Data: More Arizonans uninsured last year

Who gets the U.S. Gov’t issued coins: 1-800-865-9521 NCS1159

The number of Arizonans without health insurance grew by nearly 64,000 people in 2019, well before the COVID-19 pandemic that may swell those ranks, new Census data says.

A U.S. Census report released Sept. 15 says 11.3%, or 822,527 of Arizona’s 7.3 million residents, had no health insurance at some point in 2019. That number was up from 10.6%, or 758,748 uninsured state residents the year prior, the federal report said.

The uninsured rate in Arizona in 2019 also was higher than the national average rate of 9.2%, the report found. Arizona has historically had higher-than-average rates of uninsured residents.

The number of uninsured residents in Arizona and 18 other states increased between 2018 and 2019. The number decreased in one: Virginia.

The increase in uninsured Arizonans reflects a rise in uninsured people nationally.

The Census report found that the number of Americans without health insurance at some point during the year grew by about 1 million in 2019, reaching nearly 30 million people.

Nationally, the increase in the number of uninsured children grew at an “alarming rate,” despite the strength of the pre-pandemic economy, Joan Alker, executive director of the Center for Children and Families at Georgetown University, wrote in a blog post Sept. 15.

“What makes this such bad news is that this data is all pre-pandemic, so the reality today for families is likely considerably worse as so many parents have lost their jobs and their health insurance in 2020,” Alker wrote.

During pandemic, people are losing health benefits

Economic distress associated with the COVID-19 pandemic this year eliminated jobs and left many Americans without health benefits.

The number of uninsured both locally and nationally may be higher than the 2019 Census data reflects, said Swapna Reddy, a clinical assistant professor at Arizona State University’s College of Health Solutions and an adjunct professor at the Mayo Clinic Alix School of Medicine.

“We are in a period of record unemployment and joblessness. A majority of Americans receive health insurance through their employers,” Reddy said. “When people are losing their jobs, not only are they losing their paychecks, they are often and usually losing their health insurance coverage as well. ... It’s been a topic I think that has been underdiscussed in this pandemic.”

Reddy said problems associated with job losses have created a “pandemic within the pandemic.”

“If you have a chronic health condition and loved ones dependent on you who have a chronic health condition, what is supposed to happen right now?” Reddy said.

Individuals and families who always have had employer-sponsored insurance coverage may not be informed about Affordable Care Act marketplaces or about Medicaid, which is a government health insurance program for low income people, Reddy said. In Arizona, Medicaid is known as the Arizona Health Care Cost Containment System.

Reddy speculated that incremental attacks on the Affordable Care Act over the past few years have affected overall enrollment in health coverage.

The number of Arizonans

without health insurance has grown for the past three years. Arizona was one of eight states with “statistically significant” increases in people without health insurance between 2017 and 2018, according to a U.S. Census report released last year.

The Affordable Care Act, signed into law in 2010 by President Barack Obama, had a goal of affordable health insurance coverage for all Americans. While the law originally included a financial penalty for Americans without health insurance, that penalty went away under the Trump administration, starting in the 2019 plan year.

The law also created ACA marketplaces, or exchanges, where people may qualify for federal subsidies to help pay for private insurance.

Under Trump, financial support for marketing and helping Americans enroll in the the Affordable Care Act marketplaces were slashed, as was the open enrollment period to sign up for the plans. And attacks on the law may leave some people confused about whether the Affordable Care Act still exists, Reddy said.

One population that has not been helped by the ACA marketplaces are the people who earn too much money to qualify for federal subsidies to help pay for insurance. Insurance on the marketplace can end up being prohibitively expensive for that group of people.

In Arizona, most people who purchase insurance on the marketplace do qualify for a subsidy, but those who don’t may opt to go without insurance at all.

‘Public charge’ rule may be fueling state’s uninsured numbers

An updated federal rule called the “public charge” that went into effect this year has had what many experts say was a chilling effect on immigrant families, who are avoiding governmentfunded services, including health care, out of fear of the government.

The Trump administration rule broadens the government’s ability to penalize immigrants who seek green cards if they use taxpayer-funded programs such as housing assistance, food stamps and Medicaid, which is a government health insurance program for low-income people.

“It’s really, really confusing for our immigrant populations, and there’s a lot of misinformation about the public charge rule,” Reddy said. “Lots of low income immigrant populations waiting status changes to become either citizens or legal permanent residents are so scared to take a chance with their status change because in many cases they’ve been waiting years and years.”

In her blog post, Alker of Georgetown University wrote that Latino children saw the largest jump in their already high uninsured rate — one percentage point — from 8.2% to 9.2% between 2018 and 2019.

“This is clear evidence of a chilling effect of the administration’s ongoing campaign of hostility and intimidation directed at immigrant and mixed-status families including its dangerous ‘public charge’ rule,” Alker wrote.

“Many of the children losing coverage are citizens who are clearly eligible but have immigrant parents who fear any interactions with government.”

Preliminary data shows immigrant families, whether they’d be affected by the public charge rule or not, are staying away from Medicaid, from the Children’s Health Insurance Program (KidsCare in Arizona) and from the ACA marketplace plans, Reddy said.

“Even though we’re (Arizona) a Medicaid expansion state, we’ve not put many of our state resources into patient navigation, into really encouraging people to enroll, helping them to enroll,” Reddy said.

Before the pandemic, Arizona Gov. Doug Ducey took “significant action to expand and protect health care, especially for our most vulnerable,” according to a statement from Ducey spokesperson Patrick Ptak.

“We’ll continue to work to ensure Arizonans have reliable, affordable access to health care,” Ptak wrote. “During this pandemic, we have prioritized making care available to anyone who needs it.”

