By CELESTE BOTT
Capital News Service
LANSING – Michigan has suffered a greater decline in employer-based health insurance than any other state, according to new Census data, and hospitals, public health agencies and free clinics are seeking ways to compensate.
The report showed that only 61.5 percent of the state’s population received employer-sponsored health care benefits in 2011, a notable reduction from 76.9 percent in 2001.
Southeast Michigan is the region with the most uninsured residents, but counties in the northern and northwestern parts of the state have the greatest proportions of their populations dependent on Medicaid, according to the Michigan Health and Hospital Association.
A number of factors contributed to the decline, including increased poverty and unemployment, an aging population and the loss or reduction of benefits from part-time employers, according to experts.
The Michigan League for Human Services says that policymakers are also to blame.
For example, the advocacy organization said that last year state government “cut employment benefits, set asset limits for food assistance, put harsh time limits on cash assistance and cut the state earned income tax credit by 70 percent.”
Judy Putnam, the league’s communications director, said there is at least one way to make up for the health insurance reductions and benefit losses. “Primarily we would like the governor to expand Medicaid,” she said.
Jan Hudson, senior policy analyst for the league, said that under the Affordable Health Care Act, the expansion of Medicaid would provide up to 600,000 uninsured Michigan residents with secure access to health care.
“Right now, the Medicaid eligibility levels are extremely low,” Hudson said. “There are many people who can’t qualify for Medicaid but who don’t have access to employer-based health insurance as an alternative.
“Others may be offered health insurance through their employers but simply can’t afford to pay it,” she said.
Meanwhile hospitals, public health departments and free clinics across the state are left to provide health care to patients without insurance.
Laura Appel, vice president for federal policy and advocacy at the Health and Hospital Association, said she is concerned that the number of Medicaid beneficiaries hit record levels last year.
“These figures would indicate that in recent years dependency on free or reduced cost coverage and care has increased significantly,” Appel said.
New data from the American Community Survey supports Appel’s statement.
The Census Bureau survey showed that while the percent of uninsured residents dropped from 12.4 percent in 2010 to 11.8 percent in 2011, residents are relying more heavily on government health coverage.
Residents covered by private insurance have declined 2.1 percent since 2009, while those with public insurance increased 7 percent.
Appel said that hospitals remain responsible for patients without any insurance who need medical care.
“Based on the association’s community benefits survey of hospitals statewide, charity care levels have increased from $240 million in 2008 to $360 million in 2010. Hospital spending on community health improvement activities has increased during that same time period from $110 million to $125 million,” she said.
Charity care includes services a patient is unable to pay for, and is provided by hospitals and free clinics on a free or discounted basis to those who meet certain financial-need criteria.
Some free clinics, such as Catherine’s Health Center, in Grand Rapids, have begun accepting residents with Medicaid – up to 25 percent of patients.
“This will add revenue not dependent on philanthropy and is another small step to assure that we will be able to continue providing the medical services so important to the uninsured in our community,” according executive director Karen Kaashoek.
Steven Gold, director of the Macomb County Health Department, said he’s more concerned about the personal consequences of a health care system that depends on employer-based insurance.
“Unemployment, layoffs and increased deductibles and co-pays provide barriers to that kind of health care,” Gold said.
“The financial requirement of health insurance must compete with mortgage payments, the purchase of food and putting clothes on your back,” he said. “Unfortunately health care is usually what gets delayed. People can almost always put off going to the doctor.”
He said that he sees promise in the Affordable Care Act and Medicaid expansion.
“The federal law will rebalance the system,” he said. “If it survives, seeing a physician will be much less sensitive to the economic climate.”
By CELESTE BOTT