High uninsured rates plague Alabama’s rural areas, new report shows
Alabama’s small towns and rural areas have among the highest rates of uninsured low-income adult citizens in the country, and residents there are more likely to be uninsured than those in metro areas, according to a new report by Georgetown University’s Center for Children and Families (CCF) and the University of North Carolina’s NC Rural Health Research Program. The uninsured rate for Alabama adults with low incomes is 36 percent in rural communities and small towns, and 29 percent in metro areas. Both rates are much higher than the national averages of 26 percent for rural areas and 18 percent for metro areas. In rural areas and small towns across Alabama, the report unveiled that the uninsured rate for low-income adults has grown stagnant — it has remained virtually unchanged between 2008-09 and 2015-16. Medicaid and the uninsured Alabama Arise — a nonprofit, nonpartisan coalition of congregations, organizations and individuals promoting public policies to improve the lives of low-income Alabamians — believe this number could look even worse in Alabama if the Medicaid “work requirement” plan that Alabama submitted for federal approval goes through. They say it would drive the uninsured rate even higher by stripping Medicaid coverage from thousands of parents in poverty. The proposal would require 35 hours of work, job training, education or volunteer service each week. Exceptions would be made for people with young or disabled children. State officials says the proposal only impacts a small number of Medicaid recipients, able-bodied parents and caretakers who qualify because their income is less than 18 percent of the federal poverty level. Most Medicaid beneficiaries in the state are children, disabled or elderly. But Alabama Arise disagrees — they believe, virtually all of those parents would be left with no realistic alternative for affordable coverage. “Not only has Alabama failed to move forward on health coverage, but now our state is seeking to move backward by leaving even more people uninsured,” said Alabama Arise policy director Jim Carnes. “Alabama should drop its cruel efforts to punish people living in poverty and focus instead on expanding Medicaid so all Alabamians can get the care they need to become and stay healthy. Medicaid expansion would save hundreds of lives, create thousands of jobs and keep rural hospitals and clinics open to serve residents across our state.” According to the report, nationally, the uninsured rate for low-income adults fell by more than half – from 35 percent to 16 percent – in rural areas and small towns in states that expanded Medicaid. For states that have not expanded, the decline was much smaller: from 38 percent to 32 percent. “Medicaid expansion would reduce the uninsured rate for residents across the entire state; however, the most dramatic improvement likely would be felt in small towns and rural areas of Alabama,” Georgetown CCF executive director Joan Alker explained. “Improved coverage rates typically translate to a more stable health care system and help rural areas and small towns maintain availability of health care providers in areas where shortages are all too common. Access to rural health providers is especially important to women of child-bearing age and those with chronic conditions like asthma.” In July 2018, 10 of the 11 Alabama counties with the highest unemployment rates were rural counties.
Survey: US uninsured up 3.5M this year; expected to rise
The number of U.S. adults without health insurance is up nearly 3.5 million this year, as rising premiums and political turmoil over “Obamacare” undermine coverage gains that drove the nation’s uninsured rate to a historic low. That finding is based on the latest installment of a major survey, released Friday. The Gallup-Sharecare Well-Being Index asks a random sample of 500 people each day whether they have health insurance. The survey found that the uninsured rate among adults was 12.3 percent during the period from July 1-Sept. 30, an increase of 1.4 percentage points since the end of last year. The increase in the number of uninsured is more striking because it comes at a time of economic growth and low unemployment. The annual sign-up season for subsidized private insurance plans under the Affordable Care Act starts Nov. 1, but it may not make much of a difference. President Donald Trump has stopped federal payments that reimburse insurers for lower copays and deductibles that the Obama-era law requires them to provide to people with modest incomes. His administration slashed the advertising budget for 2018 sign-ups, cut the length of open enrollment in half, and sharply reduced federal grants to groups that help consumers navigate the process. “The number of uninsured Americans likely will continue to rise,” the Gallup-Sharecare analysis noted, unless Trump and Congress take steps to stabilize insurance markets. A bipartisan bill to restart the canceled insurer payments faces opposition from conservatives and Trump has sent mixed signals. While “Obamacare” remains politically divisive, its coverage expansion helped about 20 million people get health insurance, bringing the uninsured rate to a historic low. Continued progress seems unlikely now. Next year’s premiums for plans sold on the health law’s marketplaces are expected to increase significantly in many communities, and insurer participation is down sharply, with about half of U.S. counties having only one carrier. Although consumers who are eligible for ACA subsidies are shielded from price hikes, many who buy individual plans get no financial assistance from the government. All told, more than 17 million people purchase their own policies. Independent experts who reviewed the Gallup-Sharecare findings said they appear to confirm other available evidence. “The results make sense and they track with the results of other rapid surveys,” said Matthew Buettgens, a senior research analyst with the Urban Institute health policy center. “No one is expecting this open-enrollment period to increase enrollment.” GOP health economist Gail Wilensky said the overall direction of the Gallup-Sharecare results seems reasonable, but she’ll await confirmation from government surveys that take longer to produce results, but dig deeper. “The only thing most Republicans in Congress seem to agree on is that they don’t like the ACA,” she said. “Hard to build an alternative legislative package without a sounder basis for policy and with the very narrow majority in the Senate.” Except for seniors covered by Medicare, the Gallup-Sharecare survey found that the uninsured rate increased among all major demographic groups. The loss of coverage was concentrated among middle-aged adults, with the uninsured rate rising by 1.8 percentage points among those 35-64 since the end of 2016. Households making less than $36,000 a year saw their uninsured rate go up by 1.7 percentage points. Among Hispanics, the rate increased by 1.6 percentage points, and among blacks the increase was 1.5 percentage points. The Gallup-Sharecare results are based on telephone interviews conducted July 1-Sept. 30, with a random sample of 45,743 adults, aged 18 and older, living in all 50 states and Washington, D.C. The margin of error is plus or minus 1 percentage point. Republished with permission from the Associated Press.
Census numbers reveal decline in uninsured Alabamians
Health insurance statistics released Tuesday by the U.S. Census Bureau indicate that the rate of uninsured Americans dropped in 47 states last year, including Alabama. The data reveals only one in 10 Alabamians lacked health insurance coverage in 2015, an improvement from the state’s 13.6 percent uninsured rate in 2013, the last year before the Affordable Care Act took full effect. Tuesday’s numbers come in the midst of a volatile election season, where citizens across the country continue to weigh the pros and cons of the Affordable Care Act, often called Obamacare, as they decide who they’re voting for in November. For some, Tuesday’s numbers serve as a reminder for the need for an expanded Medicaid program in the state. “[The] good news about health coverage in Alabama would be even better if the state had expanded Medicaid,” said Alabama Arise State Coordinator Kimble Forrister. “More Alabamians have coverage today than in 2013, and the Affordable Care Act deserves much of the credit for those gains. Nearly 200,000 Alabamians have signed up for health insurance through the ACA marketplace. Many of them have coverage for the first time, and all of them now have the peace of mind that comes with knowing that a medical emergency won’t lead to financial ruin.” According to Forrister, Medicaid expansion would close the coverage gap for more than 300,000 uninsured across Alabama. “That would mean a more productive workforce, thousands of new jobs and big state savings on mental health care and other services,” Forrister explained. “We’re being left out. States like Kentucky and West Virginia that have expanded Medicaid have much lower uninsured rates than those that haven’t. They’re also enjoying the job creation and cost savings that come from injecting new federal money into their budgets and economies. It’s time for Alabama to expand Medicaid and reap those same benefits.”
