The Looming Crisis of Healthcare Inaccessibility During the COVID-19 Pandemic

The Looming Crisis of Healthcare Inaccessibility During the COVID-19 Pandemic

The Looming Crisis of Healthcare Inaccessibility During the COVID-19 Pandemic

I want to start this post with a little bit of a walk back in time. The year was 2003, and I had just started a new job. I was in my 20s, single, very active, taking no medications, and with no health issues. For these reasons, friends and colleagues were surprised when I said I was going to sign up for my company’s HMO health plan. Why choose an HMO when a PPO plan, which provided more (and presumably better) choice, was available?

I answered: because it wasn’t available to me.

As a child and adolescent, I had epilepsy. I hadn’t taken medication nor had seizures since I graduated from high school, but for the purposes of health insurance, that didn’t matter. I, along with 130 million other Americans, had a pre-existing condition that precluded me from accessing most health insurance plans. At that time, employer-sponsored HMOs were the only non-public (not Medicaid or Medicare) healthcare options available to people like me. My peers were skeptical that I would be denied health insurance. Well, there was a mixup in my paperwork, and somehow I was put into the PPO plan. A few weeks later, I received a letter telling me that I was rejected for health insurance due to my history of epilepsy. 

Until the Affordable Care Act (ACA) was passed in 2015, I was one of millions of Americans whose life chances and choices were directly impacted by the lack of affordable healthcare available for those with pre-existing (not even active or current) conditions. I could not just quit a job, move, or become a consultant or freelancer without fear of losing my healthcare and thereby facing a financial catastrophe if I experienced any major medical issue. Once married, I could not divorce if our health insurance was accessed through my spouse rather than myself. The Affordable Care Act changed all that, and enabled people like me to have personal,  employment and geographic mobility for the first time without risking a health crisis that might lead to bankruptcy.

Having health care directly tied to employment has notable consequences for all Americans, regardless of whether or not they have pre-existing conditions. Since the COVID-19 pandemic began in March of 2020, more than 14 million people have lost their jobs, and 12 million have lost their health insurance along with their employment. For many, this has meant a double-whammy of sorts: the loss of income at the same time that large COBRA payments, or more expensive premiums through the Affordable Care Act exchanges, would come due. By June, more than 500,000 additional Americans had signed up for healthcare under the Affordable Care Act due to the loss of health coverage as a result of the pandemic. It is not a stretch to imagine that many of those individuals have pre-existing conditions.

Within a few weeks, this healthcare crisis might grow exceedingly worse, as the Supreme Court will take up a case in November that might overturn the Affordable Care Act, leaving 23 million people without healthcare coverage immediately, and putting at risk the third of Americans with pre-existing conditions who rely on the prohibition of exclusion from care that the Act provides. 

What does this looming crisis mean for the financial health and stability of American families? The loss of healthcare through employment has led to immediate and acute need for families that can no longer afford reasonable coverage. At the same time, people are waiting to learn what will happen to their healthcare if they lose a job and/or the ACA is repealed. Further, the impact of healthcare costs is already a crisis for millions of Americans, even before any imminent policy changes. 

Indeed, a majority of US adults have to delay getting medical care or put it off completely because they can’t afford it. This is not just an issue for the uninsured. Recent studies show that most people who experience difficulty paying medical bills have health insurance. The unaffordability of medical care is also impacting families’ ability to pay off their non-medical debts and take advantage of new financial products. Recent numbers show that the 137 million Americans struggling with medical debt are dipping into their retirement and savings accounts and defaulting on other loans. Another 2019 study found that one-third of credit card holders are in debt because of medical bills. Healthcare costs and access impact every aspect of Americans’ financial health.

Here at SpringFour, we have seen first-hand how the COVID-19 pandemic has led to the increased need for additional healthcare savings resources for families. The charts below show the actual and percentage of total figures for healthcare-related referrals by quarter. These referrals include three categories: healthcare savings, health insurance assistance, and COVID-19 health (which is a category that SpringFour created in the weeks following the pandemic to cover COVID-19-specific healthcare needs). 

