Upstate New York’s rate of those without health insurance hit a record low last year, but there’s still room for improvement, said an Excellus BlueCross BlueShield official.

Overall, 3.5 percent of upstate New Yorkers lack health coverage, the lowest number ever, according to Excellus’ analysis of Census data. That compares to an all-time low state uninsured rate of 5.4 percent.

"Even though we’re proud of the uninsured rate, we’re not completely satisfied because there are more people who should be covered," said Eve Van de Wal, Excellus’ regional president for Utica/Rome/North Country.

Many area residents qualify for, but haven’t signed up for, free or low-cost coverage under Medicare, Medicaid, Child Health Plus and the state’s essential plan, which covers people who earn a little too much for Medicaid, she pointed out.

For example, there are more than 23,000 New Yorkers age 65 or older who probably qualify for Medicare, but haven’t enrolled, according to an Excellus analysis of numbers from the recently released 2018 American Community Survey by the United States Census Bureau.

And more than 107,000 uninsured state residents younger than 19 probably could get coverage under Child Health Plus, Excellus estimated.

"I think the low uninsured rate is monumental," said Steve Wood, director of insurance programs for ACR Health, in an email. "People have access to health care, which only increases the health of the community overall, as well as a reduction in emergency room visits, catastrophic illness and likely a reduction in communicable diseases like the flu. The trend of healthier babies, children and seniors will continue to rise as well."

BY THE NUMBERS

The improvements in coverage in New York come as the federal government has rolled back the Affordable Care Act’s individual mandate, requiring everyone to have health insurance or face penalties, and scaled back its promotion of the federal health plan exchange. New York, though, has its own exchange, New York State of Health, which it has continued to promote heavily.

"Despite aggressive efforts at the federal level to block access to healthcare, New York continues to lead the nation in enrolling people into quality, affordable health coverage," said New York State of Health Executive Director Donna Frescatore in a statement. "As we prepare to enter our seventh open enrollment period, we will continue our efforts to help more New Yorkers gain access to the affordable healthcare they deserve."

PUBLIC AWARENESS

Van de Wal called for more education efforts to make people aware that they may qualify for government programs. The state has a network of enrollment facilitators who help people sign up for both government plans and for plans in the state marketplace for which subsidies are available depending on income.

But Excellus also is working to spread the word, she said. Within the past year, for example, Van de Wal said, the nonprofit health plan has hired community engagement outreach coordinators who go out into the community to share information with groups and reach out, in particular, to vulnerable populations.

"Our motto is one person at a time," she said. "If we can just get to one person at a time and can make a difference for that one person — that’s why we’re in business."

Wood works as a facilitator, helping to sign people up for insurance. "I think the biggest improvement we’ve seen is that more younger people are becoming insured," he said. "Historically, they have not sought insurance, but that has changed since the Affordable Care Act."

Rural residents and new citizens or those on the path to citizenship are among the hardest to reach, Wood said. The political climate can make immigrants reluctant to look for services, and rural residents don’t always trust the system, he said. They also may not have access to enrollment help or prioritize health insurance, Wood added.

And money definitely plays a role, Van de Wal said. The essential plan helps people who don’t quite qualify for Medicaid, but people who don’t quite qualify for the essential plan may still have trouble affording insurance even with subsidies on the health exchange, she acknowledged.

"That’s the population that’s the most challenging," she said.