Access to health care for the uninsured on Long Island: a case study

Sixteen percent of people living on Long Island have no health insurance. They do not receive health insurance at their place of employment and are too poor to pay for it on their own. Most are too young to qualify for Medicare and fall between the cracks of the Medicaid system. Not-for-profit hospitals receive funding from the state that requires them to provide some community benefits--the most important of which is charity care. The Long Island Health Access Monitoring Project (LIHAMP) was established as an arm of the Long Island Coalition for a National Health Plan to study the access to charity or free care for Long Island's uninsured population. In a study that incorporated three phases, LIHAMP surveyed 23 not-for-profit hospitals on Long Island. The results led to the passage of legislation in Nassau and Suffolk counties designed to assist the uninsured in receiving care. This article summarizes this project, which may be used as a model for other communities.