6.3% of children uninsured statewide

An estimated 11.8 percent of St. Cloud residents ages 18-64 did not have health insurance last year, according to the Census Bureau’s 2008 American Community Survey. An estimated 3.2 percent of St. Cloud’s children under 18 are uninsured.

The American Community Survey is the federal government’s annual survey of about 3 million households. It provides a wealth of social, economic and demographic information between the 10-year census.

Last year was the first time the American Community Survey included a question about health insurance coverage.

The results show that uninsured rates vary greatly across the nation. According to the new snapshot, one in four people in Texas lacked health insurance in 2008, the highest rate in the nation. At the other end of the spectrum, fewer than one in 20 Massachusetts residents lacked coverage.

The uninsured rate for children ranged from 2.1 percent in Massachusetts to 20.2 percent in Nevada.

Among the 50 states, Minnesota’s uninsured rates — 11 percent for working-age adults and 6.3 percent for children — were near the bottom.

That’s partly because Minnesota has a state-sponsored health insurance program for low-income residents called MinnesotaCare. Enrollees pay a monthly premium based on their family’s income, size and number of family members covered.

“Minnesota tends to have a lower uninsured rate than many other states,” said Kathy Parsons, director of managed care for St. Cloud Hospital. There are additional programs that cover children, she said.

But Parsons said the survey results indicate a higher percentage of uninsured than she would have expected, and could be due to people losing insurance coverage because of job layoffs.

In Stearns County, the number of uninsured — 9.2 percent for adults and 4.5 percent for children — is slightly below the state rate.

Sherburne County’s numbers are similar to Minnesota’s, with an estimated 12.5 percent of adults age 18-64 and 4.8 percent of children without insurance. No data is available for Benton County because it is too small to be included in the ACS.

The uninsured rate for adults 65 and older tends to be very low because they qualify for Medicare, the federal government’s health insurance program for seniors.

No job, no insurance

It’s not clear from the data how the recession is affecting uninsured rates, but experts say they suspect it’s having an impact.

Andy Vinson, executive director of HealthPartners Central Minnesota Clinics, said his clinics have seen only a slight increase in the number of uninsured patients in recent months.

However, they have seen a shift from most people having employer-backed insurance plans to more having government-sponsored insurance, something Vinson attributes to job loss.

An employee can get continuing insurance coverage after losing a job, but it may be more expensive, said Li Zhang, assistant professor of finance, insurance and real estate at St. Cloud State University.

And if there’s a lapse in coverage of more than a couple months, the employee’s pre-existing conditions won’t be covered for a certain period of time once he or she does get insurance, she said.

Zhang said she expects the uninsured rate to increase if job losses in the area continue. Even for those with health insurance, the costs are going up as many employers shift more of the cost to employees, she said.

Reasons, impact

There are other reasons a percentage of the population doesn’t have coverage despite the availability of government-sponsored insurance, experts say.

They might earn too much or have too many assets to qualify for MinnesotaCare or other programs, or they might not think they can afford the premiums, Parsons said. Or they might not even be aware of the programs.

“Sometimes you don’t think about it until you need it,” Parsons said.

Sometimes recent college graduates who haven’t found a job remain uninsured, Parsons said, or younger, healthy adults decide not get coverage.

“They’re kind of in that middle place where they’re going to take that chance,” she said.

The impact of the uninsured on the health care system can be costly. People without insurance often skip regular physicals and preventive or prenatal care and can end up in the emergency room with a more complex health problem, Parsons said.

“The ER is the most expensive place to try to get your basic care,” she said.

It can also be costly for individuals, particularly if they have a catastrophic health problem or accident.

“It is a leading cause of personal bankruptcy,” Zhang said.