What we see below is a numeric spike in demand for healthcare-related referrals during Q2, at the height of when many Americans were losing their jobs. At the same time, we are seeing a continuous increase in healthcare-related referrals as a percentage of our total referrals — this tells us that healthcare is taking over more space in the lives of people who are experiencing financial challenges. In Q3 2020, these referrals accounted for more than twice the percentage that they accounted for in Q1. This trend is unlikely to wane any time soon — and it might explode if policy changes occur in Q4.

While these trends are alarming and concerning for American families, we believe that companies should be doing everything they can to help stave off a further healthcare crisis. For SpringFour, this means that we are committed to providing as many resources as we can. Throughout October, SpringFour added over 700 new resources in the Healthcare Savings category. The majority of these resources are Federally Qualified Health Centers that increase access to primary care, dental health, women’s health, disease management, and other preventative care. With increasing unemployment and more Americans losing their private health insurance along with their jobs, more people are beginning to look to Health Centers and other community resources for their basic health needs. The additional Healthcare Savings resources were focused on increasing coverage in rural communities where the Health Centers provide a crucial safety net. 

While we are dedicated to helping in any way we can, SpringFour is also aware that the impending healthcare and health insurance crisis is one of epic proportions. While we work with our partners to provide assistance, we also recognize the devastating impact that a loss of health insurance will have on families, particularly in the middle of a pandemic. And as a person who is currently covered by the protections afforded under the ACA, I know I for one can relate to the fear that families have in losing access to care — right when I might need it most. 

Katy Jacob

VP of Research & Impact, SpringFour

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Foreclosures in the U.S.: The Calm Before the Storm?

Foreclosures in the U.S.: The Calm Before the Storm?

Foreclosures in the U.S.: The Calm Before the Storm?

Economists and housing specialists are closely watching the impact of the COVID-19 crisis on current and impending foreclosure rates. Certain regions of the country are more at risk than others, with areas along the West Coast, clustered around New York, Massachusetts, Baltimore, and Washington, D.C., and numerous markets in the Chicago area,  more likely to see foreclosures as the pandemic continues. A recent poll conducted by NPR shows that 34% of households in Houston and 25% in Chicago are having serious difficulties paying their mortgage or rent; these trends hold throughout the country and are more severe for Black and Latino households.

For the first several months of the crisis, forbearance programs were in place in many markets. In April, homeowners stopped paying their mortgages in record numbers, culminating in almost one in ten mortgages being placed in forbearance. While 3.6 million mortgages continued to be in forbearance as of August 30, accounting for 7.6% of all mortgages, this is down from previous months. At some point, however, these programs will end — and at that point, we might begin to see major spikes in foreclosure rates. While the potential for large-scale evictions in the rental market looms larger in our collective consciousness, there remains a very real threat of a coming foreclosure crisis. SpringFour has seen some signs of this in its application usage data, and continues to monitor trends to uncover potential foreclosure issues.

Take, for example, the chart of SpringFour referrals below. This graph shows a sharp decline in demand for foreclosure counseling services in Q2 of 2020 over Q1, while other homeownership-related categories of need remained relatively constant. Through our partnerships with housing counselors and lenders, we know that this is because mortgage forbearance programs were in effect during Q2 as the pandemic took root, and households began to focus on other basic needs with the knowledge that at least temporarily, they would not lose their homes due to COVID-19. SpringFour has started to see demand for foreclosure counseling rise in Q3, however — and this is a trend that we are watching closely. 

As SpringFour is well aware, the COVID-19 crisis is very different from the 2008 financial crisis that led to record foreclosures and community disinvestment across the country. SpringFour was founded in 2005 as MortgageKeeper, and was built to help families stay in their homes by offering access to local financial resources that could help address the root cause of the inability to pay a mortgage or other monthly bills. We saw the devastation wrought by the 2008 crisis and helped thousands of families through that difficult time. 

