As numbers of uninsured rise, health cuts concerns mount (Crosscut.com)
January 11, 2012
A doctor tells legislators: Yes, the lack of insurance does cause deaths. The lawmakers got an early briefing on declining access to health care, which could worsen with further state budget cuts.
As the number of people without coverage rises, hospitals face the surging costs of uncompensated care. Insurance commissioner Mike Kreidler released the disturbing statistics, but the reality can also be seen when a uniformed service member waits with family members for ER care.
By John Stang
Roughly one in seven Washington residents don't have health insurance. The overall number of uninsured already has reached 1 million, according to a report last month from the state insurance commissioner's office, and is expected to grow until 2014, which is when the federal Affordable Care Act is supposed to go into effect.
Washington Insurance Commissioner Mike Kreidler and Jim Keogh, an economist in Kreidler's office, briefed the state's House health and Human Services Appropriations Committee about the state's health insurance picture on Tuesday (Jan. 10).
The early session briefing comes as lawmakers are just starting to face the issues created by more budget difficulties. "Your report is quite alarming," said committee member Rep. Ruth Kagi, D-Shoreline.
The insurance commissioner's office's numbers included:
- Washington's roughly 1 million people without health insurance make up 14.5 percent of the state population. The uninsured numbers are a marked change from as recently as 2008, when the total of less than 800,000 without insurance represented 11.6 percent of the population The number of uninsured is expected to reach 1.1 million by 2014.
- Roughly half of the state's uninsured people are employed.
- If the state legislature eliminates the Basic Health and Disability Lifeline programs, that would add 55,000 uninsured people. Removing or trimming those programs are among the measures being considered by the legislature to deal with a $1.5 billion budget shortfall for fiscal 2011-2013.
- Among insured private-sector employees, 15 percent of now pay at least 10 percent of their income for health care — meeting a state definition of "underinsured." That means slighlty less than 30 percent of the state's residents are underinsured or uninsured.
- King, Pierce, Thurston, Snohomish, and Kitsap counties' populations have uninsured rates of 10.7 to 13.6 percent. The counties with the highest rates of uninsured —greater than 20 percent — are in eastern Washington with Yakima County being the most-populated. "The more rural the county, the more likely it will have a higher uninsured rate," Kreidler said.
- When the federal Affordable Care Act goes into effect in 2014, almost 355,000 additional Washingtonians will become eligible for Medicaid, plus another 466,000 will be eligible for subsidies to help put affordable health care in reach, according the state insurance commissioner's office.
One major reason for the growing number of uninsured is insurance premiums rising faster than incomes, Kreidler said. At the same time, employers facing their own financial pressures are passing on more insurance costs to their workers.
Working people who are the most likely to be uninsured are in agriculture and outdoors jobs (46 percent uninsured); arts, entertainment and food services (33 percent uninsured); and construction (26 percent uninsured). Forty-two percent of the uninsured are ages 35 to 64. Almost 47 percent of the uninsured are ages 18 to 34.
The young adults have seen the greatest insurance premium increases and the greatest income drops since 2007.
"The lower your income, the more likely you will be uninsured," economist Keogh said.
In Washington, 11.4 percent of non-Hispanic whites don't have health insurance, compared to 17.2 percent for blacks and Pacific Islanders, 14.2 percent for Asians and mixed races, and 25 percent for Native Americans.
Several health-care representatives argued Tuesday that the Basic Health and Disability Lifeline programs are needed not only to ensure the targeted poor get decent health care, but also to head off greater future health-care costs. If those programs are cut, "we would see the beginning of the dismantling of the primary safety net," said Thomas Trompeter, CEO of HealthPoint, a King County-based collection of 12 community health centers.
HealthPoint patient Karen Diepeveen, an apartment manager from Renton attending Tuesday's hearing wiht her husband Rollo, said: "This program (Basic Health) literally saved our lives." Her husband was diagnosed with a tumor behind his nose, which has been successfully treated. She was treated for very high blood pressure. Without Basic health Health, the pair would not have been diagnosed, received treatment, nor could afford the presriptions drugs, she said.
Dr. Dan Lessler, associate medical director at Harborview Medical Center, said, "Do people die due to lacking insurance? The answer is yes. ... Providing the right care at the right time saves money."
Len McComb, lobbyist for the Washington State Hospital Association, said the state's hospitals expect to provide at least $1 billion in uncompensated care in 2102, with that figure going even higher if the state cuts the Basic Health program. Washington's community health centers and emergency rooms are legally required to treat everyone going to them, including the uninsured. Meanwhile, they would lose roughly $150 million in annual income without the Basic Health and Disability Lifeline programs, Trompeter said.
Lessler and Trompeter said the ripple effects of losing the programs would be people having less access to prescription medicines, less access to medical specialists, staff layoffs resulting in health centers forced to handle fewer patients, and possible closure of some clinics. Fewer screenings would be available to detect cancer and heart problems in their early stages, they said.
John Stang is a longtime Inland Northwest newspaper reporter who recently earned a Masters of Communications in Digital Media degree at the University of Washington. He can be reached by writing email@example.com.