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New Census Reporting Confirms that PA’s Uninsured Rate Held Steady at 5.5% for 2017; Cuts to Navigator Funding Pose Challenges for 2019 Open Enrollment

September 17, 2018

The U.S. Census Bureau last week announced good news for Pennsylvania’s health care. Despite uncertainty stemming from federal policy actions that could have undermined marketplace enrollment during 2017, Pennsylvania’s uninsured rate held steady at a low 5.5 percent.

Other findings from the report, Health Insurance Coverage in the United States: 2017, show that:

  • As in Pennsylvania, the nation’s overall uninsured rate held steady. During 2017, 8.8 percent of people, or 28.5 million, lacked health insurance at some point during the year. This rate is statistically the same as the rate during 2016.
  • Although the rate of people with health insurance coverage for all or part of the year was statistically the same, the number of people with health insurance coverage actually did increase by 2.3 million, up to 294.6 million.
  • Private health insurance coverage (covering 67.2% of people in the U.S.) continued to be more prevalent than government coverage (covering 37.7%). Employer-based insurance was the most common (56.0%), followed by Medicaid (19.3%) and Medicare (17.2%).

Pennsylvania ranks among the 25 states and District of Columbia with uninsured rates of 8.0 percent or less.

  • Six states (Hawaii, Iowa, Massachusetts, Minnesota, Rhode Island, and Vermont) and the District of Columbia had an uninsured rate of 5.0 percent or less
  • Massachusetts (2.8% uninsured) had the lowest percentage of people without health insurance
  • Texas (17.3% uninsured) had the highest percentage of uninsured 

The report also shows strong correlation between household income levels and race and insurance status:

  • For children under the age of 19 who live in poverty, the uninsured rate (7.8%) was higher than for other children (4.9%).
  • For adults aged 19 to 64 with household incomes less than $25,000, uninsured rates were highest (nearly 25%). For adults with household incomes of $125,000 or more, uninsured rates were lowest (just over 5%).
  • Non-hispanic whites had the lowest uninsured rates, followed by African Americans, Asians, and Hispanics, whose uninsured rate for non-elderly adults exceeded 20 percent.

With Navigator Funding Cut 80%, Outreach Efforts Will Be Crucial 

The U.S. Department of Health and Human Services last week awarded $400,000 to Pennsylvania navigator organizations to assist consumers in enrolling in the health insurance marketplace for 2019. 

Compared to $2 million received last year, this year’s award represents an 80 percent reduction in funding. This is the third year of cuts to navigators nationally and in Pennsylvania. Since 2016, navigator funding has dropped 84 percent nationwide.

Pennsylvania’s navigator funding for 2019 Open Enrollment went to the Pennsylvania Association of Community Health Centers and these “sub-awardee” contracted organizations:

  • The Health Federation of Philadelphia
  • Consumer Health Coalition
  • Meadville Medical Center
  • La Comunidad Hispana

These navigators will focus on marketplace and Medicaid enrollment among:

  • Rural and low-income populations
  • Hourly wage workers and people with variable income
  • African Americans and Hispanics/Latinos
  • Pennsylvanians with limited English proficiency
  • Migrants and refugees
  • People who do not have health insurance due to the lack of affordable coverage options in their area

Given the most recent funding challenges, Pennsylvania must redouble efforts to encourage participation in 2019 Open Enrollment from November 1–December 15. To that end, HAP and the Pennsylvania Department of Insurance are again partnering to convene stakeholder groups, including consumer advocates, providers, insurers, and government agencies. These stakeholders will meet on October 19 to finalize outreach, education, and enrollment assistance efforts.

HAP invites Pennsylvania hospitals and health systems to participate in the October 19 meeting and urges them to consider how they plan to assist their patients and communities in getting, and staying, covered. For more information, please contact Jolene Calla, vice president, health care finance & insurance.
 

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