Date of Publication



Abstract: Uninsured Americans are a growing population as insurance premiums climb and fewer employers offer health coverage. Providing medical care to the uninsured often represents a significant financial loss to medical institutions. Our study sought to describe the insurance history and barriers to obtaining health coverage for uninsured patients at the Community Health Center of Burlington, Vermont (CHCB). The potential benefit of adding an insurance eligibility position to the staff at CHCB was also explored. Data were collected by random phone survey from 100 CHCB patients identified as uninsured at their last visit; patients were queried regarding insurance history and interest in enrollment assistance. At the time of survey 66% were currently uninsured, and the majority (87.9%) of these respondents previously held insurance. Loss of insurance was most often due to a change in job status, income or a change in eligibility. Cost was a major barrier to insurance noted by individuals; on average respondents indicated they would be willing to pay around $65 per month for overage. A majority (75.7%) of uninsured respondents also expressed interest in an onsite eligibility worker. These data suggest that the patient population at CHCB would be well served by implementing some form of eligibility staffing. There are a number of different health insurance options in Vermont that could benefit these patients, provided they have assistance with applying. Due to the small sample size of our survey, we recommend that the scope of the eligibility position be determined by closely examining the caseload encountered.


Jon Bourgo, Community Health Centers of Burlington

Hendrika Maltby, PhD, RN, FRCNA, University of Vermont College of Nursing and Health Sciences


Community Health Center of Burlington


Access to Health Services


Presented at the 136th APHA Annual Meeting, San Diego, CA, October 21, 2008 as "Health Coverage History of Local Uninsured Patients: Assessing the Need for an Eligibility Specialist," by Caleb Bailey, Lyle Gerety, Michele H. Guignon, Aaron S. Helminski, Audrey A. Merriam, Joseph Ravera, Alice Tang, William G. Tharp, Jon Bourgo, Hendrika Maltby, PhD, RN and Jan K. Carney, MD MPH.

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Health Coverage History of Local Uninsured PatientsAssessing the Need for an Eligibility Specialist