1. The North Carolina Council of Churches continues to take a strong stand on the right of all people, and all North Carolinians, to have equal access to healthcare.  It is an issue of social justice.  Over ten years ago, the Council affirmed that “Our concern is especially great for those most vulnerable in our society: the poor, children, people of color, and the elderly… [We call] for a national health plan that would guarantee universal coverage for health care, coupled with effective cost control, broad-based and equitable financing, and assured quality of services.”

 

2. According to the most recent statistics, which are from 2007, over 1.5 million North Carolinians ages 0-64 do not have health insurance.  That is approximately 1 out of every 5 people in our state.  Children account for over 280,000 of the 1.5 million uninsured.  18-34 year-olds had the highest rate of uninsurance, with more than one in four of this group being uninsured.

 

3. The percentage of people without health insurance coverage is growing at a faster rate in North Carolina than in the rest of the country. Compared to the other 49 states, North Carolina had the largest percentage increase of uninsured persons between 2007 and 2009: 22% or approximately 322,000 people.  These estimates would put the current number of uninsured at about 1.8 million.  The uninsurance rate in NC has grown faster than the rest of the states because North Carolinians lost Employer-Sponsored Insurance (ESI) at almost twice the rate as the nation.  Unlike in other states, public coverage in NC did not expand significantly to cover the growing number of uninsured.

 

4. There were 457,000 non-elderly uninsured with family incomes less than 100% of the Federal Poverty Guidelines (FPG) (i.e. $20,650 for a family of four).

 

5. Almost two-thirds (65%) of uninsured adults were employed in the labor force; of the 65% who were employed, 51% were employed full-time and only 14% were employed part-time.  In other words, the majority of uninsured adults work full-time.  Only 8.4% of uninsured adults were unemployed.

 

6. Demographically in North Carolina,

• Individuals who work for small employers or in certain industries, such as construction, health & education, or hospitality, are less likely to have health insurance coverage.
• Lower-income individuals and families are the most likely to lack health insurance coverage.
• Most of the uninsured are whites, but racial and ethnic minorities have much higher chances of being uninsured.
• Young adults are more likely than older adults to lack insurance coverage.
• Men are more likely to lack insurance coverage than women.
• The uninsurance rate varies across the state, but people living in rural areas have a greater likelihood of being uninsured.

 

7. Although policy efforts aimed at improving access to health care (such as insurance expansion) remain most visible in the public’s consciousness, policy makers recognize that expansion efforts are hindered in the context of rapidly increasing costs.  Research has shown that the primary driver of decreased insurance coverage is an increase in health insurance premiums, which are largely driven by increases in the underlying cost of health care.  One effect of increasing health insurance premiums is a decline in coverage obtained through one’s employer.  38% of NC companies with less than 50 employees do not offer health insurance.

 

8. The Institute of Medicine of the National Academies estimated that the uninsured have a 25 percent greater chance of premature death than those with insurance coverage.  For example, the risk of dying is even higher for uninsured women with breast cancer.  Their risk of dying prematurely is 30-50 percent higher than for women with similar characteristics who have health insurance coverage.  Not only does the lack of health insurance affect health status, but it also impacts worker productivity and children’s achievement in school.

 

9. Fortunately, health care is changing in NC due to the recent adoption of reform legislation by Congress.  After all of the provisions of reform are enacted by 2019, approximately 95% of non-elderly legal residents of NC will have insurance coverage.  After 2014, Medicaid will expand to cover all people with incomes less than 133% of the federal poverty level ($29,326 for a family of four), which will provide insurance to the more than 50% of the uninsured in NC.  Insurance companies will be barred from denying coverage or charging higher premiums to people with pre-existing conditions.

 

 

SOURCES

1. North Carolina Council of Churches, “Healthcare: A Policy Statement,” www.nccouncilofchurches.org/resources/policystatements/healthcare.html.

2. North Carolina Institute of Medicine, “Characteristics of the Uninsured in Five Southern States,” http://www.nciom.org/data/uninsured.shtml.

3. North Carolina Institute of Medicine, “North Carolina’s Increase in the Uninsured: 2007-2009,” http://www.nciom.org/data/uninsured.shtml. “Health Care Access Issue Brief: Expanding Access to Health Care in North Carolina,” http://www.nciom.org/pubs/access.html.

4. North Carolina Institute of Medicine, “Characteristics of the Uninsured in Five Southern States,” http://www.nciom.org/data/uninsured.shtml.

5. Ibid.

6. Ibid.

7. North Carolina Institute of Medicine, “Health Care Cost and Insurance Coverage in Five Southern States,” http://www.nciom.org/data/uninsured.shtml.

8. North Carolina Institute of Medicine, “Chapter 2: The Uninsured,” www.nciom.org/projects/uninsured/Chapter2.pdf

9. North Carolina Justice Center, “Health Care Reform: How It Will Help,” http://www.ncjustice.org/?q=node/535.