But this time, things are different. First, this is a different type of crisis. In 2008, the crisis was created within the financial and housing markets themselves, through unscrupulous practices and pricing. The markets were bifurcated in such a way that collapse was practically built into them. Thus, in the first half of 2010, 1.65 million American homes went into foreclosure, according to ATTOM Data Solutions. In the first half of 2020, barely 165,000 loans were hit with foreclosure actions, and ATTOM is predicting a total of 200,000-500,000 total foreclosures from COVID-19. This time, we are dealing with a global pandemic that is first and foremost a public health crisis, as opposed to a crisis of inflated market values or negative home equity. Due to the far-reaching nature of the current crisis, the housing market is just one component of the economy experiencing a shock, and this is due largely to the surge in unemployment and uncertainty in longevity of the small business sector. 

This crisis is a jobs crisis, brought about by a public health crisis. Low-and moderate-income households have been particularly hard hit by job and income loss. A SpringFour survey of LMI households shows that more than a quarter of these households have been furloughed or had hours reduced due to the pandemic, causing 40% to delay nonessential purchases.

Thus, while the financial and housing markets did not create this crisis, they definitely could, and SpringFour believes, should, play a major role in helping to mitigate it. In addition to continuing to offer mortgage forbearance programs, banks and other lenders can help customers potentially stave off foreclosure by limiting or eliminating fees on a temporary basis, allowing payment deferrals, freezing interest rates, and instituting other hardship programs. History has shown us that doing so, is not only good for the customer but business as well. 

We know, for example, that housing and foreclosure prevention counseling programs work. A 2018 study by the Urban Institute of the National Foreclosure Mitigation Counseling (NFMC) program found that counseled homeowners were 67% more likely to remain current on their mortgage nine months after receiving a loan modification–and that counseled borrowers were more likely to get a modification in the first place.  Building off of this knowledge and the lessons of the 2008 crisis, banks and lending institutions are in a much better position to work with partner organizations to help stave off another foreclosure crisis.  And we know through our work that borrowers who receive SpringFour referrals are twice as likely to engage in foreclosure prevention programs than those who do not receive our referrals.

“BALANCE is preparing for a significant increase in foreclosure prevention and rental counseling once the moratoriums and forbearances conclude in January. It is important for those in need to have access to a knowledgeable and unbiased resource, such as a HUD certified housing counselor. We would also encourage those impacted by COVID-19, whether they are currently struggling or think they will be struggling with their mortgage or rent, to reach out to discuss their options now. There is no need to wait until the New Year. Time is of the essence, as we learned during the previous crisis. It is important for those impacted to maintain communication with their mortgage servicer or property owner.” 

 

-Linda Davis-Demas, Senior Director of Housing, BALANCE

Moreover, now more than ever, financial institutions should partner with experts in the field who know how to help families access the resources they need and deserve in order to get through a widespread crisis outside of their control. For example, with its financial institution partners, SpringFour has already provided well over  2 million referrals to struggling families in the year 2020. Almost half of these referrals are in the basic need categories of food assistance, financial assistance, employment services, and rental resources. Our survey of LMI households shows us that families feel they need a large safety net that they do not have access to currently, they do not know where to turn for help, and they would welcome assistance from their bank or lender to get them through this long-term crisis:

Key takeaways from SpringFour survey of LMI households, August 2020:

While families struggle to pay for basic necessities, banks and lenders can and should help them avoid the most devastating consequence of any financial crisis–the loss of their home through foreclosure and the potential for not only homelessness but overall community disinvestment that could last a lifetime and impact future generations. SpringFour is here to help banks and lenders be that partner in financial wellness, and to do everything we can to ensure people can stay in their homes. SpringFour offers a wealth of resources that can help prevent foreclosure, including:

 

  • Referrals to local HUD-certified counselors that can help people budget before foreclosure hits and also help them navigate their options;
  • A tip sheet with information about mortgage relief options during the pandemic; and
  • A wide range of financial health resources that can help families save money in other areas so that it is easier to stay on top of mortgage payments
Please feel free to contact Katy Jacob at katy@springfour.com to talk about how we could work together to help families hold on to their American dream of homeownership.

Katy Jacob

VP of Research & Impact, SpringFour

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Financial Health Survey of LMI Families

Financial Health Survey of LMI Families

Financial Health Survey of LMI Families

SpringFour, the only social impact fintech that helps financial institutions give customers the support they need to regain financial control, today published the results of its COVID-19 financial health survey, which shares how the pandemic has impacted low- and moderate-income households. 

