THE UNINSURED & MEDICAID
At The Access Project, we believe that true change occurs when communities have engaged, informed and confident community leaders who can influence the policymaking process, articulate the needs of the uninsured and the underserved, and work together with sometimes unlikely allies to find solutions. To accomplish this goal, The Access Project specializes in helping community groups gather data to be used to inform policy decisions and design strategies to change policy.

REPORTS AND PUBLICATIONS

The Free Care Safety Net: A Fact Sheet (9 p., ©1999)
Information about what free care is and why providers should be expected to provide it. Includes a discussion of how free care is different from bad debt, what a model hospital free care policy should include, and how to help hospitals to be accountable for their community responsibilities.
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Paying for Health Care When You're Uninsured: How Much Support Does the Safety Net Offer?
(18 p., ©2003) In 2000, The Access Project collaborated with 24 community-based organizations to survey the uninsured about their experiences getting care at local, mainly safety-net, health care institutions. Called the Community Access Monitoring Survey (CAMS), the survey gathered data from over 10,000 uninsured people who received care at 58 different health care facilities in 18 states.
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The Uncompensated Care Pool: Saving the Safety Net (32 p., ©2002)
This Issue Brief examines the Uncompensated Care Pool through the lens of access to care. It presents the basics of the history of the Pool, how it works and how it is funded; considers how well the Pool promotes access to care; and examines whether Pool financing is adequate to fulfill its central purpose. Finally, the brief identifies areas of reform for policy makers to consider concerning financing, how and where care is provided, and the monitoring of Pool operations.
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Untangling DSH: A Guide for Community Groups to Using the Medicaid DSH Program to Promote Access to Care (77 p., ©2000)
If you are looking for resources to increase access to healthcare services in your state, you may want to learn more about Disproportionate Share Hospital funds. DSH was created as part of the Medicaid program to compensate hospitals for the added cost of serving a disproportionate share of low-income individuals who either are part of the Medicaid program or have no insurance and use of these funds are not widely understood. This manual helps to "untangle" DSH.
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Using Risk Factors to Assess Health Care Access in a Community  (12 p., ©2000)
Risk factors are a useful tool in local policymaking efforts. Although there is no single access measure broadly available that evaluates access to health care in any state, county, or town, research literature has documented “risk factors”—certain population and economic characteristics—that are associated with primary measures of access. This paper examines those risk factors and suggests how this info rmation might be used to improve access.
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COMMUNITY SPECIFIC REPORTS

The follow community reports were produced by The Access Project in conjunction with local organizations across the country.

District of Columbia
A Healthcare Safety Net in Tatters: Hospital Free Care in the District of Columbia (12 p., ©2000)
Risk factors are a useful tool in local policymaking efforts. Although there is no single access measure broadly available that evaluates access to health care in any state, county, or town, research literature has documented “risk factors”—certain population and economic characteristics—that are associated with primary measures of access. This paper examines those risk factors and suggests how this information might be used to improve access.
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Florida
Health Care Access Issues in Palm Beach County (24 p., ©2002)
The info rmation included in this report was gathered from a review of available secondary materials, including census data, state health data, local reports and assessments, and from key info r mant interviews with 28 community leaders in Palm Beach County.

2002 Palm Beach County Community Health Assessment (©2002)
The 2002 Palm Beach County Community Health Assessment is a systematic, data-driven approach to determining the health status and needs of residents in Palm Beach County, with particular emphasis on the health care access issues impacting so many in the community.

Lives At Rick: Nearly Half Million Uninsured in Miami-Dade County (41 p., ©2000)
This report analyzes data from the Florida Health Insurance Study. Mandated by the Florida legislature in 1997, the purpose of the FHIS was to develop more accurate and precise estimates of who lacks health insurance in the state and within defined geographic regions. Using the FHIS and other sources, this report presents a picture of the uninsured in one of these regions, Miami-Dade County
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Illinois
Reducing The Number of Uninsured People in Illinois: Models for Action (9 p., ©2000)
The report, prepared with United Power for Action and Justice of Illinois, is based on a review of Census Bureau data. It describes the dramatic increase in the number of uninsured people in Illinois between 1997 and 1998. Despite a booming economy, the number of uninsured people grew from 1.5 million to 1.8 million in a year's time. This one year increase from 12.4 percent to 15 percent of the population, gives Illinois one of the fastest growing uninsured populations in the country.

The Uninsured in Illinois and Chicago: Close to 2 Million Face Barriers to Health Care (19 p., ©1999) Produced to support the work of United Power for Action and Justice of Illinois, this report describes the growing number of people without health insurance in Illinois and the consequences associated with this situation.
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Massachusetts
Ecu-Health care: An Ecumenically sponsored Medical Program in North Adams, Massachusetts (14 p., ©1999)
Private citizens helping members of their community: Educating public agencies and combating the stigma associated with public health insurance programs.
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New York
Neglected and Invisible: Understanding the Unmet Healthcare Needs of People on Long Island (57 p., ©2002)
This report documents the efforts of the Long Island Health Access Monitoring Project (LIHAMP) to learn more about the people whose medical needs are largely unmet by the limited and frayed safety net of Long Island. The LIHAMP set out to survey the unmet health needs and the barriers to care encountered by uninsured and medically indigent people on Long Island.
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Oregon
The Marion and Polk Counties Health Access Monioring Project: A Report on Health Access for the Underserved Populations of Marion and Polk Counties (14 p., ©2000)
This report was done in collaboration with the Oregon Health Action Campaign (OHAC). The report represents OHAC's recommendations to improve health access in Marion and Polk counties by broadening and deepening community involvement in healthcare advocacy.
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Texas
Profile of the Uninsured in Texas (23 p., ©2000)
Texas has one of the highest uninsured rates in the country; more than one-tenth of the nation's uninsured live in Texas. This report describes the characteristics of the uninsured in Texas comparing some of the key characteristics with national data. The report then looks at where the important gaps in coverage are and recent Texas policies to address the problem.

Providing Health Care to the Uninsured in Texas: A Guide for County Officials (72 p., ©2000)
This comprehensive guide provides, in detail, a description of the health care system for the uninsured in Texas. It includes an outline of the types of health insurance people have in Texas, and a description of the Texas uninsured in comparison to the general population.
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