By Barbara Pash
Despite the deep recession and high unemployment, the number of Marylanders without health insurance under the age of 65 remained relatively stable from 2004 to 2009, according to a new report that surprised health officials.
From 2008 to 2009, 14.5% of residents younger than 65 — about 720,000 people — were uninsured, according to “Health Insurance Coverage in Maryland through 2009,” released by the Maryland Health Care Commission last month. About 10,000 more who are older than 65 don’t have insurance.
These numbers were essentially unchanged from rates in 2004 through 2007. According to the report, in that demographic in 2004 the percent of uninsured was 14.9%; in 2005, 14.8%; in 2006, 15.5%; and in 2007, 15.3%.
Ben Steffen, director of the commission’s Center for Information Services and Analysis, said officials were pleasantly surprised by the results of the most current analysis of the uninsured in the state. The commission is part of the state Department of Health and Mental Hygiene.
“The expectation we had was that the report would show an uptick in the number of uninsured given the economic times,” Steffen said. “The fact that the rate has stayed stable is somewhat reassuring.”
Health insurance is generally tied to employment, Steffen said. His rule of thumb is that for every 1% increase in unemployment, there’s a one-quarter to one-half percent uptick in the number of uninsured. In 2007, Maryland’s unemployment rate was 7%; in 2009, it was 9.6 %, according to the report.
But Maryland bucked the national trend of having more uninsured.
“It leads me to believe we have a number of dual-income families where if one spouse is laid off, the other spouse’s insurance carries over,” Steffen said.
He said that insurance coverage had expanded over the past two years, particularly through Maryland Medicaid and a new state mandate that allowed adult children up to age 25 to remain on their parents’ health policy. (The state policy was supplanted in 2010 by the federal health reform act that allowed adult children up to age 26 to stay on their parental plan.) These two initiatives added about 100,000 residents to the ranks of the insured.
Steffen said the report is intended to give policymakers the information they need to craft health reform in the state.
“This report gives the specifics of what we need to look at in how insurance programs and coverage expansion could be better targeted, particularly to populations with high uninsured rates,” he said.
Maryland uninsured rate of 14.5% for those under 65 was lower than the national average of 18%, and below the uninsured rate in 21 states. The report found that Maryland has a higher rate of employment-based coverage than other states. Maryland’s uninsured level is lower than New Jersey’s, but higher than Delaware’s and Pennsylvania’s. It is statistically similar to the rate in 15 other states, including Virginia and West Virginia.
The report detailed other demographic and insurance information, including:
- 26% of young adults between 19 and 29 did not have insurance.
- Low-income families account for 23% of the population, but 48% of the uninsured were people living at or below 200% of the poverty level.
- Three-fourths of Maryland’s residents under 65 were covered by private insurance.
- Of the three-fourths residents with private insurance, 70% have insurance through employer-sponsored programs; 11% are insured through public plans including Medicaid, Medicare and military-related plans; and 7% have insurance purchased it directly from an insurance companies or through an insurance broker.
- Employed adults were 63% of the uninsured, with a disproportionate number of them working at places with fewer than 100 employees.
There are currently no state or federal mandates requiring people to have health insurance. Federal health reform passed by Congress mandates such coverage, but that provision in the law has been struck down by federal judges in Virginia and Florida. The law has been challenged by attorneys general and officials in many states — but not Maryland.
The report noted that under the federal health care reform, about 350,000 Marylanders who are currently uninsured would be forced to get access to health coverage. This would drop the uninsured rate of people under 65 to slightly over 7%.