The insights reveal that the pandemic has impacted families’ ability to cover their monthly expenses and pay for basic resources, including food, prescriptions, and utilities. Households state that they need $4,000 in an emergency fund. Many families are unaware of financial resources that exist to help, but trust their banks to provide financial guidance and support. SpringFour commissioned Competiscan for this survey, which included a nationally representative sample of 105 individuals with household incomes of under $50,000 per year.

A complimentary copy of the report can be accessed here.

“The pandemic has made financial challenges even more acute for low- and moderate-income families. The government’s stimulus payments have not alleviated their financial pressures and many are unaware that local resources exist to help them cover basic needs,” said Rochelle Gorey, SpringFour Co-Founder and CEO. “The good news is that families feel confident in their banks’ ability to help, giving banks the opportunity to step up and meet their clientele’s challenges.”

Key takeaways include:

Unemployment has greatly impacted low- and moderate-income families: 26% have been furloughed, let go, or had their work hours reduced.

Households are facing challenges in making regular payments: 30% of families are unable to cover their monthly expenses completely and on time.

Families expressed concern about covering the following expenses:

70% are not confident that they can set aside money for emergencies.

55% are concerned about paying for basic necessities, like food, utilities, and health care.

40% are concerned about paying their credit card bills on time.

Households expressed a need for financial assistance to cover basic resources, including food (47%), heating/utility costs (47%), prescription savings (40%), health care savings (40%), and home repair (39%). 

Families do not know where to turn for financial assistance. 40% are unaware of local resources to reduce household expenses.

Households want to receive financial guidance and support from their financial institutions: 83% expressed interest in receiving support from their banks.

Families lack the necessary emergency funds. 47.6% stated that they need more than $4,000 in an emergency fund.

Families expect the pandemic to have long-term implications. 41% stated that once the country opens up, their financial situation will not change.  

“Research in the financial health field has long shown that families are one step away from a financial emergency and that they do not have sufficient funds to cover an unexpected expense. The survey results show that a crisis like COVID-19 uncovers the need for long-term, ongoing solutions,” said Katy Jacob, SpringFour Vice President of Research & Impact. “Families know they don’t have enough money saved and they need financial support and specific, targeted resources that help reduce household expenses and create opportunities to save for emergencies.” 

Learn More

For more information, download a copy of the report here.

Katy Jacob

VP of Research & Impact, SpringFour

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COVID-19 Impact Report Executive Summary

COVID-19 Impact Report Executive Summary

COVID-19 Impact Report Executive Summary

Back to Basics: Providing Resources to Struggling Families

COVID-19 has led to unprecedented levels of unemployment and upsurges in payment delinquencies for households all over the country. May marked the largest one month increase in mortgage delinquencies in history. A third (33%) of Americans have lost income because of COVID-19. An estimated 5.4 million Americans have lost health insurance as a result of job loss during the COVID-19 pandemic. These trends reveal that the safety net in the US is precarious, and families are often one small shock away from financial insecurity or peril. 

SpringFour is in a unique position to help address these issues, as its mission and business model has always been to partner with financial institutions and others to provide specific, local resources to families who need financial assistance. To this end, in late July, SpringFour issued a report of findings related to trends in resource need following the COVID-19 pandemic.

In a matter of weeks following the onset of the pandemic, SpringFour added 3,000+ COVID- specific resources in: Food Assistance; Financial Assistance; COVID-related health resources. SpringFour finds that families are looking for referrals to cover basic needs in light of the pandemic. In Q2 2020, these three new categories accounted for nearly half of all referrals (44%). Employment Services was the third-highest category of need in May 2020. Families are also struggling to pay for basic services such as heating and utility bills – the fourth-highest referral category.

And demand for these resources is exploding. SpringFour has seen a fourfold increase in referrals in Q2 this year versus Q2 of 2019. SpringFour provided nearly 1 million referrals to families in need in Q2 2020 alone, compared to 1.1 million referrals in the year 2019 as a whole. In the first half of 2020, SpringFour has provided over 1.6 million referrals.

