The Missouri Economy and Changes in Health Insurance Coverage, 2000-2004: Cover Missouri Project: Report 3

The Missouri Economy andChanges in Health InsuranceCoverage, 2000-2004MISSOURIFOUNDATIONFORHEALTHCover Missouri Project: Report 3 Established in 2000, the Missouri Foundation for Health is dedicated to its mission ofempowering the people of the communities we serve to achieve equal access to qualityhealth services that promote prevention and encourage healthy behaviors. In support of itsmission, the Foundation undertakes policy research to educate the public and decisionmakers on effective health policies that will result in long-term, positive health system changein the state of Missouri. Formulating sound health policies advances the Foundation’s effortsto increase access to high quality, cost-effective preventive and curative care, especially forthe uninsured, underinsured, and underserved in our service region of 84Missouri countiesand the City of St. Louis.The Missouri Foundation for Health does not take responsibility for any analysis, errors, oromissions of fact found in this report.MISSOURIFOUNDATIONFORHEALTHAbout MFH Cover Missouri ProjectPrefaceIn an effort to inform the discussion regarding practical policy options to expand health care coverage for the uninsured in Missouri, the Missouri Foundation for Health (MFH) has established the Cover Missouri Project. Under this project, MFH has engaged The Urban Institute to produce a series of papers which considersstrengths and weaknesses of the current health care system in Missouri and explores options for decreasing the number of uninsured. MFH offers these studies as a means to further understand and ultimately improve access to health care coverage. Missouri currently faces considerable challenges related to creating an equitable and comprehensive system of health care for all Missourians. In 2005, between635,000 and 707,000Missouri residents were without health insurance. In addition,eligibility cuts and cost-sharing changes to Missouri’s Medicaid program made in2005 increased the number of uninsured. Ultimately, these changes may shift Missourifrom being one of the 12states with the lowest uninsurance rates to being among the12states with the highest rates of uninsurance.Research broadly documents the serious health and financial consequences associatedwith being uninsured. The uninsured live sicker and die younger than those withinsurance. They forego preventive care and seek health care at more advanced stagesof disease. Society then bears these costs through lower productivity, increased ratesof communicable diseases, and higher insurance premiums. Those without healthinsurance often must choose between visiting a doctor and paying for other essentials. This paper “The Missouri Economy and Changes in Health Insurance Coverage,2000-2004,” represents the third report in the series emerging under the CoverMissouri Project. It provides demographic data on the impact of economic change onhealth care in the state. This study concludes that the changing Missouri economy hasnegatively affected the availability of employer-based insurance and, as a result, morelow-income white adults are without insurance. The authors suggest if current trendspersist the number of uninsured will only increase. Leslie ReedVice President for Health PolicyMissouri Foundation for Health About the AuthorsJohn Holahan, PhD, is the Director of the Health Policy Research Center at The Urban Institute.He has managed numerous health research projects in the last 25 years and authored manybooks and papers on health policy. His recent work has focused on the Medicaid program, aswell as state health policy more broadly, and issues of federalism and health. He has publishedresearch on the reasons for the growth in the uninsured over the past decade and on the effectsof proposals to expand health insurance coverage on the number of uninsured and the cost tofederal and state governments.Allison Cook, BA, is a research assistant with The Urban Institute. She provides support to seniorhealth policy researchers on quantitative research projects. Her work focuses primarily onanalyzing national and state level health insurance coverage rates and trends using the CurrentPopulation Survey (CPS).The authors thank John Graves and Marlene Niefeld for their help in preparing this document.About The Urban InstituteThe Urban Institute is a nonprofit nonpartisan policy research and educational organizationestablished to examine the social, economic, and governance problems facing the nation. Itprovides information and analysis to public and private decision makers to help them addressthese challenges and strives to raise citizen understanding of the issues and tradeoffs in policymaking. The Urban Institute works to promote sound social policy and public debate on national priorities through gathering and analyzing data, conducting policy research, eval-uating programs and services, and educ