The U.S. Census Bureau released data this week showing 2010 estimates of health insurance coverage for all 50 states and each of the nation’s counties. The data are exactly what journalists need to do their own stories about the problem of the uninsured and the potential impact of Medicaid expansion under federal health reform. Laura Ungar of The Courier-Journal in Louisville used the data to show what parts of Kentucky have the most uninsured and which would benefit most from Medicaid expansion.
The census report "looked at how many of the uninsured fall into an income category that would make them eligible for Medicaid under the Affordable Care Act -- which would be expanded to cover those who earn up to 138 percent of the federal poverty level ($15,415 for one person and $31,809 for a family of four)," Ungar reports.
"The U.S. Supreme Court’s June ruling upholding the health care law forbade the federal government from withholding current Medicaid funds from states that refuse to expand the program in 2014 -- and Kentucky and Indiana leaders haven’t yet decided whether to opt in or out," writes Ungar.
The greatest area of need in Kentucky was in the state's south-central region which is part of Appalachia but has no coal. Ronald Wright, judge-executive in Casey County, told Ungar that his hilly county depends largely on industries such as timbering and farming, and many residents don’t have employer-sponsored health coverage. “I don’t know how we correct it,” Wright said. “Most people just can’t afford (insurance.) It’s getting so expensive.” He said the uninsured often seek care in emergency rooms that can’t turn them away or at the local health department, which “is always busy.”
Michael Price, Kentucky state demographer, said the state’s poorest counties, generally in the Appalachian region, don’t usually have the highest rates of uninsured residents. “In the poorest areas of Kentucky, there’s a fair amount of participation in federal programs, so they’re covered,” Price said. “It’s the marginal folks who aren’t qualifying for federal programs who are falling through the cracks.”
The web page with Ungar's story has a list of Kentucky counties and the number of uninsured. To read it, click here. The Census Bureau press release has a link to a list of every U.S. county with estimates of the number of people who would be covered if Medicaid were expanded to 138 percent of the poverty level.