Health Insurance and Access
Most American households would not be able to afford adequate health care without health insurance of some kind. Researchers have documented a relationship between lack of health insurance and delaying medical care, not getting appropriate screenings or managing chronic disease as well as to increased risk of poor health, hospitalization and premature death.
• In 2007, 12.6% of King County adults under age 65 did not have any health insurance. This compares to 16.3% in Washington State and 16.6% nationwide. (figure 1) Medicare coverage is almost universal for people ages 65 and older, therefore, this indicator focuses on the remaining adult population and children.
• In King County, the percentage of uninsured adults under age 65 declined between 1993 and 2001. Since 2001, the percentage has returned to approximately the 1993 level. Regional trends have followed a similar pattern over time.
• East Region had the lowest average rate of uninsured adults of any of the four regions during the period 2005 to 2007. (figure 2) No other differences by region or in comparison to the County were significant.
• Health coverage varied widely among age groups with younger adults most likely to be uninsured. One-fourth of 18-24 year olds lacked health insurance - double the rate Countywide. By contrast, 6.8% of those ages 45-64 were uninsured.
• Hispanic/Latinos had the highest percent of uninsured adults by race/ ethnicity. Further, those choosing to be interviewed in Spanish were most likely to lack health insurance (68.1%, data not shown). Asians and whites were least likely to be uninsured.
• A higher percentage of men were uninsured compared to women.
• Lower household income increases the likelihood that adults will not have health insurance. Those in households earning less than $25,000 per year were 12 times more likely to be uninsured than households making more than $50,000 a year.
• King County adults with less education were less likely to have health insurance at every level of education. On average from 2005 to 2007, almost half of people without a high school degree had no insurance, compared to 5.3% of college graduates.
• Adults (ages 18-64) in Mercer Island/Point Cities, Issaquah/Sammamish, Lower Valley & Upper Snoqualmie, and Cascade & Covington health planning areas were more likely than King County overall to have health insurance. (figure 3) Adults in Burien/Des Moines and Tukwila/SeaTac were less likely to have health insurance than King County as a whole. All other health planning areas were similar to the King County average.
• On average, for 2002, 2004, and 2006, 3.2% of King County children under age 18 did not have health insurance. (figure 4) This is similar to the 2000, 2002, 2004 average.
• In 2006, approximately 15,000 children were uninsured and some 9,000 were eligible for state health insurance programs. A County initiative to enroll eligible children is on target to meet a goal of 6,500 enrolled by the end of 2009.
• Children in households with incomes at 300% or more of the poverty level were more likely to have health insurance coverage than children from households with incomes from 100% to 300% of the poverty level. Children living in povertylevel households would more likely meet income requirements to qualify for Medicaid coverage.
Data Source, Definitions, and Limitations
Data on adult health insurance coverage are from the Washington State Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is a random telephone interview survey of non-institutionalized adults ages 18 and older. Starting in 2003, the BRFSS was administered in English and Spanish. The limitations of an English-and-Spanish-only telephone survey include the following: a) people who do not have a land line telephone or who do not speak English or Spanish are excluded, and b) people who have less education and lower incomes are underrepresented. Data on children’s health insurance are from the Washington State Population Survey (SPS), Washington State Office of Financial Management, 2002, 2004, and 2006. The SPS is a random telephone interview survey of all ages.
The 2006 Federal Poverty Level (FPL) for a single person under age 65 was $10,488. For a family of four, the FPL was $20,614.
