Friday, December 12, 2008

Georgia’s Uninsured Rate Holds Steady but Employer Coverage Loses Ground

Georgia’s Uninsured Rate Holds Steady but Employer Coverage Loses Ground

Georgia has the sixth highest number of residents without health insurance in the United States and ranks 11th in its percentage of the population lacking coverage, according to a new report from the Georgia Health Policy Center and the Center for Health Services Research at Georgia State University. In 2007, about 18 percent of all Georgians and 20 percent of those under age 65 (approximately 1.66 million people) were without health insurance — roughly the same number reported in 2005 and 2006 but higher than the national average of 15 percent (45.7 million Americans).

Nationally, the number of uninsured Americans decreased from 46.9 million in 2006 to 45.6 million in 2007 while Georgia’s number of uninsured remained constant.

The report is a combination of data from the U.S. Census Current Population Survey (CPS) and an independent Georgia Population Survey of more than 15,800 people commissioned by the Georgia Department of Community Health. The Georgia Population Survey was conducted between February and April 2008.

Though the overall number of uninsured Georgians remains relatively unchanged over the past few years, the share of the population with employer-based private insurance has declined over the past eight years while the share with publicly funded health plans (Medicaid, PeachCare) has edged upward. Between 2000 and 2007, the percentage of Georgians with private health insurance coverage dropped by about eight percentage points. And from 2000-'06, the percentage of uninsured non-elderly Georgians rose from 16 percent to 20 percent. All Georgians 65 or over are eligible for Medicaid and are therefore not included in the report.

Unemployment or employment with a small firm increases an individual’s likelihood of being uninsured. According to the report, roughly half of Georgia’s uninsured live in a family headed by someone who works for a small business with fewer than 100 employees.

And while the majority of Georgians have private insurance through companies large enough to provide it, the economic slowdown could leave thousands without coverage. More than 90 percent of Georgians with private health insurance have employer-based health plans, the report finds.

“When people lose their jobs, they lose their coverage,” said Bill Custer, director of the Center for Health Services Research in the J. Mack Robinson College of Business at Georgia State. “And throughout economic downturns, more people move into poverty, putting added strain on sources of public health coverage.”

According to the report, only one in five individuals living below poverty have private insurance and nearly 38 percent are uninsured.

In addition to employees of small businesses and those in poverty, other groups at particular risk for being uninsured include those in families headed by a part-time or part-year worker and young adults between the ages of 18 and 24, according to the report. And while those aged 45 to 65 were once the least likely to be uninsured, they’re the only age group to see an increase in the percentage of uninsured over the past two years.

Georgia’s men are also at risk – they’re more likely than women to go without coverage, but women are more likely than men to have public coverage.

Those surveyed who were without health coverage were also more likely to report being in poor health, increasing their likelihood of needing emergency care in the near future, Custer said.

As in past years, residents of Georgia’s rural areas, who are more likely to have low incomes and work for small firms, were also found to be more likely to lack health insurance than those living in urban/suburban areas. When grouped by public health district, about 22 percent of residents in Southeast and South Central Georgia health districts are uninsured; 21 percent in Southwest Georgia; 20 percent in North Georgia; and 19 percent in West Central, Northwest and Northeast Georgia districts.

By contrast, metro Atlanta has a significantly lower percentage of uninsured (though greater in its total number of uninsured due to its larger population). Only 12 percent of residents in the East Metro Georgia health district (including Gwinnett) are uninsured, 13 percent in Fulton, and 15 percent in the Cobb-Douglas and DeKalb districts. The only exception, according to the report, was Clayton County, in which 24 percent of residents are uninsured.

“Georgia’s relatively high rank nationally for uninsured residents has several causes,” said Patricia Ketsche, an associate professor in the Robinson College of Business. “We have a large rural population and rural workers are more likely to be employed at small firms. Rural residents usually have fewer options for employment and for coverage. And although parts of metro Atlanta have high coverage rates, there are other areas where a large number of families live at or near poverty.”

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