1 in 10 Washington residents now without health insurance

By Kyung M. Song
Seattle Times staff reporter


Washington State - The number of Washington residents without medical coverage swelled by 150,000 in the past two years, prompting warnings that the problems of crowded emergency rooms and rising insurance premiums will grow even worse.

High unemployment and cutbacks in employer-sponsored health plans have left 644,000 people 10.7 percent of the state's population without coverage, up from 8.4 percent two years ago, according to the 2002 Washington State Population Survey.

The survey, from the state Office of Financial Management, is considered the most definitive source of health and insurance statistics in Washington. The recession had left health-care experts expecting a surge in the uninsured rate, but yesterday some said they were surprised by the magnitude of the situation.

"That was one of the fastest rises in the uninsured rate that I've ever seen," said Aaron Katz, director of the Health Policy Analysis Program at the University of Washington.

Many state residents, Katz said, are living in fear that they're one pink slip away from losing their health insurance.

But even those with secure jobs and cushy health benefits aren't immune to the consequences of a growing uninsured population, Katz said. Some people who lack coverage will get sicker and need more expensive care, so hospitals and doctors will treat more patients who can't pay, and then insurers will raise premiums to offset higher health-care costs.

"It all comes back to our pocketbooks," Katz said. "There is no one to bail us out."

Enrollment at Washington's three largest insurers, Regence BlueShield, Premera Blue Cross and Group Health Cooperative, has dropped as unemployment has risen. Seattle-based Regence, which administers Boeing's insurance plans, has lost 75,000 members since 1999.

Already, some private health plans that renew rates in January have boosted premiums by 20 percent or more because of rising claims costs. Washington's high-risk insurance pool, which sells coverage to the sickest 8 percent of the people who apply for individual health insurance, is raising rates by as much as 52 percent for some members in January.

Cassie Sauer, a spokeswoman for the Washington State Hospital Association, said those on the front lines of health care already see signs of a mounting crisis.

For instance, the number of emergency-room visits, a leading indicator of lack of access to health care, jumped 10.2 percent statewide last year after several years of modest increases, Sauer said.

"The health-care system really doesn't have the capacity to absorb a whole bunch of people who don't have insurance," she said.

Katz expects the problem to only deepen under the weight of the state's recession and budget crunch.

Washington has been a national leader in expanding health coverage for the working poor, especially the children in those families.

But Basic Health, the state's subsidized health plan for people who earn too much to qualify for Medicaid, almost certainly will have to pare back enrollment for lack of funding.

"What we are facing is the possibility that all that progress is going to evaporate," Katz said.

Sharon O'Dell, development director for the Puget Sound Neighborhood Health Centers, said many patients who lack insurance or money put their health at risk out of financial desperation. Some skip doses to make their medicine last longer. Diabetics stop coming in for regular blood-sugar checks. Many wait until they are sick enough to end up in the emergency room.

According to the latest population survey, adult residents too young to qualify for Medicare accounted for the biggest jump in the uninsured. The percentage of people between 19 and 64 without insurance rose to 12.9 percent this year from 10.2 percent in 2000.

The percentage of adult residents covered by employer-sponsored plans, individual insurance or state-run public plans all shrank. Results from a more detailed analysis will be released by the state in the coming months.


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