Uninsured in state hits 1 million

13.3 percent of Clark County residents lack health coverage

By Marissa Harshman, Columbian health reporter



Uncompensated care

Hospitals and providers across the state provide nearly $1 billion in uncompensated medical care each year, according to the Washington State Office of the Insurance Commissioner. Here’s the breakdown of uncompensated care at the two Clark County hospitals each fiscal year:

• Legacy Salmon Creek Medical Center charity care (services provided to patients who don’t have insurance or cannot pay their bills)

2008 $5.6 million

2009 $6.1 million

2010 $8.3 million

2011 $10.4 million

• PeaceHealth Southwest Medical Center charity care

(discounted care provided to patients); and bad debt (unpaid bills)

2008 $26.3 million; $29.7 million

2009 $40 million; $35.4 million

2010 $42.5 million; $48.5 million

2011 Not available

The state of Washington has reached a “grim milestone”: 1 million residents do not have health insurance.

The Washington State Office of the Insurance Commissioner on Tuesday released a report detailing the rising number of people without health insurance and the increase in charity care provided by hospitals and health care providers across the state.

“This is a grim milestone for the state, and we believe the situation will remain bleak for two more years,” Insurance Commissioner Mike Kreidler said in a news release. “But it’s important for people to know that there is hope on the horizon.”

That “hope on the horizon” will come in 2014 when major provisions of federal health care reform are set to take effect, Kreidler said.

Currently, about 14.5 percent of Washingtonians are uninsured, up from 11.6 percent in 2008.

In Clark County, 13.3 percent of residents — 56,747 people — do not have health insurance. That’s an increase of two percentage points since 2008, according to the new report.

Still, the Clark County rate is lower than many other Washington counties — only six counties have lower percentages.

Dr. Lisa Morrison, medical director for Columbia United Providers, which manages Medicaid programs in Clark County, suspects the low number is due to more local people qualifying for Medicaid. Countywide, nearly 68,000 people are eligible for Medicaid, she said.

“I bet we have more people that are poor so they meet the qualifications of getting on (Medicaid),” Morrison hypothesized.

Enrollment in CUP’s Medicaid programs has increased in the past four years. In December 2008, CUP enrollment was at 33,768. This month, enrollment is up to 46,650, Morrison said.

Barbe West, executive director of the Free Clinic of Southwest Washington, agreed with Morrison’s hypothesis.

Demand for medical services at the clinic is up slightly over last year, however, the people coming to the clinic are sicker, West said.

“People don’t have insurance and are waiting longer until they come in for care,” she said. “They’re afraid to go to the emergency room because they know they’ll have bills to pay.”

Hospitals and providers across the state are seeing an increase in the amount of uncompensated care provided to uninsured people and those who have insurance but cannot pay their medical bills.

According to the Office of the Insurance Commissioner, uncompensated care has reached nearly $1 billion a year in Washington and is continuing to rise rapidly.

The state report calculated a total of $55.7 million of uncompensated care in Clark County in 2010. However, figures from Legacy Salmon Creek Medical Center and PeaceHealth Southwest Medical Center suggest the total may be much higher.

In the 2010 fiscal year, Legacy reported $8.3 million in charity care, which is defined as the cost of providing care for patients who don’t have insurance or cannot pay. This year, that number is up to $10.4 million, nearly double the amount four years ago.

Last fiscal year, PeaceHealth Southwest reported $42.5 million in charity care, which the hospital defines as discounted care provided to patients. The hospital’s bad debt (unpaid bills) totaled $48.5 million in 2010.

When hospitals and providers endure significant levels of uncompensated care, they often pass those costs to other consumers and businesses. In other words, the cost is shifted to people who do have insurance, according to the insurance commissioner’s office.

The hidden cost of uncompensated care — estimated to be about $1,017 per insured family per year or $368 per year for an individual — is reflected in the cost of health care premiums and out-of-pocket payments for everyone, according to the insurance commissioner’s office.

Marissa Harshman: http://twitter.com/col_health;http://facebook.com/reporterharshman;marissa.harshman@columbian.com; 360-735-4546.