WASHINGTON,Sept. 20 – Few public policy advocates and researchers seem to agree on exactly how many residents of Kentucky and Ohio live without health insurance.
But they do agree that numbers continue to rise and cost both states billions of dollars a year.
A study released Thursday by the health consumer organization Families USA indicates that of all residents under the age of 65,29 percent of Ohioans and 31 percent of Kentuckians went without health insurance for at least a month in 2006 and 2007.
“This is a story of working people,of working families,” said Ron Pollack,the executive director of Families USA. In the Midwest,nearly 80 percent of those who went without insurance at some point had a breadwinner working at least part time,while 70 percent had someone working full time.
That translates into roughly 2.9 million people in Ohio and 1.1 million people in Kentucky – an increase of more than 500,000 in the past seven years. Both states,however,rank above the average for total coverage. Texas,with 46 percent uninsured,and New Mexico,with 44 percent,had the highest percentages of uninsured residents.
The report found that about 89 million people nationwide were uninsured for at least a month during the past two years,more than 1 in 3 Americans under the age of 65. Reports do not count senior citizens,as they are eligible for Medicare.
“The rise in the numbers of the uninsured helps explain why health care has become the No. 1 domestic policy issue,” said Pollack,who was flanked by Sen. Debbie Stabenow,D-Mich.,and Rep. Frank Pallone,D-N.J.,the chairman of the House Subcommittee on Health.
Families USA credits the rise in Kentucky and Ohio to a combination of higher insurance premiums that have pushed many small businesses to no longer provide insurance for their employees,a labor market more skewed toward the service industry and under-funded programs like Medicaid that should serve as a safety net
The dwindling of the local manufacturing and coal industries forced workers from secure jobs with better health care into service industry jobs that rarely provide benefits,analysts said.
Others have proffered different answers. Columbus-based Buckeye Institute published a report in April called “Who Are Ohio's Uninsured?” in which it states “a large portion of the uninsured choose to go without insurance.” The author,Marc Kilmer,argued that some Ohioans earning above the poverty line just do not see the value in a health insurance policy.
“It is likely that the vast majority of these people,if they really wanted insurance,could afford it,” he wrote.
Pallone said it could be a matter of choice,such as a family deciding to buy groceries instead of paying health insurance premiums. Stabenow laughed at the suggestion that people who can afford insurance decide to live uninsured.
“Nobody chooses to go without health insurance,” she said.
Another study done by the Heath Policy Institute of Ohio,a non-partisan research organization,puts the number of uninsured Ohio residents at 1.3 million for 2006. The institute counts only those who did not have insurance coverage for the entire year,said Jason Sanford,the director of communications,the same way the Census Bureau calculates its annual findings.
He said the Families USA report overstates the number by including those who are uninsured for a month,those who could be making the transition between jobs or recent college graduates.
“We are doing better than most states,” Sanford said. “That doesn't mean there isn't a very large problem in Ohio.”
The authors of the Families USA report,Kim Bailey and Kathleen Stoll,said only 6 percent of the people went uninsured for one to two months,while more than half went without insurance for at least nine months.
Both Sanford and Pollack said that when people cannot visit a physician,minor medical problems can turn much worse,resulting in lengthy hospital stays and steep bills and cost the uninsured and the state upward of $3.5 billion. It's estimated that businesses lost an additional $2 billion in productivity in 2006 from employees missing work for conditions that a visit to a doctor could have prevented.
At those rates,Sanford said,it would be cheaper to just provide basic health insurance for Ohioans,in addition to Medicare,Medicaid and the State Children's Health Insurance Program.
In Kentucky,the steady rise in the number of children eligible for KCHIP – those in families with incomes at or below 200 percent of the poverty line – coincides with the rise in the total number of uninsured Kentuckians. As of July 2007,more than 54,000 Kentucky children received insurance through the program,said Lisa Lee,KCHIP's director.
She said she could not point to any specific causes,because “so many factors” contribute.
Ohio Gov. Ted Strickland,a Democrat,pressed the state to extend its SCHIP program to include children at or below 300 percent of the poverty line,which will most likely take effect in January,said a spokesman for the governor's office.
The speakers could not avoid discussing next week's likely vote on the SCHIP program in Congress or President Bush's threatened veto.
Stabenow and Pallone vehemently criticized the president for his “hypocrisy” and his unwillingness to put forward health care proposals of his own.
“This is a national crisis,” Pallone said. “I am certain that if we don't do anything and just let the status quo continue,this trend is going to accelerate and we are going to be back here in a year or two and we'll have an even greater problem.”
Stabenow said the legislative process “has worked as it should” in writing a bipartisan SCHIP bill. But she went a step further.
“I hope this is the first step toward a universal policy,” she said,something that Pallone and Pollack avoided.
Democratic presidential candidates Sen. Hillary Clinton,of New York,John Edwards,of North Carolina,and Sen. Barack Obama,of Illinois,all offer some kind of plan that will extend coverage to nearly all Americans,either through public-private partnerships,the creation of new tax breaks or establishment of a national public insurance program.