Profile of Virginias Uninsured 20042005

1
Profile of Virginias Uninsured(2004-2005)

• Presented by Genevieve M. Kenney
• The Urban Institute
• to the
• Governors Health Reform Commission
• Access to Care Workgroup
• December 7, 2006

2
Data Sources

• Insurance Rates and the Share of the Uninsured by
  Demographic Characteristics
• Two-year merge of the March Annual Social and
  Economic Supplements to the 2005 and 2006 Current
  Population Survey (CPS).
• Employer-Sponsored Insurance Offers
• Matched 2005 February Contingent Workers
  Supplement of the CPS and the 2005 March Survey
  of the CPS.
• (Unless otherwise stated, the data pertain to the
  nonelderly - ages 0 to 64).

3
Data Sources (continued)

• Access and Use Measures for the Uninsured Versus
  the Insured
• Urban Institute tabulations of the 2004 Virginia
  Health Care Insurance and Access Survey (Virginia
  Department of Health).
• SHADAC The State of Kids Coverage. Prepared for
  the Robert Wood Johnson Foundation, 2006.

4
Presentation Roadmap

• Who is at risk of being uninsured in Virginia?
• Uninsured rates by economic, employment, and
  demographic factors.
• Who are the uninsured in Virginia?
• The composition of the uninsured by social,
  economic, employment and demographic factors.
• The Impact of Uninsurance on Health Care Access
  and Use.

5
Scope of the Uninsured Problem in Virginia

• It is estimated that 15.5 of Virginians
  (1,012,000) lack health insurance coverage.1
• About 1 in 5 adults lack coverage compared to
  about 1 in 11 children in the state.

1Uninsured rate of 15.5 with standard error of
1.2. Source Urban Institute Tabulations of the
2005 and 2006 Annual Social and Economic
Supplement to the Current Population Survey
6
Who is at High-Risk of Being Uninsured in
Virginia?
7
Nonelderly Adults Have Higher Uninsured Rates
than Children
Source Urban Institute Tabulations of the 2005
and 2006 Annual Social and Economic Supplement to
the Current Population Survey
8
19 to 34 Year Olds Have the Highest Uninsurance
Rate of All Nonelderly Adults
Source Urban Institute Tabulations of the 2005
and 2006 Annual Social and Economic Supplement to
the Current Population Survey
9
Virginia Residents Living in Households Where at
Least One Adult Works in a Large Firm Have the
Lowest Risk of Uninsurance
Number of employees
Source Urban Institute Tabulations of the 2005
and 2006 Annual Social and Economic Supplement to
the Current Population Survey
10
Uninsured Rates are Over 6 Times as High for
Those Living Below Poverty Compared to Those With
Incomes Above 300 Percent of FPL
Household Income as Percent of Family Poverty
Level
Source Urban Institute Tabulations of the 2005
and 2006 Annual Social and Economic Supplement to
the Current Population Survey
11
Who Are The Uninsured in Virginia?
12
40 of the Uninsured Have Incomes Above 200
Percent of FPL
301FPL
201-300 FPL
100-200 FPL
lt100 FPL
Source Urban Institute Tabulations of the 2005
and 2006 Annual Social and Economic Supplement to
the Current Population Survey
13
Virginias Uninsured Represent Diverse
Ethnic/Racial Backgrounds
Source Urban Institute Tabulations of the 2005
and 2006 Annual Social and Economic Supplement to
the Current Population Survey
14
A Substantial Portion of Virginias Uninsured Are
U.S. Citizens
Source Urban Institute Tabulations of the 2005
and 2006 Annual Social and Economic Supplement to
the Current Population Survey
15
41 of Virginias Uninsured are Aged 19 to 34
Source Urban Institute Tabulations of the 2005
and 2006 Annual Social and Economic Supplement to
the Current Population Survey
16
Nearly Two-Thirds of Uninsured 19 to 34 Year Olds
Are in Low Income Households
400 FPL
200-299 FPL
100-199 FPL
lt100 FPL
Source Urban Institute Tabulations of the 2005
and 2006 Annual Social and Economic Supplement to
the Current Population Survey
17
Nearly 70 Percent of the Uninsured Live in
Households With at Least One Full-time Worker
Source Urban Institute Tabulations of the 2005
and 2006 Annual Social and Economic Supplement to
the Current Population Survey
18
61 of the Uninsured Live in Working Households
with a Self-employed Worker or with a Worker
Employed by a Firm with Fewer than 100 Employees.
Source Urban Institute Tabulations of the 2005
and 2006 Annual Social and Economic Supplement to
the Current Population Survey
19
Most Uninsured Do Not have Access to
Employer-Sponsored Insurance

• Only a quarter (26.8) of the uninsured live in
  households that have an offer of
  employer-sponsored insurance.

Source Urban Institute, 2006. Based on data from
the 2005 Contingent Workers and Alternative
Employment Supplement to the CPS and the 2005
Annual Social and and Demographic Supplement to
the CPS provided by Lisa Clemans-Cope and Bowen
Garrett
20
Impact of Uninsurance on Health Care Access and
Use
21
Low-income Uninsured Adults in Virginia are More
Likely to Have Unmet Health Care Needs and Less
Likely to Have a Usual Source for Health Care and
go to the Doctor, than Low-Income Insured Adults.

Source Urban Institute tabulations of the 2004
Virginia Health Care Insurance and Access Survey
22
Low-income Uninsured Adults are More than Twice
as Likely To Lack a Usual Source of Care Because
they Either Cannot Afford it or Do Not Have
Insurance
Percent of Virginia Adults Who Lack a Usual
Source of Medical Care because of Cost or Lack of
Insurance
Source Urban Institute tabulations of the 2004
Virginia Health Care Insurance and Access Survey
23
Uninsured Children in Virginia Fare Worse than
Insured Children on Access Measures
Source SHADAC. 2006. The State of Kids Coverage
(Virginia Sample). Prepared for the Robert Wood
Johnson Foundation
24
Conclusions and Policy Implications

• Virginias insured enjoy greater access to care
  than the uninsured.
• Adults comprise a significantly greater portion
  of Virginias uninsured than children.
• Since 41 of Virginias uninsured are ages 19-34,
  one way to greatly reduce the number of uninsured
  is to target this population.
• Although 71 of Virginias uninsured live in
  working households, employment-based coverage
  will have limited impact since only 26.8 of the
  uninsured live in households that have access to
  employer coverage.
• Public subsidies are likely necessary to
  dramatically reduce uninsured numbers in
  Virginia, because 60.4 of the uninsured live
  households with incomes 200 FPL.