Omicron could hit the hardest of low-income uninsured Texans

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Much of the last two years have felt unrealistic for the staff of Centro De Salud Familiar LaFe, a federal qualified health center in El Paso. Overnight, the Women’s Health Center became a coronavirus unit. They started offering the COVID-19 test and then provided the vaccine pop-up as soon as possible. They announced public services, made door-to-door visits, and encouraged people to be vaccinated.

But despite the unprecedented nature of the pandemic, some things weren’t surprising, as how much it hit their low-income, uninsured customers.

“This area has been hurt for a long time,” said spokesman Estela Reyes-López. “I don’t have the money I need. I don’t have the care providers I need … The coronavirus situation only exacerbated what was already happening.”

La Fe primarily serves the low-income, uninsured Texans and sees the various impacts of the pandemic on the most vulnerable communities. Many people have an hourly public job that they cannot wait for the COVID-19 test or rest for quarantine. Others have a chronic, untreated health condition that makes them more susceptible to serious illness. Nationwide Uninsured people have a delayed immunization rate.

And now, as the new COVID-19 wave could hit the Texas coast, Rafe’s staff are once again preparing to hit these same communities the hardest.

“Currently, the biggest crisis we face among uninsured people is the cost of getting tested and the confusion about where they can be tested,” said Jorge, LaFe Community Health Manager. Salazar said. “And it’s a free vaccine, but they hesitate even if people aren’t used to it.”

Medical vulnerability

Many questions remain about Omicron, a new variant of the highly contagious coronavirus, but medical experts say that preparation has proven to be the key to how the community survives the disease. increase. And many uninsured, low-income Texas people may be underprepared after decades of lack of medically adequate service.

2019, Over 18% of Texas people did not have health insurance, The highest rate in the country, more than double the national average. Texas is one of only 12 states that have opted out to expand access to Medicaid under the Affordable Care Act.

In El Paso County, where Rafe is based, A quarter of adults under the age of 65 I do not have health insurance. According to Salazar, this means that the area was already behind the ball when the pandemic occurred.

“The problem is not only the lack of current health insurance, but the lack of historic health insurance,” Salazar said. “They were unable to participate in preventive care or stay healthy.”

According to Salazar, health center clients often deal with chronic or untreated health conditions that endanger the immune system and make it more susceptible to severe cases of COVID-19. This undertreatment may have been exacerbated during the pandemic, as many were unable to avoid or receive treatment in the emergency room, which could be the gateway to uninsured patients’ health care systems. He said.

Like El Paso, it’s the same story in the Lower Rio Grande Valley. One of the lowest health insurance rates in the state..

“For example, many people have comorbidities such as undiagnosed diabetes and under-treated diabetes,” said Deputy Director and Chief Medical Officer for Clinical Studies at the University of Texas at Health Rio Grande Valley. Michael Dobbs says. “Their immune system may not work well. They are susceptible to infection. Therefore, long-term hospitalization with a ventilator is very dangerous for these patients.”

“Perfect Storm”

The year-end and New Year holidays are approaching, the number of omicrons is increasing, Many Texas people are scrambling to get the COVID-19 test.. But that too would be difficult for the low-income, uninsured Texans. Many of them can’t afford expensive home kits or can’t make long lines on free test sites.

“Initially, access to publicly accessible test centers was much more and free,” said Brian Sasser, Chief Communications Officer at the Episcopal Health Foundation. “Obviously, it was beneficial to everyone, especially those without insurance.”

However, many uninsured people will not be able to get the test if the test requires out-of-pocket costs or a doctor’s consultation, Sasser said. This is especially true for people who work on paid leave or work that does not provide insurance.

“This is one of the harder loops to take the test, and the incentive to take the test is lower, because if you find yourself positive, you won’t be paid for the job.” He said. “The end result is that people are at risk … and potentially endangering others. It’s all a perfect storm.”

Sasser hopes that the pandemic emphasizes employment and the vulnerability of the health insurance system, which is often associated only with the full-time profession. By May 2020, just two months after the pandemic occurred It is estimated that more than 650,000 Texas people have lost their employer-sponsored health insurance.

Delayed vaccination rate

Currently, one of the most pressing questions for healthcare professionals is how effective the COVID-19 vaccine is against the Omicron strain and how to introduce more vaccines and boosters to the community. In El Paso County 65% of residents It is fully vaccinated and is about 10 percentage points higher than the entire state. Salazar, along with La Fe, said it would take a lot of work to get these shots into weapons.

“The most important part is outreach. People knock on the door, let people know that we are there, we don’t need insurance, and we don’t need any paperwork other than identification. To be able to immunize everyone, “he said. ..

Coronavirus vaccines and booster shots are free, regardless of whether the patient is insured. Texas does not track the insurance status of vaccinated individuals, National survey from Kaiser Family Foundation In September, it was found that uninsured adults were significantly behind vaccination.

Health care workers who serve uninsured patients say they are hearing concerns about hidden costs, such as side effects that require medical care. Or, they worry, uninsured people may not have a reliable medical professional they can seek advice on.

In border areas like El Paso, Salazar said he is fighting growing distrust of the government. He said the governor. Greg Abbott And former President Donald Trump has aroused fear of immigration law enforcement in the Latin community.

“Then, suddenly, they say we have to be immunized, and we’re starting to see some of these ghosts of the lack of trust in the past appear,” he says. I did.

“Wearing immigrant shoes that are front-line workers who can’t speak a language, live in a colony, have to work to survive, and at the same time may have someone else in their home. Please. “There is all the proper paperwork,” he said.

In addition to these personal situations, the rising rhetoric and enforcement of immigration restrictions, Salazar said, is an “unstable combination” of forces that discourage locals from seeking public services, including vaccines. Stated.

This fear is not limited to borders. In other parts of the state, Black leaders mobilized Dealing with vaccine hesitation due to Distrust of government and health care system, often hostile to black patients.. There was also early concern that the black and Hispanic communities did not have equal access to vaccination sites.

Hispanics are currently vaccinated at a slightly higher rate than whites in Texas, Blacks continue to have the lowest immunization rates in the state..

Disclosure: The Episcopal Health Foundation is a financial supporter of The Texas Tribune, a non-profit, non-partisan news organization partially funded by donations from members, foundations and corporate sponsors.Financial supporters play no role in the tribune‘Journalism.Find the perfect one List them here..