In the waning days of July and into early August, Jermaine Parkey was expecting to be become a father at any moment.

Though he’s run his own small business for more than four years, private health insurance remains too expensive. His wife, Erica, and their first baby will instead be covered by MediPASS, a Medicaid managed care program. He remains uninsured.

“I’ve looked into ways to afford (health coverage),” said Parkey, owner of Hip Hop Heaven, 2302 University Ave. “It’s just way out of reach for me.”

When he last looked into a health policy, the premium was about $200 a month, too costly when he considers his other expenses. He said coverage in the $50- to $100-range would be affordable for him, depending on the type of coverage he could get.

Parkey is among an estimated 234,000 Iowans – about 8 percent of the state’s population – who don’t have health coverage because they can’t afford it. The Iowa Department of Public Health estimates about 81 percent of the state’s uninsured are working.

Help may be on the way for Parkey and others like him, however.

The Health Access Partnership, a 2 1/2-year old grassroots outreach effort, is looking into ways to launch a health insurance purchasing cooperative for small businesses. The partnership is made up of about 30 health care organizations, government agencies and foundations.

“As a partnership, we met and identified primary barriers (to obtaining health coverage),” said Kathryn Bradley, director of the Mid-Iowa Health Foundation, one of the partnership’s members. Those barriers include cultural and language differences and a lack of access to transportation among lower-income residents.

Another partner, the Neighborhood Healthcare Access Initiative, has been working to put a face on the statistics about Des Moines’ uninsured population, said Rachel Lewis, the initiative’s outreach coordinator.

“In looking at the information that my staff has collected, we realized that there are a large pot of people who are working who do not have health insurance,” she said.

Churches, childcare centers, salons and restaurants are among the type of small businesses or organizations that are mostly likely to lack health care coverage, the initiative has found.

The Des Moines effort follows those made in other communities, such as Madison, Wis., and Muskegon, Mich., which have established community-based health insurance pools.

One group that represents small businesses, the National Federation of Independent Business, hopes Congress will pass legislation that would let associations, including theirs, offer health insurance to members across state lines.

Of the 8,500 businesses in Iowa that the NFIB counts as members, more than a third can’t offer their workers health insurance because it costs too much, according to Dave Brasher, NFIB state director in Des Moines. For companies with fewer than five workers, the percentage of companies without coverage probably increases to 50 percent, Brasher estimates.

As premiums rise, the number of companies that can afford health insurance for their workers will probably decline. Some companies have experienced a 60 percent hike in their premium expenses, Brasher said.

For more information about the Neighborhood Healthcare Access Initiative, call Rachel Lewis at 241-6121, or e-mail (lewisre@ihs.org).

MUSKEGON PROGRAM MAY BE MODEL FOR DES MOINES

In Muskegon, Mich., a hardscrabble port town on the shores of Lake Michigan, about 400 small businesses have enrolled in Access Health, a health insurance pool that lets small companies pool their resources to better afford health care insurance for workers.

Access Health targets businesses that haven’t provided health insurance coverage for workers in the past 12 months. About 1,200 people used it the program last year.

To be eligible, the median wage of employees can’t exceed $11.50 per hour. Neither an HMO nor traditional insurance, Muskegon’s program is instead designed to fill the gap between those who have commercial products and those who don’t have any insurance at all.

The cost of coverage is shared between the employee and the employer at 30 percent each. A community subsidy pays for the rest.

In Des Moines, organizers of the Neighborhood Healthcare Access Initiative, a fledgling group that hopes to form a health insurance pool for local companies, plan to reach out to the business community.

“We’re going to develop a database of who they are and go out to them,” said Rachel Lewis, the group’s outreach coordinator.