The tragic shooting at a movie theater in Aurora last week has horrified all of us in Colorado and across the country. In addition to the 12 people who were killed, 58 more were shot and have required medical care that ranged from relatively minor to very major. And while we don’t know the health insurance status of the victims (to my knowledge that information hasn’t been released), we do know that The Dark Knight’s audience included a large number of young adults, which is the population most likely to be uninsured in Colorado.
Five years ago, when the Lewin Group was preparing data for the Colorado Blue Ribbon Commission, they found that 38.7% of 19 – 24 year olds in Colorado were uninsured, as were 27.1% of 25 – 34 year olds (see the graph on page 6). Those two age groups were significantly more likely to be uninsured than any other age group. More recent data from the Colorado Health Institute found that 27.7% of 19 – 34 year olds in Colorado had no health insurance in 2011, up from 22.7% in 2009 (the increase comes despite the fact that starting in 2010 the PPACA allowed young adults to remain on their parents’ health insurance policies up to age 26). As with the earlier Lewin Group study, that age group is far more likely to be uninsured than any other age group in Colorado.
So now the 58 surviving victims of the theater massacre will need medical care that ranges from relatively minor to very major. Some have already been discharged from the hospital, while others will likely remain there for a while. Three of the five hospitals in the Denver metro area that are treating the shooting victims have agreed to waive most or all of the hospital bills incurred by the victims. The other two hospitals – University of Colorado Hospital and Denver Health – haven’t said what their specific policy will be with regards to medical bills for the shooting victims in their care, but those are Colorado’s top two safety net hospitals and they provide hundreds of millions of dollars worth of free care to uninsured patients each year.
It’s reassuring to know that the theater shooting victims – quite a few of whom likely have no health insurance – will have at least some help with their immediate hospital bills. What’s less clear is the financial implications for the more gravely injured victims as they move forward with their treatment after being discharged from the hospital. Physical and occupational therapy, outpatient follow ups, mental health treatment to cope with the trauma – these expensive services are likely to be a big part of some of the victims’ lives for the foreseeable future. Individual health insurance is still medically underwritten (until January 2014), so it would be difficult or impossible for uninsured victims to obtain health insurance now to cover future medical bills related to the shooting (CoverColorado and GettingUSCovered – the state’s high risk pools – are an option available to people with pre-existing conditions). They may be able to obtain health insurance through an employer group plan, but the ones who are uninsured likely didn’t have that option in the first place.
Some of the families are raising money on their own, and there are various organizations – including Warner Bros. studio – that are raising or contributing money on behalf of the victims. And although they are facing a terrible ordeal, even the uninsured victims of this shooting are far luckier from a financial perspective than most people – especially the uninsured – who are injured or become seriously ill every day. Because the killer shot so many people in such a public and random manner, just about everyone in the country knows at least the basics of what happened. And when tragic circumstances receive a lot of publicity, support tends to pour in. This isn’t usually the case with the vast majority of tragic stories that play out all across the country every single day. Those stories usually involve just one person at a time and don’t command gripping news coverage – so we often don’t hear about them at all. But the injured or ill people involved – especially if they are uninsured – have just as much of a financial burden to bear as the victims of violent acts that are highly publicized.
The news coverage about the medical bills for people injured in the Aurora shooting will hopefully bring attention to the financial struggles faced by people who suffer a catastrophic medical condition without health insurance. Although it’s great that many of the victims won’t have to cope with crippling hospital bills, their rehab could still be very costly. And most importantly, we need to remember that there are millions of uninsured (and very under-insured) Americans who could find themselves in a similar predicament on any given day.