More than 10 percent of state's residents had no health insurance in 2002

Friday, October 17, 2003

By Christopher Snowbeck, Post-Gazette Staff Writer

Christine Wallace takes insulin shots daily for her diabetes and recently chipped a tooth while biting into a piece of chicken.

Neither is a happy circumstance, but the 57-year-old Beltzhoover resident was better able to handle both when she had health insurance. She lost the coverage Sept. 30, some six weeks after she was laid off from her job of 21 years with the city recreation department.

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One of Wallace's cousins is a dentist, so she hopes to get help with the tooth, but there are no doctors in the family to help her deal with the diabetes. And she needs that help. She's not alone.

The Census Bureau reported last month that the number of uninsured Americans swelled to 43.6 million in 2002, an increase of nearly 2.4 million from a year earlier. Using two-year averages, the report estimated that 10.3 percent of Pennsylvania's 12 million residents lacked health insurance during 2002, up from 9 percent during 2001. That works out to an increase of roughly 166,000 people.

The increase is especially noteworthy because it came despite a new health insurance program for the state's working poor, which now covers 44,000 people, some of whom might otherwise have been uninsured last year. Another 58,000 people are on the waiting list for the state's adultBasic program, which was created in 2002 with tobacco settlement money.

"We have had enough money to accommodate basically half the population that has applied, so there are just as many waiting for the opportunity to be part of it," said Rosemarie B. Greco, director of the state's Office of Health Care Reform. "All of this is embedded in the economic picture in the country and certainly in our state."

Fueling the jump was a decline in employment-based insurance since 2000, said Robert Mills, a researcher with the Census Bureau. Some laid off workers, but others stopped providing benefits.

Jack Kent, 54, of Stanton Heights, lost his health insurance when he lost his job with a social service agency last November.

Kent has taken medication for hypertension for eight years, but without insurance he wasn't able to afford his prescriptions. As a result, he ended up in hospital emergency rooms twice in the past year with elevated blood pressure. The hospital visits were followed promptly by a stream of bills.

"I have a few that I haven't even opened," Kent said. "I don't open that kind of stuff -- I can't pay them."

Last month, Kent switched doctors so that he can participate in a discounted medicine program at East Liberty Family Health Care Center and its satellite in Lincoln-Lemington. The practice participates in a medicine program run by the Monroeville-based Coordinated Care Network, a nonprofit group that can purchase drugs at deep discounts.

Otherwise, Kent's monthly medicine tab would be nearly $200, an impossible amount now that his unemployment benefits have expired. Utility bills and mortgage payments already exhaust his wife's income, Kent said.

Kara Clicquennoi, 36, of Hazelwood, started working as a janitor Downtown last year, but the job didn't provide health benefits. More than a year later, Clicquennoi and her union are trying to negotiate the benefits into the workers' contract, but the trend is against them.

The proportion of private-sector workers covered by employer-sponsored medical care plans fell from 63 percent during 1992-93 to 45 percent this year, according to a report last month from the U.S. Department of Labor. Those that are providing coverage are shifting costs to workers, the report found. The large majority of covered employees were in plans that required worker contributions and those premium payments have risen about 75 percent during the past 10 years.

Yet Clicquennoi's need for insurance has also grown at an alarming rate. Last month, she awoke in a pool of blood and was taken to an emergency room. Doctors think she could have endometriosis or fibroid tumors, but Clicquennoi said she has delayed getting follow-up care, in part because she can't pay the medical bills she's already collected.

"I never considered us poor until now," said Clicquennoi, whose husband drives a tow truck and is also uninsured. The couple's 2-year-old son has no insurance either, even though the boy is likely eligible for the state's Children's Health Insurance Program.

CHIP and adultBasic are health insurance programs that provide coverage to more than just the poorest state residents, who are covered already by Medicaid. There's still plenty of room for more children to be covered by CHIP, which is given credit for stemming the tide of children lacking health insurance across the country. But there's long waiting list for adultBasic, said Rosanne Placey, spokeswoman for the state Department of Insurance, which administers the program.

The Insurance Department expects to spend nearly $109 million on the program in this fiscal year, but that won't buy coverage for all of those waiting. Wallace, the laid-off city employee who recently chipped her tooth, has applied for adultBasic with help from the Consumer Health Coalition, a Downtown nonprofit group.

A woman who answers her telephone with the words "Praise the Lord," Wallace has faith that she will find a solution to her health insurance woes. She's looking for a job, and in the meantime is using diabetic supplies she collected just before her coverage expired. Some laid-off city workers have extended their health benefits through a federal program called COBRA, but others say the program is too expensive.

"If you have been working for 15 or 20 years somewhere, you feel pretty secure in that," Wallace said. "You never come to the real reality, when you hear about other people being laid off, that you could be one of those people."

"But I believe that as God closes one door, he also opens a window," she added.

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