A registered nurse administers a shot at the Franklin-Williamson Bi-County Health Department during a clinic in 2012.

Most Illinoisans say they have a health plan or coverage and a primary care doctor, but many also indicate that access to high quality health care is a problem for their local community, according to findings from a statewide poll conducted March 11-17 by the Paul Simon Public Policy Institute at Southern Illinois University Carbondale.

The poll sampled 1,000 registered voters and has a margin of error of plus or minus 3.1 percent. The results of this poll vary considerably between age and racial groups.

Compared to a nationwide poll conducted by Pew Research Center in Spring of 2016 and 2018, though, Illinois respondents say they have better health care coverage and see access as less of a problem. Illinois is a state with Medicaid expansion and a diversity of rural, suburban, and urban populations.

Almost all (96 percent) of the respondents said that they had a health plan or coverage, only 4 percent reported no coverage. Health care coverage varies little across income and education levels, regions of the state, and party affiliations.

“When Illinois opted to accept federal funds from the Patient Protection and Affordable Care Act to expand Medicaid, the state increased the eligibility threshold for people to receive Medicaid to 138 percent of the poverty level, making it possible for more people to receive health care coverage,” Kristen Dunlap-Berg, a social work intern at the Paul Simon Public Policy Institute, said in a news release.

The polling shows disparities in health coverage based on age and employment. Ninety-six percent of those ages 51 to 65 and 99 percent of those older than 66, reported that they have health coverage, compared to 92 percent of those younger than 35 and 93 percent of respondents ages 35 to 50. Additionally, full-time and retired employees are insured at rates of 95 percent and 99 percent, respectively, but rates of health coverage of those who are employed part-time and those who are unemployed are only 91 percent and 88 percent, respectively.

When asked if they currently have one person they regard as their primary care doctor or health care provider, 88 percent of the respondents said yes and 12 percent said no. There were considerable differences among age groups. Sixty-six percent of respondents under the age of 35 said yes, and 81 percent of respondents ages 35 to 50 said yes. Meanwhile, 92 percent of respondent between the age of 51 to 65, and 95 percent of those over 60 said yes. This indicates that the elderly, those who are eligible for Medicare, are the group most likely connected to a primary care doctor.

Similarly, 81 percent of full-time employees, 87 percent of part-time employees, and 85 percent of those who are not employed reported they had one person they think of as their primary care doctor, while 96 percent of retired respondents said they did.

“The Affordable Care Act encourages the usage of patient-centered medical homes, so patients can have consistent care from one medical team, including a primary care doctor," Dunlap-Berg said in the release. "This provides increased access to preventive services and sustained management of chronic illnesses.” 

Respondents were asked if access to high quality health care in the local community is a big problem, small problem or not a problem. Twenty percent said access to good quality healthcare was a big problem, and 19 percent said it was a small problem. Fifty-six percent said it was not a problem, and 5 percent said other or they didn’t know.

White respondents answered big problem at a rate of 15 percent, as opposed to 33 percent of black respondents, 29 percent of Hispanic respondents, and 32 percent of respondents of other races. Sixty percent of white respondents said that it wasn’t a problem, compared to 43 percent of black respondents, 42 percent of Hispanic respondents, and 46 percent of respondents of other races.

Young adults were more likely to report access as a big problem (30 percent), compared to 21 percent of those ages 35-50, 20 percent of those ages 51-65, and 15 percent of those 66 and older.

“This poll highlights the strengths the state of Illinois has in terms of health care coverage rates, as well as the racial and ethnic disparities that need to be addressed,” Dunlap-Berg said. “Due to the state’s expansion of Medicaid, almost all people have health coverage, a fact that would be affected by any decision made about the future of the Patient Protection and Affordable Care Act.”

National Results

Since the ACA has been enacted, millions of individuals in states throughout the country have purchased new plans from the marketplace and millions of others have either joined the state’s Medicaid rolls, been granted the authority to stay on their parent’s insurance coverage or taken part in Medicaid expansion. The Institute poll results suggest that healthcare coverage in Illinois is above the national average. Only 84 percent of national survey respondents reported having healthcare coverage. Seventy-six percent of the respondents in the national poll responded yes, they have one person they think of as their primary care doctor or health care provider. Twenty-seven percent of national respondents reported access to good quality health care as a big problem, and 30 percent said it was not a problem at all.

Respondents in Illinois were more likely to report that they had one person they saw as their primary care doctor, as well as have health coverage or a health plan. Likewise, when responses were totaled, respondents reported health care access to be less of a problem in Illinois than in the national survey.

“Both the Illinois poll and the national data point to a marked increase in the number of individuals enrolled in insurance. However, the results indicate that disparities in access persist by race and age; therefore, policy makers must continue to pay attention to the social determinants of health and the impact for certain racial, ethnic and socioeconomic groups,” said Linda Baker, university professor at the Paul Simon Public Policy Institute.

These questions were replicated from surveys by the Pew Research Center for the People and the Press. Questions about health care access in the community and having one person respondents thought of as their primary care doctor were duplicated from a survey conducted May 10 to June 6, 2016. The question regarding whether respondents have health care coverage was replicated from a survey conducted April 25 to May 1, 2018.

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