Health Insurance and West Virginias Uninsured

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Health Insurance and West Virginias Uninsured

• Sally K. Richardson
• Grand Rounds
• January 25, 2006

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Acknowledgements

• This presentation is based on work funded by two
  Robert Wood Johnson State Coverage Initiative
  grants and four State Planning Grants from the
  Health Resources and Services Administration,
  USDHHS.   The work was accomplished by staff of
  the WV Health Care Authority, the WVU Institute
  of Health Policy Research, Mountain State Blue
  Cross and Blue Shield, and contracts with Taylor
  Nelson Sofres International, the Lewin Group, and
  the University of Minnesotas State Health Access
  Data Assistance Center. (SHADAC). 
• It was also strongly supported by the advice and
  counsel of concerned health care system
  leadership from across the state who regularly
  participated in reviewing and helping to shape
  recommendations to both Governors Wise and
  Manchin, two of which were passed into law in
  2004, and two of which are on Governor Manchins
  health agenda for this years legislative
  consideration.  

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Presentation Goals

• A demographic portrait of uninsured West
  Virginians focusing on non-elderly adults, aged
  19 to 64. 
• The impact of being uninsured on their use of
  health care services and their health status. 
• West Virginia employers their role in health
  insurance.
• Some solutions underway and a few ideas to
  think about. 

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West Virginias Uninsured Population
Source West Virginia Healthcare Surveys, 2001
and 2003
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Non-Elderly Adults

• 238, 212 (21.9) uninsured on any given day
• 314,353 (28.9) uninsured part or all of previous
  year
• Reasons for being uninsured
• Cost 46.6
• Job-related reasons 24.6
• Uninsurable due to health problem 3.5

Source West Virginia Healthcare Survey, 2003
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Insurance Type
Source West Virginia Healthcare Survey, 2003
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Age Marital Status Profiles of Uninsured Adults
Source West Virginia Healthcare Surveys, 2001
and 2003
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Education Household Income Profiles of
Uninsured Adults
Source West Virginia Healthcare Surveys, 2001
and 2003
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Changes in Employment Status from 2001 to 2003
Source West Virginia Healthcare Surveys, 2001
and 2003
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Geographic Distribution of Uninsured Adults
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Employer-Based Insurance
Source West Virginia Healthcare Surveys, 2001
and 2003
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Number of Workers by Employer Size
Source West Virginia Employer Survey, 2003
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Offering vs. Non-Offering Employers by Size of
Company
Source West Virginia Employer Survey, 2003
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Offering vs. Non-Offering Employers by
Percentage of Full-Time Workers
Source West Virginia Employer Survey, 2003
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Offering vs. Non-Offering Employers by Employee
Earnings
Low wage-majority of employees earn less than
15,000 Moderate low wage-majority of
employees earn between 15,000 and
25,000 Moderate wage-½ of employees earn between
15,000 and 25,000 and ½ earn more than
25,000 High wage-majority of employees earn more
than 25,000
Source West Virginia Employer Survey, 2003
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Employers that Offer Health Insurance to
Employees Only or Employees and Dependents
Source West Virginia Employer Survey, 2003
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Employers Experiences with Insurance Premium
Changes
Source West Virginia Employer Survey, 2003
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Primary Reasons Employers Dont Offer Coverage
Source West Virginia Employer Survey, 2003
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Usual Place for Medical Care
Source West Virginia Healthcare Surveys, 2001
and 2003
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Not Getting Needed Medical Care
Source West Virginia Healthcare Surveys, 2001
and 2003
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Overnight Hospital Stay in Previous Year
Source West Virginia Healthcare Surveys, 2001
and 2003
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General Health Status
Source West Virginia Healthcare Survey, 2003
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Diagnosed with a Chronic Health Condition or
Disability
Source West Virginia Healthcare Surveys, 2001
and 2003
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Incremental Solutions Underway

• WV Small Business Plan uses PEIA provider
  payment rates and a reduced administrative ratio
  to cover 600 small business employees and their
  families
• Access WV high risk pool offering insurance to
  those whose existing health conditions make the
  cost of insurance unaffordable in the private
  market, HIPAA eligible people, and those who have
  lost insurance due to NAFTA-related plant layoffs
  or closures
• Proposed Clinic Model Demonstration currently
  before Legislature monthly fee would provide
  primary and preventive health care , health
  education, and other services available in health
  care setting
• Proposed Defined Benefit Insurance for Low-Income
  Workers currently before Legislature would
  provide health insurance with defined primary and
  preventive care benefits and limits for a premium
  in the neighborhood of 100 a month

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