Spokane Community Indicators e-Newsletter


One of the hottest topics in the latest presidential election and currently in national politics, is health care and health care reform.

The Spokane Indicators site doesn't weigh in on any of the political arguments but simply looks at the data for the total numbers and share of the population who are uninsured in Spokane County. It is inescapable that the changes in this measure have been drastic. Note that this indicator only measures the uninsured rate, not those who are satisfied or dissatisfied with their health current plan.

Taking a look at the Share of the Population Uninsured by Age Group, we see that at the beginning of the series in 2011, the estimated total uninsured population of Spokane County was 67,166, roughly 14.0% of the total population. Each subsequent year in the series produced a decrease from the previous year, and dramatic ones in the last two years measured. By 2015, the estimated total uninsured population was 25,880, or approximately 5.3% of the population. A similar steep decline in the Washington State is observable, with the estimated share of the population uninsured in 2011 at 14.2%, decreasing to 5.8% in 2015.

A significant part of the increased share of the population with health insurance here is due to the Medicaid expansion. According to HealthInsurance.org, "…total enrollment in Washington Medicaid and CHIP grew by nearly 613,000 people between the fall of 2013 and August 2015."

According to Brian Myers, Vice President of Rural Health & Capacity Building with Empire Health Foundation, "One of the greatest factors is Medicaid expansion, which provides health insurance to a greater number of people living in or near poverty."

Taking a look at a closely related indicator, the Share of the Uninsured Population by Age Group in Spokane County, the most drastic changes (representing decreases) occurred in the working age group of 18-64. In 2008, the estimated share of this age group who were uninsured in Spokane County was 17.0%, peaking in 2013 at 21.1%.Two years later, it had decreased to 7.4%. Comparatively, the share of uninsured in this age category in the state was 17.0% in 2008, decreasing to 9.4% in 2015. In the U.S., estimates put the shares of the uninsured in this age category at 19.8% in 2008, and track a

decrease to 13.1% in 2015.

The uninsured by age group indicator shows some peculiarities. In 2013, each age category increased from the previous year, but then dropped the following year. As previously mentioned, the decrease in the share of uninsured for ages 18-64 dropped 9.9 percentage points from 2013 to 2014. For people under the age of 18, an estimated 7.4% of the population was uninsured, dropping to 2.8% in 2014.

Myers said "While it is not exactly clear as to why there is a spike in uninsured youth in Spokane went up while nationally, as shown on the chart, the number of uninsured youth decreased as they were likely enrolled in public coverage. One thought is that Washington State had CHIP before 2008 and many other states added it as part of the Recovery Act of 2009. When new programs like these are added, there is often a lot of outreach. Whereas if a parent lost their employer sponsored health coverage due to loss of employment they would have needed to seek out benefits to know there was a program for their children. Many of the children enrolled in 2014 were eligible before."

Throughout the series, the estimated share of uninsured ages 65 years or older in Spokane County was generally about 0.1% to 0.2%, with a peak year in 2013 at 0.5%. In Washington State, the estimated uninsured share was 1.1% in 2008, decreasing to 0.7% in 2015 and 1.4% and 0.8% in the U.S. respectively.

Myers says "The In-Person Assister Network, a collaborative led by Better Health Together, partnered with many local organizations to assist people with enrollment, especially those who were newly eligible due to Medicaid expansion. Within the first 18-months there were nearly 100,000 people newly enrolled in the region, many of them through expanded Medicaid."

As a practice we make no predictions about the future of any particular indicator, basing comments solely on the facts the data offer. The political and social volatility surrounding this indicator make it nearly impossible to do so, even if we tried. That said, we know precisely why this indicator has dropped over the last five-years, especially over the last two.

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