Impact of COVID-19 on Referral Demand by Quarter

Unfortunately, the COVID-19 pandemic and its impacts are likely to reverberate throughout the economy and our culture for years to come. But just because the world has changed doesn’t mean that we can’t work together to make people’s lives better. In fact, innovative partnerships are our best bet for lifting up families and businesses during COVID-19 and beyond.

“If something good is to come from this, it’s that companies now understand that most people are just a day away from a financial emergency, and that providing help and assistance is not only the right thing to do — it’s good for business.”

 

– CEO & Co-Founder of SpringFour, Rochelle Nawrocki Gorey

For more information on this report of SpringFour’s research and insights, contact Katy Jacob at katy@springfour.com.

Read the full COVID-19 Impact Report here.

Katy Jacob

VP of Research & Impact, SpringFour

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A Looming Crisis: Unprecedented Levels of Eviction

A Looming Crisis: Unprecedented Levels of Eviction

A Looming Crisis: Unprecedented Levels of Eviction

The United States might very well be on the brink of an unprecedented eviction crisis, with as many as 23 million renters at risk of losing their homes, and Black and Latinx households being hit disproportionately. The CARES Act, which included a temporary eviction moratorium, stopped protecting renters from eviction on July 31. This moratorium covered more than a quarter of all renters in the country. More than 26% of households have already missed a rent or mortgage payment and have no idea if they will be able to pay their next housing payment on time. Given the fact that the next stimulus bill is currently stalled in Congress, there is no sign that the federal government will be able to stave off an eviction crisis that puts tens of millions of households at risk of homelessness. Eviction causes a cascading series of related social issues, from mental and physical health risks to difficulty enrolling in school to disenfranchisement. In addition to the social costs, the actual costs to the economy are staggering: For the worst-case scenario of 23 million evictions, experts have estimated a nationwide one-year cost of $128.7 billion. Being able to maintain adequate housing is a staple of financial security and financial health, so the effects of this crisis have the potential to be catastrophic.

SpringFour Recognizes the Need and is Working to Help

SpringFour and our Resource Integrity Team have been hard at work to figure out how we can use our expertise to help households in this dire situation. Since the onset of the COVID-19 pandemic, SpringFour has seen a sharp increase in usage of our Rental Resource Category. The Team has added more than 3,000 resources to address financial challenges since the pandemic began. The rental resource category is now consistently in the top five of all categories referred through SpringFour. In fact, we have seen a 48% increase in rental resource referrals in S4Pro since February 2020.  SpringFour has provided over 92,000 referrals to households needing assistance with rental resources since the onset of the pandemic.

Going even further, SpringFour’s data team developed a tenant tip sheet to help end users struggling to maintain adequate housing. This tip sheet, released on July 15th, was referred over 2,200 times in the first 3 weeks. It provides essential information on tenant rights and responsibilities under the CARES Act, provides links to local and state eviction moratoriums, and provides links to tenant advocacy organizations and rental resources available through SpringFour. Tip sheets like these go above and beyond SpringFour’s usual offerings and instead compile tips and resources that can help renters navigate their way through this crisis. Efforts to provide additional rental resources and create the tip sheet showcase the expertise of our incredible Resource Integrity Team, including Kate McCarthy, an experienced housing professional, and Jessica Williams, a talented systems management and operations guru.

For questions on the tenant tip sheet or if you have ideas for additional tip sheets, contact resources@springfour.com.

Rochelle Nawrocki Gorey

Co-Founder & CEO, SpringFour

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Rochelle Gorey on SpringFour Being Selected for The Financial Health Network’s Leaders Program

Rochelle Gorey on SpringFour Being Selected for The Financial Health Network’s Leaders Program

Rochelle Gorey on SpringFour Being Selected for The Financial Health Network’s Leaders Program

SpringFour is proud to be recognized as a 2020 Financial Health Leader by the Financial Health Network. Leaders are Members that have committed to measuring the financial health of their customers, employees, and/or clients.

Rochelle, can you tell me about SpringFour’s relationship with the Financial Health Network?

