insurance premiums, and people who were previously ineligible are now able to apply for coverage.
Mai Nguyen, who owns a nail salon in Dorchester, says those changes in subsidies had a massive impact on her financial situation — a reduction of $300 per month that she had been paying to secure health insurance for herself and her son.
“Before this year, I paid $500, and they didn’t cover everything, when I went to clean my teeth, nothing,” she told GBH News. As of this year, Nguyen pays $200 per month.
Even for people who are currently ensured, Lefferts says there are existing ways — and new opportunities — to reduce their monthly premiums.
“That's the biggest part of what we're trying to do here,” Lefferts said, “to make sure people know that there's financial assistance available and there's people who can sit down and help you get that assistance.”
The open enrollment period ends Jan. 29. Residents can sign up for coverage at www.MAhealthconnector.org, over the phone at 1-877-MA-ENROLL (1-877-623-6765), or in-person through a local navigator organization.
