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Going Without: Lack of insurance is often linked to loss of a job
Journal Photo by Walt Unks
Nuilza Nuñez applies for treatment at the Community Care Center. Her job pays $15,000 a year, not enough for her to afford health insurance.
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Published: March 26, 2009
Updated: 03/26/2009 01:00 am
Nuilza Nuñez lost her health insurance eight years ago, when the company she then worked for shut down.
Her current job pays her $15,000 a year -- just enough to cover her rent and other living expenses.
"She has a little left over at the end of the month," said Heather Patton, the volunteer coordinator and a Spanish translator for the Community Care Center, a free health and dental clinic staffed mostly by volunteers. "But not enough for insurance on her own."
The story is becoming more familiar to health-care providers and medical researchers around the state.
North Carolina had the nation's highest percentage increase in the number of people under age 65 who go without health insurance, according to a state health-research agency.
Researchers from the N.C. Institute of Medicine and the Cecil G. Sheps Center for Health Services Research at the UNC Chapel Hill estimated that between 2007 and 2009, the number of North Carolinians without health insurance increased about 22 percent.
A different national study released yesterday said that North Carolina is among 14 states with a fifth or more of the working-age population uninsured. That report, by the Robert Woods Johnson Foundation, said that in 2006-07, North Carolina and South Carolina tied for 13th on a list of the highest rates of uninsured, working-age adults at 20.1 percent.
The numbers mean that about 1.8 million North Carolinians under the age of 65 don't have health insurance, an increase of about 322,000 since 2007 -- just 20,000 shy of the entire population of Forsyth County. Mark Holmes, the vice president of the N.C. Institute of Medicine, said that the researchers prepared the report at the request of the General Assembly. The researchers based the estimate on a rule of thumb from previous periods of high unemployment that each percentage-point increase in joblessness creates about two-thirds of a percentage point increase in the uninsured.
Researchers also factored in year-old survey data by the U.S. Bureau of Labor Statistics that asked workers about their economic status and social activities.
North Carolina's unemployment rate jumped in January to the highest rate in more than 25 years -- 9.7 percent -- as the manufacturing and construction industries each shed more than 10,000 jobs each.
The accelerating layoffs meant that North Carolina and South Carolina tied for the country's largest jump in joblessness over the previous year, with each state's rate soaring by 4.7 percent since January 2008. The national unemployment rate was 7.6 percent in January.
The numbers are not news to local health-care advocates, many of whom said they have seen similar increases for the last six to nine months.
Nuñez, who is 53, came to the Community Care Center to reapply for health care to treat her carpal tunnel and high cholesterol. She told Patton that her new employer offers insurance, but even if she could afford it, the policy would not cover the help she needs.
Nuñez, who came to the United States from Honduras 13 years ago, was one of a handful of people applying for care yesterday on an unusually slow day, Patton said.
According to James Robinson, the center's executive director, applications had held steady at about 30 a week until the week before last, when they jumped to 48.
"Virtually every one of them had lost a job," Robinson said. He said he expects the upward trend to continue.
Robert Jones, the director of the Downtown Health Plaza, said that visits by pregnant women without insurance to the plaza's gynecologists or obstetricians is up by 4 percent from the 2007-08 fiscal year. He said he suspects that the health plaza is treating more people without insurance, but the numbers are not up-to-date.
"A lot of these patients will work two or three jobs, especially two jobs -- that's not unusual," Jones said. "But neither job offers insurance."
Holmes said that the researchers plan to forward their study to the General Assembly. He said that they have developed a few suggestions for legislators, including ways that the legislature might reduce the cost for small-business owners to provide insurance to their workers.
Their study also considered that North Carolina's Medicaid-qualification threshold makes it more difficult for parents to get government-paid health care for their children than in other states, Holmes said. For example, a North Carolina family of four cannot earn more than about $15,000 a year to qualify for Medicaid coverage of the children, he said, while in Arizona the income threshold is about $40,000 for a family of four.
The vast majority of North Carolina's residents under age 65 who lack health insurance are children, employed adults whose jobs don't provide insurance coverage, and adults who were out of the job market to raise children or for other reasons, the institute said. The number of people who were unemployed, looking for work, and lacking insurance climbed about 75 percent in 2008 to about 200,000.
"Access to health care is something that is always an issue," Holmes said. "Ensuring that North Carolinians have access to quality health care -- that's a big mountain to climb, and we just have to do it one step at a time."
Laura Graff can be reached at 727-7279 or at lgraff@wsjournal.com.
Janice Gaston can be reached at 727-7364 or at jmulhern@wsjournal.com.
The Associated Press contributed to this report.
Growing percent
North Carolina had the largest percentage increase in the number of people without health insurance in the United States over the past two years:
State Increase
North Carolina 22.5%
Rhode Island 22.3%
Indiana 22.0%
Nevada 21.0%
Michigan 20.2%
United States 13.7%
More uninsured
The number of uninsured people in the state has risen by more than 300,000 since 2007, the fourth-largest increase in the country:
State Increase
California 890,000
Texas 551,000
Florida 506,000
North Carolina 322,000
Georgia 285,000
United States 6.3 million
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