I attended my first EMERGE Forum in Los Angeles in 2015–and was introduced to the Financial Health Network and the concept of financial health. I realized this is precisely what SpringFour is doing and has always been about— helping people get back on track and live a financially healthy life.

Everything that we do and have done since 2005 is about financial health. I was excited to realize that there was a concept that encompassed what SpringFour does. I left feeling energized. That summer, we applied for an award from the Promontory Financial Group, and we learned that fall that we had won the 2015 Empowerment Award. This was a defining moment for SpringFour, and coincided with our rebranding as SpringFour from Mortgage Keeper. We knew what we had built went beyond mortgages and foreclosure assistance and our brand needed to encompass that. 

Being at the EMERGE Forum, I was able to meet with so many different people from banks, fintechs, and other organizations that were new to me, and several partnerships spurred from that. The event really is a who’s who of those you want to talk to in this field. After attending the conference for several years, SpringFour became a member of the Financial Health Network in 2019 because we understood that these were our people. Never have I attended a conference where everyone seemed to be on the same page, where everyone was truly focused on the same mission.

What made SpringFour decide to pursue being a Financial Health Network Leader?

SpringFour has been a leader in financial health for 15 years, as have our leadership team prior to working for SpringFour. When we started SpringFour, no one was talking about financial health. This was a natural fit for us. Several of our clients are in the program, and we saw an opportunity to further our work and strategic partnerships that have financial health at their core.

“SpringFour was selected as a 2020 Financial Health Leader as they will be using financial health measurement and transactional data such as bill payment rates and credit scores to evaluate customer’s financial health. This will help them adjust products and offerings to be more responsive to the financial health needs of their customers.”  -Rob Levy, VP of Research and Measurement for Financial Health Network

Now that SpringFour is a part of the Leaders program, what do you see as the primary benefit to SpringFour?

The camaraderie! Being a part of this group of esteemed leaders dedicated to financial health is very validating. We get different exposure to some Financial Health Network members that we work with more closely through this group, and we are looking forward to sharing best practices and collaborating on research.

What are the unique things that SpringFour brings to the table within the group?

Our track record, long history, scalability, and ability to work with multiple sectors that are focused on financial health. When we bring on a new client, we have the opportunity to quickly impact their customer base. All of a sudden, their portfolio has the opportunity to access financial health resources that can make a real difference.  We are unique because we are not focused on providing products direct to the consumer. Our focus is on bringing value to those financial health leaders who work with consumers, from banks to fintechs to nonprofits and employers. We are a neutral third party that has the mutual benefit of the end consumer and the company in mind. We want people to be able to save and get out of debt at the same time that we want companies to get repaid and maintain positive relationships with their customers. 

What is SpringFour’s goal as a Financial Health Network Leader?

We are a mission-based, woman-run fintech company that has managed to grow over the years without raising outside funds, and we are able to work with any company that wants to help its constituents manage their financial health. We know that when you can get to the root cause of financial issues, you can help people get back on track. We want this vision to become an integral part of what companies do, and in doing so we all win–the customer, the company, and the field as a whole. We have a unique opportunity to play a major role in that by interfacing with other companies that have the same overall vision of financial health. Though we are small, through this work, we see large scale impact on millions of people. Through the Leaders program, we can share impact with others who are doing this type of work.

SpringFour partners with several of the Leaders in the Financial Health Network’s program. Could you tell me a little bit about how SpringFour works with other Leaders?

We are proud that we were already in partnership with the following Financial Health Network Leaders: Balance; Elevate; GreenPath; MMI; OppLoans; and SalaryFinance. Some are new and others have been working with us for years. That says a lot. Again, it is unique how we are able to work with nonprofits as well as fintech, employer-based and financial institutions.  All of these organizations trust and rely on SpringFour to add value to their offerings and impact their bottom line. By providing access to vetted, curated fin health resources, SpringFour is helping these organizations further assist their customers. We enable them to provide tangible assistance that elevates a difficult conversation, by delivering actionable next steps and ensuring that the consumer at the end of the line sees their bank or lender as their partner. 

The Financial Health Network helps amplify our voice and mission as a company. We are proud to be in the Leaders Program.

 

 

Katy Jacob

VP of Research & Impact, SpringFour

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