Study Of Uninsured Finds Wide Disparity Among States

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At least 20 million working Americans do not have health care insurance coverage, ranging from a high of 26.9% of the adult population of Texas to a low of 6.5% in Minnesota, a new analysis of federal data from 2002 shows.

The analysis, by the Robert Wood Johnson Foundation, Princeton, N.J., found that in 6 states, at least 1 in 5 working adults were uninsured. In addition to Texas, states with the highest rates of uninsured working adults were Louisiana, Mississippi, Nevada, New Mexico and Oklahoma.

In 38 other states, at least 1 in 10 working adults did not have health insurance, according to the RWJFs analysis of data from the Centers for Disease Control and Prevention in Atlanta.

States with the lowest rates of all uninsured adults ages 18-64 were Minnesota (7.8%), Hawaii (10.2%), Delaware (10.3%), Iowa (10.7%) and Massachusetts (10.7%).

The study also suggests that a lack of health care insurance goes hand in hand with a number of health-related problems. For instance, adults who lack health insurance receive much less medical care than the insured, thus they are much more likely to report feeling in poor or fair health.

Nationally, 19% of the uninsured reported being unable to get needed medical care in the previous 12 months, compared to 5% of those with health coverage.

Again, the RWJF report found a wide disparity among states. Among the uninsured population, the percentage reporting being unable to get needed care ranged from roughly 29% in Hawaii to about 8% in South Dakota.

Uninsured adults were also less likely to have a personal doctor or other health care provider. Nationally, 56% of adults with no health insurance say they do not have a personal provider, compared with 16% of those with health insurance.

California scored the worst on this point, with around 71% of the uninsured reporting having no personal provider. In addition, more than 60% of the uninsured in Hawaii, Colorado, Nevada and New Mexico report having no personal provider.

There also were important differences between the uninsured and insured in their use of important preventive medical services.

For instance, 46% of uninsured women who were 40 and over said they had not had a mammogram in the past 12 months, more than double the rate for insured women (20%) in the targeted age group, while 69% of men in the targeted age group of 50+ had not gotten an exam for prostate cancer, compared to 47% of insured men.

The head of a leading health care insurance organization says the report underlined a problem with which health insurers were already familiar.

“Health insurance plans have long recognized that the lack of insurance coverage cuts across economic boundaries, affecting millions of working Americans,” says Karen Ignagni, president and CEO of Americas Health Insurance Plans, Washington.

She says her associations board recently adopted “a new policy framework to leverage quality-of-care improvements and cost-containment strategies.”

Ignagni says AHIP has sent specific proposals to congressional leaders suggesting ways diverse uninsured populations could be covered.

RWJFs new report was prepared by the State Health Access Data Assistance Center at the University of Minnesota.

Additional findings of the report, which was based on a survey of adults ages 18 to 64, include the following:

–Uninsured adults are twice as likely to report being in poor or fair health than adults who are insured. Nationally, 21% of uninsured say their health is fair or poor, compared to 11% of adults with health coverage. The figure for uninsured adults was above 25% in Texas, Kentucky, Alabama and North Carolina.

–There were considerably more uninsured among Hispanic populations, proportionately, than other major ethnic groups. Among working adults, RWJF found around 35% of Hispanics were uninsured vs. 18% of blacks and 11% of whites.


Reproduced from National Underwriter Edition, May 14, 2004. Copyright 2004 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.