A new study based on Centers for Disease Control and Prevention data shows almost one in eight working Rhode Islanders lacks health insurance, and nationally, at least 20 million working adults don’t have coverage.
The study, released by the Robert Wood Johnson Foundation to kick off “Cover the Uninsured Week,” a national campaign to promote affordable health coverage, shows 41 percent of uninsured Americans couldn’t see a doctor when needed in the last 12 months because of the cost, and they were almost twice as likely to be in “poor” or “fair” health.
“The myth that the uninsured are receiving the primary and preventive care they need is dispelled by this study,” said Amy Lapierre, project director for Covering Kids & Families Rhode Island, which released the report locally. “The uninsured are clearly not getting necessary medical care, and they are suffering adverse health outcomes as a result. This is a problem in Rhode Island and it is a problem nationwide.”
The study used data from the CDC’s 2003 Behavioral Risk Factor Surveillance System Survey to compare uninsured rates and health outcomes by state and by race. It found big differences between states: Texas, for example, has more than three times the adult uninsured rate (30.7 percent) of Minnesota (8.3 percent) or Hawaii (9.8 percent).
And while Hispanics in all states had higher uninsured rates than whites, the size of the gaps varied drastically: from 2.8 percentage points in Pennsylvania, to 51.8 in North Carolina. The difference between blacks and whites also varied, from minus-0.4 percentage points in California, to 12.3 percent in Massachusetts and 15.5 percent in Louisiana.
On all measures, Rhode Island is more or less in the middle of the pack – a notch down from its status as a leader in children’s health insurance. As of 2003, 4.8 percent of the state’s children under age 18 were uninsured, the second-lowest rate in the nation, after Vermont.
Rhode Island’s children have not always done this well; the uninsured rate has dropped by 56 percent in the past nine years, according to Rhode Island Kids Count, which runs Covering Kids & Families. What changed this, experts agree, was the RIte Care system, the state’s Medicaid program for the poor, which as of Dec. 31 covered 80,953 children and 44,199 parents.
In an interview, Lapierre said there are “many lessons to be learned from our success with RIte Care,” and expanding the program to cover more parents could reduce the uninsured rate, though it wouldn’t address the full extent of the need.
It’s also critical to do more to make health insurance more affordable for small businesses, Lapierre said. She wouldn’t take a position on specific policy proposals being considered by the General Assembly – though she cited a bill to mandate community rating for small-group coverage as one positive step – but said it may take multiple efforts to close the insurance gap.
“There’s probably not a one-size-fits-all solution to health care issues in Rhode Island or anywhere in the country,” she said.
Health Insurance Commissioner Christopher F. Koller, whose job is to tackle these issues, said he’s seen the Robert Wood Johnson report, but the figures aren’t surprising, given that the state Department of Health has produced similar analyses of the CDC data.
But the problem is real, and quite serious, Koller said. Rising insurance costs are making it harder for employers to cover workers, he said, and the state has to help stop that trend.
There are “vastly different strategies” under consideration to address those problems, Koller said, none of which he’s yet prepared to endorse, having just assumed his post. But his priority – and that of the governor’s health care Cabinet, which he will chair – will be the most vulnerable populations, he said.
“The people at most risk of becoming uninsured are low-income folks and people in small businesses, and I think this is going to be an area of focus,” Koller said.
The new study’s authors also stopped short of endorsing any specific measures, though they did stress the urgency of doing something.
“Too many families suffer, and too many lives are lost because our nation has not taken action to address this problem,” said Dr. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation. “As a nation, and as individuals, we can either let 45 million of our neighbors live without health insurance, or we can come together and do something about it.”
Cover the Uninsured Week is the largest nonpartisan campaign in history to focus attention on the need to provide health insurance for all Americans, with more than 1,000 public events scheduled in every state and the District of Columbia. Sponsors include the U.S. Chamber of Commerce, the AFL-CIO, the American Medical Association, America’s Health Insurance Plans, the American Association of Retired Persons, and several other organizations.