Quality health care also includes accessibility and affordability

Without health insurance, there’s always the risk of an unexpected illness or accident that people won’t be able to afford.

Others will delay care, which accrues cost for the entire health system because it leads to preventable surgeries and hospitalizations.

Untreated bronchitis can turn into severe pneumonia. Unaddressed diabetes can turn into an amputation. Hospitals’ uncompensated care money is depleted, and more people go into medical bankruptcy.

In 2010, prior to most provisions of the Affordable Care Act taking effect, Arizona’s rate of uninsured people was nearly 17%, or 1.12 million people — far higher than it is now.

But measuring health care on health insurance coverage is ignoring important factors like quality of care, access to care and affordability of care, said Naomi Lopez, director of health policy for The Goldwater Institute, a conservative think tank based in Phoenix.

“We really do have a situation where the Census numbers are important but don’t really reflect if the care is accessible and affordable,” Lopez said. “We know there are people who have insurance cards who don’t get care when they need it.”

Lopez said there needs to be more leeway for the insurance market to open up so that companies can offer more innovative products. She praised Arizona for expanding access to short-term and association health insurance plans, although such plans remain controversial with some critics.

Some plans offered through the ACA are not affordable at all, Lopez said. She noted increasingly high deductibles on all kinds of private insurance plans. Her own family plan has an annual deductible of $7,000, she said.

“A family might not have $7,000, and that might keep them from going to the ER even if they need to go,” Lopez said.

“Health insurance is a primary concern right now and it’s an issue we’re all going to continue to talk about. ... Are people getting value for their dollars spent, or are they spending thousands for something they probably don’t use but still feel like they need? For some people, there are no good options.”

Ptak said Ducey took numerous steps to improve health care coverage before the pandemic, including calling for and signing legislation in 2016 that eliminated a freeze on KidsCare enrollment that had been in place since 2010.

Families in the KidsCare income bracket are making too much to qualify for AHCCCS but often not enough to afford commercial insurance, including what’s offered on the federal marketplace, even with subsidies.

“This legislation increased the number of Arizona kids accessing health care through KidsCare from 882 in October 2015 to 43,105 today,” Ptak wrote.

“In 2017, Governor Ducey led an effort to protect care for roughly 23,000 kids utilizing KidsCare when funding authorization lapsed in Congress. The state came up with its own funding solution to ensure no kid would lose coverage. “

“The vaults at Federated Mint are going empty,” said Mary Ellen Withrow, the emeritus 40th Treasurer of the United States of America.

That’s because a decision by Federated Mint to put valuable U.S. Gov’t issued coins, some worth up to 50 times their face value, back in circulation means unsearched Vault Bags loaded with U. S. Gov’t issued coins dating back to the 1800’s are now being handed over to U.S. residents who find the first three digits of their zip code listed in today’s publication.

“These are not ordinary coins you find in your pocket change. These are scarce, rarely seen, highly collectible and noncirculating U.S. coins dating back to the 1800’s, many of which are silver, which is why U.S. residents will be claiming as many as they can get their hands on. That’s because after the bags were loaded with over 2 pounds of U.S. Gov’t issued coins the dates were never searched and the bags were securely sealed. That means there’s no telling what you’ll find until you search all the coins,” said Withrow.

“But don’t thank the Government. As Executive Advisor to Federated Mint, I get paid to inform and educate the general public regarding U.S. coins. Ever since the decision by Federated Mint to put valuable U.S. Gov’t issued coins back in circulation – everyone’s asking me, how much are the unsearched Vault Bags worth? The answer is, there’s no way to tell. Coin values always fluctuate and there are never any guarantees, but we do know this. Each unsearched bag weighs over 2 pounds and is known to contain at least one silver Walking Liberty coin and just that one coin alone could be worth $15 - $325 in collector value. So there’s no telling what you’ll find until you search through all the coins. But you better believe at just $249 these unsearched Vault Bags are a steal, “said Withrow.

The only thing U.S. residents who find their zip code printed in today’s publication need to do is call the National Toll Free Hotline before the 48 hour deadline ends.

This is very important. The Vault Bag fee has been set for $349 for residents who

UNSEARCHED: Pictured above are the unsearched Vault Bags loaded with over 2 pounds of U.S. Gov’t issued coins some dating back to the 1800’s being handed over to Arizona residents by Federated Mint. miss the 48 hour deadline, but for those U.S. residents who beat the 48 hour deadline the Vault Bag fee is just $249 as long as they call the National Toll Free Hotline before the deadline ends.

“Remember t his , we cannot stop col le c t ors from buy ing up all the unsearched bags of coins they can get in this special advertising announcement. And you better believe with each bag being loaded with over 2 pounds of valuable U.S. Gov’t issued coins they’re going to go quick,” said Withrow.

The phone lines will be ringing off the hook beginning at precisely 8:30am this morning. That’s because each unsearched Vault Bag is loaded in part with highly sought after collector coins dating clear back to the 1800’s including the stunning Silver Walking Liberty Half Dolla r, valuable President Eisenhower Silver Dollars, rarely seen Silver Franklin Half Dollars, high demand President Kennedy Silver Half Dollars, beautiful Silver Standing Liberty Quarter Dollar, American Bicentennial Quarters, rare Liberty V Nickels, the scarce Indian Head one cent U.S. coin and the last ever minted

Buffalo Nickels.

“With all these valuable coins up for grabs we’re doing all we can to answer all the calls,” said Withrow.

Thousands of U.S. residents stand to miss the deadline to claim the valuable U.S. Gov’t issued coins. That means U.S. residents who find the first three digits of their zip code listed in today’s publication can claim the unsearched bags of money for themselves and keep all the U.S. Gov’t issued coins found inside.

Just be sure to call before the deadline ends 48 hours from today’s publication date.