By Tony Eskridge and Shailly Gupta Barnes

October 2022

Health Care and Health Outcomes for the Poor 

Denial of Healthcare

  • In 2018, there were 87 million people who were uninsured or underinsured. 
  • During the pandemic, 6 million workers lost their employer sponsored insurance. Factoring in family members, closer to 12 million people lost health insurance.
  • 42% of uninsured immigrants are undocumented and nearly 60% of people in the Medicaid coverage gap are people of color
  • 75% of low-wealth people who have insurance coverage still cut back on basic necessities to pay for medical expenses.
  • Nearly half of rural hospitals have a negative operating margin, and nearly 25% of rural hospitals (over 450) are on the verge of closing. Of those that remain, 62% do not have ICU beds. 

Poverty and the Pandemic 

  • During the pandemic, the poorest communities experienced a COVID death rate twice as high as the richest communities. During the deadliest waves of the pandemic, the death rates were 3, 4.5, and sometimes 5 times as high.
  • The poorest counties with the highest death rates have double the uninsurance rates and a larger population of cost-burdened renters than richer counties. 
  • If the United States had in place a universal health care system, at least 330,000 lives could have been saved from COVID-19 related deaths. 
  • At the height of the pandemic in 2020, 30-40 million people were at risk of eviction
  • During the first two years of the pandemic, families had their power cut off more than 3.6 million times. This data is vastly underreported.
  • 100 million people do not have access to paid leave after the birth or adoption of a child, and 46% of workers are not guaranteed unpaid, job-protected leave
  • Low-wage workers are more likely to not have access to paid sick and personal leave than any other group.

Disability and Long COVID

Medical Debt

  • The American people hold over $195 billion in medical debt, and medical debt is the number one reason for household bankruptcy in the US. Poor, historically oppressed and people with disabilities or chronic illnesses are most likely to be burdened with medical debt.
  • Over one-third (37%) of people with medical bill issues used up all their savings to pay for their medical bills. Nearly two-thirds (63%) avoided or delayed medical care for fear of the cost. 
  • Out-of-pocket costs have doubled in the past 20 years, from $193 billion in 2000 to 388 billion in 2020. Deductible payments have grown 10 times faster than inflation from 2007 to 2017. The average out of pocket spending for COVID related care was $788 for privately insured people.
  • Big hospitals engaging in predatory billing practices seek over $71 million from patients too poor to afford life saving care.

This is why the Poor People’s Campaign: A National Call for Moral Revival has been calling on Congress to do the following to secure the human right to health: 

  • Expand Medicaid and Protect Medicare as public goods
  • Establish a universal, single payer healthcare system that provides healthcare to all, regardless of income, disability, prior health conditions, employment status, immigration or carceral status 
  • Move federal resources and capacity towards rural hospitals, prioritizing hospitals in poor, low-income, rural and native communities.
  • Increase resources for Indian Health Services
  • Expand veterans health care 
  • Establish a federal relief fund to end all medical debt, especially for poor and low-income people
  • Secure the right to housing by stopping all evictions, building public housing, and ensuring the costs of housing are within the income abilities of every household
  • Institute a moratorium on all shut-offs; turn the water and lights back on; and relieve water and utilities debt 

Resources for additional study: