HFMA NEWS

More than 20 percent of the U.S. population in 2007--one in five people--reported not getting or delaying needed medical care in the previous 12 months, up significantly from 14 percent in 2003, according to a national study released June 26 by the Center for Studying Health System Change (HSC).

In 2007, more than 23 million people reported going without needed care, and approximately 36 million people delayed care, for a total of about 59 million people reporting access problems, according to findings from HSC’s 2007 Health Tracking Household Survey, a nationally representative survey containing information on 18,000 people; the survey had a 43 percent response rate. HSC has conducted the survey five times since 1997 as part of the Community Tracking Study, and the 2007 survey shows the sharpest increase in access problems in a decade, particularly among insured Americans.

The study’s findings are detailed in a new HSC tracking report, Falling Behind: Americans’ Access to Medical Care Deteriorates, 2003-2007. Read the report.

Covering low-income people through public programs such as Medicaid and the State Children’s Health Insurance Program (SCHIP), rather than through private health insurance, results in lower per person medical spending and considerably lower out-of-pocket expenses for consumers. That’s the conclusion of a new study published June 24 on the Health Affairs web site, which looks at different ways of providing health insurance to Americans with family incomes below 200 percent of the federal poverty level.

For example, the total annual medical spending required to cover an average low-income uninsured adult with Medicaid for a full year would have been $3,084 in 2005, while covering that person with private health insurance instead would have cost $3,899, or about 26 percent more. More dramatically, if the uninsured person were covered by Medicaid, the annual out-of-pocket expenses for that person--including payments for deductibles, copayments and coinsurance, and noncovered services, but not premiums--would be $109, but would be $771 under private health insurance, or about 600 percent more. Similarly, if an average uninsured child were covered for a full year by Medicaid or SCHIP, total annual spending would be $918, but would be $1,194 with private insurance. The amount spent out of pocket for the child would be $36 per year with Medicaid or SCHIP, compared with $305 with private insurance, say the coauthors. Read the abstract.

New England had the lowest percentage of uninsured individuals under age 65 in 2004-06 and the Southwest had the highest, according to a report from the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics released June 25. The report is based on data collected from 240,000 people under age 65 as part of the 2004-06 National Health Interview Survey.

Overall, 91.1 percent of New Englanders had some kind of health insurance in 2004-06. The Southwest had the greatest proportion of uninsured--18.2 percent of children and nearly 30 percent of adults.

Among other findings, the survey found that nationally, 67.8 percent of the population under age 65 had private health insurance, whereas 13.2 percent had insurance through Medicaid or the State Children’s Health Insurance Program and 3.4 percent had other types of public coverage, leaving 16.6 percent uninsured during the 2004-06 period.

Preliminary national data for 2007 were also released in a separate report, showing 43.1 million Americans of all ages were uninsured in 2007 (14.5 percent of the population.) This report also shows that 8.9 percent of children under age 18 had no health insurance in 2007--the lowest percentage of uninsured children in the past decade. Read the report.