A combination of rising health insurance premiums and falling wages has hit middle-income people especially hard, causing them to lose health insurance coverage faster than workers both poorer and richer than they are, according to a recent report from the Robert Wood Johnson Foundation.
Over the 10-year period between 1999 and 2008, more than two million people with incomes from 200 to 399 percent of the federal poverty level (roughly $44,000 to $88,000 for a family of four), became uninsured — an increase of 2.4 percentage points to 12.9 million people. This represents an uninsurance rate of 16.2 percent.
At nearly 25 million, the number of uninsured people with incomes under 200 percent of the poverty level is almost twice that of middle-income earners, and their 31.3 percent rate of uninsurance is significantly higher. But because people in this group are often eligible for public insurance programs like Medicaid if they can’t afford or aren’t offered employer-sponsored coverage, the proportion of uninsured in this group grew by just 0.8 percentage points during the period studied.
Meanwhile, the 5.9 million people with incomes at or greater than 400 percent of poverty experienced an increase in uninsurance of 1 percentage point, to 5.8 percent in 2008. People in this income group are more likely to be able to afford increases in premiums and out-of-pocket costs, say experts.
The annual study, conducted by the University of Minnesota’s State Health Access Data Assistance Center for the Robert Wood Johnson Foundation, examines population and employer survey data to track trends in health insurance at the national and state level.
The report, published last month, found that over all the average annual employee contribution for family health insurance coverage rose 81 percent, to $3,394, during the 10-year period. Single coverage contributions increased 65 percent, to $882. Median household income, however, fell 2.5 percent during the study period.
Drilling further into the data, the study found that the percentage of companies that didn’t offer health insurance rose to 12.3 percent from 10.8 percent. In companies that offered health insurance, however, fewer people signed up. More than 21 percent of employees said “no thanks” to employee health coverage in 2008, an increase of 3.1 percentage points.
In addition, more than one in five employees weren’t eligible for the health insurance offered by their employers, perhaps because of enrollment waiting periods or part-time status, experts said.
The report also provided state-level detail of insurance coverage and costs. Although there was wide variation among states, the data showed that health care had been affected everywhere. “Even in states that have withstood the economic downturn, there’s been an impact on employer-sponsored coverage and wages,” said Lynn Blewett, director of the University of Minnesota State Health Access Data Assistance Center and lead author of the study.
Given rising premiums and falling wages, it’s no surprise that enrollment in public insurance programs like Medicaid grew during the study period. By 2008, 19.2 percent of people — nearly 50 million in all — were enrolled in public insurance programs, an increase of 4.5 percentage points. (In addition to Medicaid, this category includes active-duty military, disabled people under age 65 and those enrolled in state children’s health insurance programs.)
Noting that an increase in government-sponsored insurance is exactly what opponents of the Democrats’ health care legislation said they didn’t want, Ms. Blewett said: “People are going to lose coverage if you don’t provide support through an exchange with subsidies if incomes are low enough or coverage for kids. It’s a no-brainer.”
Under the new health care law, beginning in 2014, people with incomes up to 400 percent of the poverty level will be eligible for premium subsidies to buy health coverage in state-based exchanges. Medicaid will also be expanded to cover people up to 133 percent of the poverty level.
source: prescriptions.blogs.nytimes
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