More go without health insurance

Friday, August 27, 2004

By Christopher Snowbeck, Pittsburgh Post-Gazette



An estimated 15.6 percent of the population, or nearly 45 million people, were without health insurance coverage during 2003, the U.S. Census Bureau said yesterday. The total was up from 2002 when an estimated 43.6 million people lacked coverage.



A greater percentage of the population was uninsured in 2003 than during any year since 1998.

At the same time, the census reported that the number of people below the official poverty thresholds was 35.9 million in 2003, an increase of 1.3 million from 2002.

There were 35.8 million people living in poverty last year, or 12.5 percent of the population. That was 1.3 million more than in 2002.

Children made up more than half the increase -- about 800,000. The child poverty rate rose from 16.7 percent in 2002 to 17.6 percent.

Together the reports delivered a double-dose of bad news for the Bush administration.

The presidential campaign of Democrat John Kerry quickly seized on the findings.

"While George Bush tries to convince America's families that we're turning the corner, slogans and empty rhetoric can't hide the real story," Kerry said in a statement.

The Current Population Survey does not produce local estimates, but information from a separate survey released by the census bureau yesterday suggested the poverty rate actually improved in the region last year.

The American Community Survey data, collected in a different manner and at a different time from the Current Population Survey, estimated Allegheny County's poverty rate at more than two percentage points below the national rate.

Analysts suggest that Western Pennsylvania's relatively high proportion of elderly residents help it maintain a poverty rate below the national average, because Social Security and pensions generally give them enough income to surpass the poverty threshold -- though not necessarily by much.

The erosion of employer-sponsored health insurance has been noted for a few years now, but the persistence of the trend in 2003 -- when the economy started producing more jobs -- is particularly troubling, said Karen Davis, president of the Commonwealth Fund, a foundation that commissions research on health and social issues.

But Donald L. Evans, the secretary of commerce, said in a conference call with reporters that the census survey was conducted just before the jobs returned.

"Our present economic recovery has lifted the prospects of many people whose circumstances were more difficult at this time last year," Evans said.

The uninsured rate in Pennsylvania between 2001-03 was below the national average, according to the report. But the state was one of 20 that saw an increased proportion of people without coverage during 2002-03, compared with 2001-02.

The fact that many of the newly uninsured in 2003 were workers matched a separate finding by the census bureau about the prevalence of employer-sponsored health insurance: The percentage of people covered by these health plans fell from 61.3 percent in 2002 to 60.4 percent last year.

But Tommy Thompson, the secretary of the U.S. Department of Health and Human Services, argued that the Bush administration's track record on providing access to health care is strong, including increases in the number of children and low-income adults being covered by public health insurance programs. Bush has many proposals that would help control costs and expand access to insurance -- from medical malpractice reform to tax credits for insurance -- but Congress has blocked the way, Thompson said.

He added: "If the Senate would pass the president's welfare reform proposal, you would also see poverty going down."

The number of people with health insurance coverage during 2003 increased by 1 million, the census bureau said, but that gain was outpaced by the 1.4 million increase in the uninsured. Non-Hispanic whites saw increases in both their uninsured rate and the actual number of uninsured people, but the numbers held steady for Blacks and Asians.

The good news: The proportion of children who were without health insurance during 2003 did not change, holding at 11.4 percent.

"They didn't get hit because enrollment in public programs -- Medicaid and the [Children's Health Insurance Program] -- was steady. So, the programs really did what they're supposed to do," said Catherine Hoffman, associate director of the Kaiser Commission on Medicaid and the Uninsured. "But parents didn't do very well."

The drop in coverage among workers is driven by the increasing cost of insurance, said Davis of the Commonwealth Fund. While some companies might be dropping coverage all together, many are stopping short of that, Davis said.

Some employers are making new workers wait longer before their coverage kicks in, Davis said, while others are dropping dependents from company health plans. Many workers are being asked to pay more for their coverage, and either can't or elect not to. Cliff Shannon, president of SMC Business Councils in Pittsburgh, said the national problem with health care costs is hitting hard here, too.

A lot of money is already being spent on health care, he said, and much of it is wasted on the costs of cleaning up after low-quality care. The huge number of preventable hospital infections is one example, he said.

"Unless there's a change in the fundamental underlying problems, we're going to see more of the same," he said.