Uninsured rising in isles


POSTED: Wednesday, April 08, 2009

Hawaii had 294,000 uninsured residents in 2007-2008 — 83.3 percent of whom were part of working families — a huge number that's “;worse than an epidemic,”; says Ron Pollack, Families USA executive director.

The national organization issued a comprehensive picture of the country's uninsured yesterday under the title “;Americans at Risk: One in Three Uninsured,”; based on the U.S. Census Bureau's current population survey.

Of Hawaii's total number of uninsured, two-thirds —195,000 or 66.3 percent — lacked health coverage for six or more months during 2007-2008, the nonprofit organization for health-care consumers reported.

Hawaii has been touted as having one of the lowest rates of uninsured residents in the country because of the state's mandatory employer-based health insurance.

A study reported last month by the Robert Wood Johnson Foundation showed one in seven adult workers in Hawaii is uninsured, compared with one in five nationally.

But Families USA said more than one out of four people — 27.1 percent — under age 65 in Hawaii had no health insurance for all or part of 2007-2008.

Nationally, about 86.7 million Americans or 33.1 percent under age 65 were uninsured at some point 2007-2008, the report said.

Pollack, in a news release, said, “;At this point, almost everyone in the country has had a family member, neighbor or friend who was uninsured — and that's why meaningful health-care reform can no longer be kept on the back burner.”;

Beth Giesting, executive director of the Hawaii Primary Care Association, said she was “;a little bit surprised at the magnitude”; of uninsured islanders reported by Families USA, “;but only because we haven't seen updated numbers lately.”;

“;It's no surprise that most people in Hawaii who are uninsured are working adults,”; she said, noting that they are part-time workers without coverage.

Giesting also pointed out that people are losing health insurance along with their jobs.

“;We have been able to do a really fabulous job of enrolling children in public insurance,”; she said. “;We have the CHIP (Children's Health Insurance Program) and good outreach.”;

But islanders 18 to 65 are falling through the cracks, she said. Most people qualify for Medicare at 65, “;but we also see people at the (health) centers who don't qualify for Medicare even though they're elderly,”; she said. “;Most people we see uninsured are in age groups that are not going to qualify for any kind of public insurance.”;

Molokai had a big increase in uninsured people last year because so many businesses closed, Giesting said.

About 1,700 middle-aged and elderly immigrants will join the growing uninsured numbers if the Legislature doesn't approve funding to meet immigrant health needs, which the executive budget eliminated, she noted. “;It's a modest expense, $550,000 a year,”; she said. Without primary care for this group, she said, “;expenses will go up considerably.”;

Giesting said some community health centers “;are seeing big numbers in uninsured already,”; especially in urban Honolulu. A big increase also is showing up at the Community Clinic on Maui because of job losses, she said.

Emmanuel Kintu, executive director of the Kalihi-Palama Community Health Center, said the center has seen a sharp increase in the number of uninsured and is fighting to keep health-care benefits for immigrants.

He said the center last year saw 16,900 patients — a 21 percent increase. Services were provided totaling $460,000, of which only $305,000 was reimbursed, he said. “;We ended up with $150,000 in uncompensated care that comes from nowhere.”;

Kintu said the center is serving growing numbers of people who have lost their jobs or had hours reduced so they don't qualify for health insurance.

“;In a way, we are better off than most other states, but we're beginning to feel the pinch,”; Kintu added. “;Look at the impact on hotels. As you reduce hours for hotel employees, you're definitely going to eat into their insurance.”;



Among findings on Hawaii's uninsured by Families USA:

» More than two out of five, or 43.8 percent, of those in Hawaii with incomes below twice the poverty line — $29,920 for a single adult and $42,400 for a four-member family last year — were more likely to be uninsured in 2007-2008.
» More than one out of five, or 21.1 percent, of those with incomes at or above twice the poverty line went without health insurance at some point in 2007-2008.
» Racial and ethnic minorities — including native Hawaiians, Asians and Pacific Islanders — make up the largest number of uninsured in Hawaii. And racial and ethnic minorities are more likely to go without health insurance than whites: 38.4 percent of Hispanics/Latinos and 27.5 percent of other racial and ethnic minorities went without health insurance in 2007-2008 compared to 21.9 percent of whites.
» In Hawaii, “;other”; ethnic minorities make up the largest category (73.9 percent) of people under age 65 without health insurance for all or part of 2007-2008.