294,000 in Hawaii now lack health coverage

Community health centers report big increases in the number of uninsured patients, primarily because of the loss of jobs and employer-paid health insurance, said Beth Giesting, Hawaii Primary Care Association executive director.

In an April 7 report on the state's uninsured, Families USA said about 27.1 percent of Hawaii residents under age 65, or 294,000, were uninsured during part or all of 2007-2008. Of Hawaii's uninsured, two-thirds, or 95,000, lacked health coverage for six or more months during 2007-2008.

Most of the uninsured were part of working families. "The huge number of people without health coverage in Hawaii is worse than an epidemic," Ron Pollack, executive director of Families USA, a national organization for health-care consumers, said in a news release.

Giesting said residents who lose insurance should not forgo care. They can call the Primary Care Association at (808) 536-8442 to locate the community health center nearest to them.

Hawaii has enjoyed 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."

HPCA’s Giesting 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. "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."

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."

Who lacks health 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.