Some see nearly 1 mil­lion additional peo­ple with­out cov­er­age while oth­ers see gains in ben­e­fits

Modern Healthcare - - Front Page -

The new U.S. Cen­sus Bureau sta­tis­tics on health in­sur­ance en­roll­ment, in­come and poverty lev­els of­fer am­mu­ni­tion to both sides of the di­vide over whether the govern­ment should play a greater or smaller role in the coun­try’s health­care sys­tem.

As mem­bers of Congress’ Joint Se­lect Com­mit­tee on Deficit Re­duc­tion met last week for the first time to find ways to cut fed­eral spend­ing, pre­sum­ably in part through Medi­care and Med­i­caid pro­gram re­duc­tions, the Cen­sus Bureau data of­fered con­flict­ing in­di­ca­tors on the state of health­care in the coun­try.

In­sur­ance cov­er­age rates held steady at the same time that poverty rates rose and real in­comes fell. The per­cent­age of res­i­dents with em­ploy­ment-based health cov­er­age con­tin­ued to drop and the per­cent­age of young adults cov­ered rose.

The an­nual es­ti­mates are based on the bureau’s Cur­rent Pop­u­la­tion Sur­vey and were pub­lished Sept. 13 in In­come, Poverty and Health In­sur­ance Cov­er­age in the United States: 2010. The sur­vey of 50,000 U.S. house­holds is con­ducted monthly, but asks only once a year about health in­sur­ance cov­er­age.

It’s a lit­tle bit per­plex­ing,” said Ti­mothy McBride, as­so­ci­ate dean for pub­lic health at Washington Univer­sity in St. Louis, in ref­er­ence to the per­cent­age of U.S. res­i­dents with­out health in­sur­ance in­creased by a sta­tis­ti­cally in­signif­i­cant amount. The unin­sured rate climbed to 16.3% in 2010 from 16.1% in 2009. The ab­so­lute num­ber of unin­sured U.S. res­i­dents in 2010 climbed 1.9%, or 919,000, to a record 49.9 mil­lion peo­ple.

The data sug­gest both pos­i­tive and neg­a­tive move­ment in the un­der­ly­ing seg­ments of the pop­u­la­tion that in to­tal kept the over­all unin­sured rate al­most flat, McBride said.

Health­care providers say that even if the per­cent­age of res­i­dents with­out in­sur­ance was ba­si­cally level, they’re still see­ing more unin­sured and the fal­ter­ing econ­omy ap­pears to be adding to the ranks this year. “We’ve seen any­where be­tween an 8% and 10% in­crease in the num­ber of unin­sured in the last year,” said Barry Ar­buckle, pres­i­dent and CEO of Me­mo­ri­al­Care Health Sys­tem, Foun­tain Val­ley, Calif. Ar­buckle noted that some­what sur­pris­ingly the num­ber of unin­sured pa­tients they’re treat­ing is ris­ing al­most as fast in the sys­tem’s hos­pi­tals in rel­a­tively wealth­ier Orange County as in its Los An­ge­les County hos­pi­tals.

And like the rest of the in­dus­try, Ar­buckle is con­cerned the deficit re­duc­tion panel known as the “su­per­com­mit­tee” will rec­om­mend fur­ther Medi­care cuts on top of what was ne­go­ti­ated as part of last year’s Pa­tient Pro­tec­tion and Af­ford­able Care Act. “Medi­care, un­for­tu­nately, is kind of an easy tar­get,” he said.

Also alarm­ing for in­dus­try ex­ec­u­tives is data in the re­port re­gard­ing in­come and


While the per­cent­age of unin­sured Amer­i­cans is hold­ing steady, the ab­so­lute num­ber of unin­sured is grow­ing. At left, crowds line up for a Re­mote Area Med­i­cal free clinic held in Oak­land, Calif., this spring.

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