Instead of being worried about losing access to the health-coverage expansions that resulted from the Affordable Care Act, my vision for 2017 and beyond is that Massachusetts continues to provide progressive leadership in developing new ways to improve the availability of high-quality medical care, behavioral health care, and oral health care. In many ways, we have an extraordinary safety net in our community through individual health care providers and partners such as pharmacies, generous donors who help fill in gaps, and benchmark facilities, including Martha’s Vineyard Hospital, Island Health Care, and Martha’s Vineyard Community Services. However, there are many areas where we could work together to achieve improved quality of life, especially for vulnerable Islanders.
Some components of an improved system for the Vineyard would be:
- Health care security for Islanders in all income brackets. This means support for those who have access to employer-sponsored health insurance, but find the premiums unaffordable. It also means additional support for those whose incomes are modestly above the income guidelines for subsidized plans: for example, a gross annual income of $48,000 for a household with two people. If a couple now earn $65,000 a year, premiums and out-of-pocket expenses are no longer affordable, particularly given the high cost of living on the Vineyard.
- Restoration of the Transportation Access Program, which helped Islanders pay for medical transportation to off-Island medical appointments. The added cost of medical transportation is often a financial hardship for individuals and families, especially for multiple appointments.
- Increased oral-health service capacity for Islanders with lower incomes. We need the equivalent of three or four dental chairs, with two additional dentists and two hygienists to really meet the dental needs of our community.
- Ongoing development of supportive social services related to affordable housing and homelessness prevention, public benefits such as food stamps and disability income; case management for people with complex medical and behavioral health challenges; and specialized geriatric care for the elderly.
The Vineyard Health Care Access Program has been assisting Islanders with affordable health care and related supports since 1999, well before the advent of health care reform in Massachusetts, and subsequently nationally. While we do not know what specific changes will take place with the Affordable Care Act and the impact on Massachusetts programs, we can safely assume that changes are coming. We are committed to providing ongoing support to the 2,800 Islanders whom we assist every year, in whatever legislative or programmatic environment the future brings.
The Dukes County/Vineyard Health Care Access Program was founded as a small pilot program by the Dukes County Health Council in 1999 and now serves more than 2,500 Islanders each year.
Sarah Kuh is the director of the Dukes County/Vineyard Health Care Access Program.