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Sept. 13, 2012
TOPEKA Kansas is bucking a trend that helped push the nation’s uninsured rate down for the first time in years.
New numbers from the U.S. Census Bureau show that a provision in the federal health reform law led to a substantial increase in the number of young adults 19-25 with health insurance in 2011. The uninsured rate for that age group fell to 27.7 percent from 29.8 percent in 2010, which helped to push the overall rate down to 15.7 percent from 16.3 percent the year before. It marked the first reduction in the nation’s uninsured rate since 2007.
Analysts credit a provision in the Affordable Care Act that allowed dependents to remain on their parents’ or guardians’ insurance policies until age 26.
There was no such increase in Kansas. Here, the uninsured rate among young adults was 23.1 percent, virtually unchanged from the 22.9 percent reported in 2009-2010.
“We’re not sure why we didn’t see an increase in the number of young adults with health insurance in Kansas like we saw nationally,” said Ivan Williams, senior analyst at the Kansas Health Institute. “A potential explanation is that while some 19-25 year-old Kansans may now be covered by their parents’ employer, a greater number have lost coverage because they or their parents no longer have employer-based coverage.”
Williams said another potential explanation is that many young adults in Kansas who could have benefitted from the extended coverage already had health insurance.
“In any case, the rate of uninsured Kansans continues to be lower than the national rate,” he said.
Mary Beth Chambers, a spokesperson for Blue Cross Blue Shield of Kansas, the state’s largest health insurer, also couldn’t explain why the ACA provision didn’t lead to an increase in young adult coverage in the state.
“We don’t really know,” Chambers said, speculating that insurers in other states might have had more restrictive age limits prior to the policy change. Kansas BCBS had allowed dependents to remain on their parents’ policies until they turned 23.
“Only 23, 24 and 25 year olds were eligible to move back onto mom and dad’s policy,” she said.
Parts of the health reform law scheduled to take effect in 2014 will substantially reduce the number of uninsured Kansans, said Anna Lambertson, executive director of the Kansas Health Consumer Coalition.
The law requires that an online health insurance purchasing exchange be up and running in each state by then. Individuals who don’t have access to affordable coverage through their employer will be able to purchase what amounts to group coverage on the exchange. Many Kansans will also be able to use federal subsidies to help them purchase coverage on the exchange.
In addition, the law calls for states to expand Medicaid eligibility in 2014 to all those earning less than 133 percent of the federal poverty level (FPL) — $29,726 for a family of four. That expansion would be especially significant in Kansas, which currently restricts adult eligibility to those earning less than 27 percent of FPL — $6,035 for a family of four.
“Some estimates that we’ve seen have indicated that about 90 percent of the uninsured could be covered through a combination of the subsidies available through the health insurance exchange and the Medicaid expansion,” Lambertson said.
Gov. Sam Brownback hasn’t yet said whether he will implement the Medicaid expansion. The recent decision by the U.S. Supreme Court upholding the ACA said that the penalties it would impose on states that failed to implement the expansion were excessive.
Several conservative Republican governors have since announced that they wouldn’t authorize the expansion. Brownback hasn’t gone that far. But he has called on voters to make the 2012 presidential election a referendum on the health reform law and said that he will not take any action to implement it until after the election.
Lambertson said if the ACA survives, her group will join others in lobbying Brownback and the Kansas Legislature to implement the Medicaid eligibility expansion.
“Hopefully together we can create the political will for expanding the program in the state of Kansas,” Lambertson said.
The KHI News Service is an editorially independent initiative of the Kansas Health Institute and is committed to timely, objective and in-depth coverage of health issues and the policy making environment. Find more about the News Service at khi.org/newsservice or contact us at (785) 783-2529.