Who Are the Missourians Without Health Care Insurance?

In the ongoing health care discussion, few have looked at who the people are without health care insurance. In Missouri, most people have some form of employer-sponsored health care insurance program, while those who are elderly have Medicare, and the indigent have Medicaid. Then who are these people without health care insurance that everyone is talking about?

To answer that question, Missouri initiated a survey in 2004 and found 463,000 citizens without any form of health care insurance, about 8.4 percent of the state population. At that time the largest demographic group consisted of people between 19 and 24 years old, because 20.1 percent of them had no health care insurance. The survey’s statistical analysis found that the minority distribution among those without health care insurance was similar to the proportions within the state. That is, no specific group had an excess, and all groups were represented equally.

In 2004, the largest economic division without health care insurance (20.9 percent of all those without health care insurance) consisted of families with incomes between 134 percent and 150 percent of the federal poverty level (FPL). Interestingly, 30 percent of the uninsured population was made of families in which at least one family member worked. In those families, the workers were either self-employed or worked less than 40 hours per week.

Many changes have occurred since then. The onset of this recession was associated with job losses, and some jobs had their benefits reduced. Data from the run-up to the recession exists, but information more recent than 2007 is not available. Nevertheless, during the interval from 2004 through 2007, the number of Missourians without health care insurance increased from 463,000 to 744,030 people, or from 8.4 to 12.6 percent of the population. By 2007, about 82 percent of the people that were health care uninsured were members of families in which at least one member had a job.

Many people in 2007 did not purchase health care insurance. This was seen in 2004, also. That year, 20.4 percent of the health care uninsured population had incomes greater than 200 percent of the FPL. Some had incomes that would have permitted them to purchase health care insurance, but they did not. In fact, in 2004, 9.0 percent of the adults without health care insurance qualified to join existing programs at no personal cost, but did not complete the applications. Since then, the uninsured population segment that could afford health care insurance has grown. By 2007, 33.0 percent of Missouri’s health care uninsured population had incomes greater than 200 percent of the FPL — about 245,530 individuals.

What is the danger to Missouri? Studies show the health care uninsured are unlikely to have regular medical care, so their problems are identified late and cost more to treat. The result is an increase in Missouri health care expenditures, because when those without health care insurance run out of funds, the state pays for their care. Is this what is in store for Missouri?