Monday, January 13, 2014

Poll in fall found more Kentuckians reporting health coverage through employers, fewer saying they're on public insurance

By Al Cross
Kentucky Health News

More Kentuckians had health insurance through their employer last year than the year before, and fewer were on public insurance, according to a statewide poll taken last fall.

Both results reversed trends the poll had found in the previous four years, away from employer-provided insurance and toward public insurance such as Medicare and Medicaid.

The share of Kentuckians who said they had employer coverage rose to 44 percent in 2013 from 37 percent in 2012. The share who said they were on on public insurance dropped to 20 percent in 2013 from 27 percent in 2012.

The margin of error in the Kentucky Health Issues Poll was plus or minus 2.49 percentage points, applied to each number in the results, so the differences in the 2012 and 2013 numbers were beyond the error margin. The poll surveyed 1,551 Kentucky adults aged 18 through 64 by telephone, with 951 land-line interviews and 600 cell-phone interviews Oct. 26 through Nov. 25. Seniors were not surveyed because 99 percent of them have some form of health coverage, the Foundation for a Healthy Kentucky said in releasing the poll results.

"Further research will be required to determine whether this is a temporary upswing or signals a shift in the source of health insurance for Kentucky adults," said the foundation, which funds Kentucky Health News and sponsors the poll with Interact for Health, formerly the Health Foundation of Greater Cincinnati. The polling is done by the Institute for Policy Research at the University of Cincinnati.

Janie Miller, CEO of the new Kentucky Health Cooperative, a not-for-profit insurer, said through spokeswoman Susan Dunlap that employer coverage could have increased through "early adopters" in the business community who saw Obamacare as a chance to cover their employees for the first time, and people between 21 and 26 who were added to their parents' policies under a part of the law that took effect in 2012.

Could an improving economy also have contributed? Ron Crouch, director of research and statistics for the state Workforce Development Cabinet, was skeptical. He said the number of Kentuckians on food stamps went up from 2012 to 2013, and many people who went back to work did so at part-time jobs with lower pay and little or no benefits.

"I would not have expected that trend in that one year," Crouch said of the shifts. "It sort of seems like an outlier result." In statistical sampling, an outlier is a rare case that is not covered by a standard margin of error. The poll's error margin was calculated to provide accurate results in 95 out of 100 cases, the most commonly used standard. The pollster, Eric Rademacher, did not respond to a request for comment.

Through Nov. 10, the midpoint of the poll, more than 40,000 Kentuckians had signed up for coverage on the state health-insurance exchange -- about 7,000 for private insurance and the rest for Medicaid. That could skew the numbers toward public insurance, but Crouch and foundation CEO Susan Zepeda noted that those plans didn't take effect until Jan. 1. Thus, there would have been no impact if people who got coverage from the exchange answered precisely the question "Which type of health insurance do you now have?"

Twenty-five percent said they were uninsured, down from 28 percent a year earlier. Another 8 percent said they lacked coverage at some time in the previous 12 months. The total of 33 percent was a clear decline from 40 percent in the fall 2011 poll. (The 2012 figure was 37 percent, not enough year-to-year difference to exceed the error margins.)

Among people earning up to 138 percent of the federal poverty threshold, who are now eligible for Medicaid under health reform, just over a third (34 percent) said they were without insurance in the previous 12 months. The percentage was the same for people earning up to 200 percent of the poverty line. People earning up to 400 percent of the poverty line are eligible for subsidies for private insurance through the exchange.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

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