Middle Class Struggling With Health Care Costs, Report Finds

Mar. 18–Health-care costs are taking a toll on America’s middle class.

The East Liberty Family Health Care Center has seen a 26 percent increase in uninsured patients coming through its doors each of the past two years.

“The face of the uninsured seeking care is changing,” said care center interim Executive Director Eileen Boyle. “They are not just the poor, but are increasingly the working class.”

Even for its own staff, the center experienced a 30 percent jump in health insurance premiums, some of which was passed on to employees.

“Because we could not absorb the additional 8 percent increase quoted to us for 2008 and 2009, we were forced to offer insurance with decreased coverage and a substantial deductible,” Dr. Boyle said. “We anticipate these trends with patients and staff to continue as the economy continues to stagger.”

What’s occurring at the health care center is occurring nationwide.

A report from the Robert Wood Johnson Foundation released Wednesday found that a growing percentage of America’s middle class has no health insurance, creating a crisis destined to climb the economic ladder.

The foundation in Princeton, N.J., said stagnant incomes coupled with soaring health insurance costs have caused the uninsured middle-income ranks in Pennsylvania to grow from an average of 249,000 people in 2000 to 381,000 in 2008, which represented 37 percent of the 1,025,000 uninsured in the state. The rate of uninsured middle-income Americans has risen by more than 2 million since 2000 to a total of 12.9 million in 2008.

That has brought the total number of uninsured Americans, as estimated by the U.S. Census Bureau, to 46.3 million — a number compiled before the economic downturn in the last quarter of 2008.

“Experts assume millions more have become uninsured since the 2008 data, due to job loss and rising costs of health insurance since that time,” according to the foundation’s report, “Barely Hanging On: Middle-Class and Uninsured,” released as part of its eighth annual “Cover the Uninsured Week.” The study also comes coincidently, according to the foundation, as Congress prepares to vote this week on controversial health-care reform legislation.

Cover the Uninsured Week each spring supports health coverage for all Americans.

While uninsured low-income Americans long have been the traditional focus of concern, the foundation says America’s middle class now “is shouldering the brunt of health insurance crisis” made all the worse by two recessions in the first decade of the 21st century.

Employers who try to cover rising health care premiums have been passing those costs on to employees, who must decide whether to bear higher costs with flat incomes or go uninsured.

The study, available at www.rwjf.org, provides state-by-state details of health coverage trends.

“The report shows that the number of middle-income earners who obtained health insurance from their employers dropped by 3 million people from 2000 to 2008,” the foundation said. “Just 66 percent of people in families earning roughly $45,000 to $85,000 are now insured through their employer — a drop of 7 percentage points from 2000 to 2008.”

The total cost for family insurance policies statewide have risen by 56 percent since 2000, to $12,339 in 2008. Nationally, the cost of family health insurance policies rose 81 percent over the same time period, while median household income fell 2.5 percent, after adjusting for inflation.

People whose employers provide health insurance coverage also have faced rising costs.

“Even though employers still pay most of the tab for their workers’ health insurance, the amount employees in Pennsylvania pay for family premium increased 96 percent from 2000 to 2008,” the report states. “Over the same period, the median income in the state increased just 0.2 percent.”

As costs continue to climb, more businesses are passing on those costs to employees or dropping health care coverage all together.

While business owners no longer can afford to shoulder more of the burden of health care costs, states cannot afford to accept the influx of laid-off workers in public programs.

Aaron Billger, Highmark Blue Cross Blue Shield spokesman, noted that the Pennsylvania Insurance Department’s 2008 survey found 8.2 percent of Pennsylvanians to be uninsured — a low rate when compared with the national average of 15.8 percent. Highmark, health insurance provider for 3.2 million people in Western Pennsylvania, has budgeted $121 million to expand health-care coverage, while also administering the Children’s Health Insurance and Adult Basic programs that cover the uninsured, he said.

Still, the foundation report says, the number of uninsured middle-class Americans will continue to rise.

Brian C. Quinn, a research and evaluation officer with the foundation, said the issue of uninsured Americans, which doesn’t always resonate with people, becomes “a stark tale once you see it on paper.”

David Templeton: dtempleton@post-gazette.com or 412-263-1578.

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