Many Ohio veterans passing up free health care
About 52,000 military veterans in Ohio younger than 65 either do not have health insurance or are not enrolled in the U.S. Department of Veterans Affairs health care system, leaving many of them and their families with unmet medical needs or leading them to forgo care because of costs, according to new research examining census data and other studies.
Veterans without insurance may be unemployed, unable to afford private coverage or unaware of VA-care eligibility.
“There are a lot of options available to veterans concerning health care,” said Mike McKinney of the Ohio Department of Veterans Services.
“The vast majority of our veterans from the last 10 years should be covered,” McKinney said.
The Washington-based Urban Institute reported that one in 10 veterans in Ohio younger than 65 and an additional 35,000 military spouses and childrenor about 7 percent of the total 504,855 military family members in Ohioare uninsured. The report analyzed state survey data for 2009 and 2010.
Uninsured veterans typically have poor access to health care, and they are less likely than their insured counterparts to visit a doctor regularly and seek out important preventive care.
Military officials are urging veterans to explore their options with the VA health care system to determine whether it can serve their needs.
Jennifer Haley, research associate with the Urban Institute and co-author of the report, said it is impossible to know exactly why many veterans lack insurance, but some may not be eligible for VA care while others may be unaware they qualify or may live too far away from a VA facility to conveniently access services.
A lack of insurance is associated with more problems accessing care. Haley said data she analyzed showed that about 41 percent of uninsured veterans have unmet health needs and more than 30 percent have delayed seeking out care because of cost.
“Some people assume that anyone who has either served themselves or had a family member serve would be able to easily access any health care they might need,” she said. “We identified (an underserved) population that would surprise some people.”
Barriers to care
Uninsured veterans face some of the same barriers to obtaining coverage as the civilian population. They may be unemployed and cannot afford coverage, or they might have a job but do not earn enough to pay for medical coverage, officials said.
Uninsured veterans tend to be younger and have lower levels of education. They are more likely to be unemployed and less likely to be married, according to the Urban Institute.
Most veterans with medical coverage have private insurance, usually through their employers. But many veteransabout 8.6 million peoplereceive health care benefits under the VA health care system. The Dayton VA Medical Center provided health care services to more than 38,000 veterans in fiscal year 2011.
Eligibility for VA care is based on income and whether a veteran has ailments and medical issues connected to their time in service, said Steffie Woolhandler, professor of public health at the City University of New York who published a study on uninsured veterans in the American Journal of Public Health.
“If you get your leg blown off, you can get care for your leg for the rest of your life, and people who develop mental health problems can get coverage for those problems,” she said. “Also, if you are veteran and you are very poor, you can become eligible for care.”
In Ohio, there are eight VA vet centers, five VA medical centers and 28 outpatient clinics. Most services are available within 25 miles of all Ohio residents, and the care they provide is very good, said Don Lanthorn, service director at the Ohio American Legion.
The only problem is that not everyone meets the criteria to receive VA care. The American Legion supports expanding eligibility to all veterans, he said. “Eligibility is the big issue.”
Many uninsured veterans could already qualify for VA care and simply not know it, said Jerry Manar, deputy director of the Veterans of Foreign Wars’ National Veterans Service.
“I think a significant number of that 10 percent of Ohio veterans who don’t have any health insurance have totally forgottenif they ever knewthat the VA exists,” Manar said. “They just don’t know they can come to the VA for health care.”
In fact, about 75 percent of the 1.3 million uninsured veterans across the nation cited in the Urban Institute’s report may be eligible to enroll in VA care based on their income or service-related disability, said Craig Larson, spokesman with the U.S. Department of Veterans Affairs.
Veterans who were recently discharged from the military after serving in Iraq and Afghanistan are generally eligible for VA health care for a period of five years, while other veterans may be eligible based on service connection, their incomes or other criteria, Larson said.
Eligibility for VA health care is unique to each individual, but all eligible veterans are encouraged to seek care at the Dayton VA Medical Center, according to center staff.
Hospital staff members said some veterans may be subject to co-payments for health care and pharmaceuticals, but people who have trouble paying their medical bills can receive financial counseling and participate in repayment plans.
About one in four veterans receiving care at the Dayton VA Medical Center have billable health insurance, and about half have Medicare coverage, according to VA officials.
If the Affordable Care Act goes into full effect, it could expand Medicaid eligibility to as many as half of uninsured veterans, according to the Urban Institute. Another 40 percent of uninsured veterans may qualify for subsidized coverage through health insurance exchanges.
