New Census Health Insurance Data Likely to Show Declines in Health Coverage throughout Washington State

Tomorrow, the U.S. Census Bureau will release national and state health insurance data for 2007-2008. The data will provide a preliminary glimpse of the impact that the current recession has had on families in Washington and throughout the nation. The data will not however, capture the full impact of the current economic crisis which deepened dramatically in 2009.

The new Census data is expected to show significant increases in the share of the population that is uninsured since the early 2000’s to 2007-2008. The loss of employer-sponsored health insurance is likely to be the dominant driver behind this trend. During the current recession, the economy sunk rapidly in 2009 and many more people lost their jobs and their health insurance. So while tomorrow’s release will signal trouble, next year’s 2008-2009 health coverage data will undoubtedly be far worse.

For example, as the graph below shows here in Washington the unemployment rate jumped from an average of 5.3 percent in 2008 to 9.1 percent by July 2009. Since the start of 2009, over 64,000 jobs have been lost in the state. As a result, next year’s 2008-2009 data will show a large drop in the number of Washingtonians enrolled in employer-sponsored health coverage.

Stay tuned to schmudget tomorrow when the Budget & Policy Center in conjunction with Washington Kids Count will post an analysis of health coverage trends in Washington using the new Census data. Our analysis will highlight changes in the share of the population without health insurance over time and will detail changes in employer-sponsored coverage and public coverage in Washington State.

Editor’s note: Tomorrow’s release will also include updated data on poverty and median income. To obtain state-level estimates of these measures, however, the Census Bureau recommends using data from a different survey, the American Community Survey (ACS). The latest ACS data for 2008 will be released on September 22, 2009. That morning, the Budget & Policy Center and Washington Kids Count will post analysis of the ACS data on poverty, median income, and health coverage in Washington State.

Four Facts About GA-U#4: What Will Happen If It's Gone?

Today is the last installment in a special series on General Assistance-Unemployable, a state program that provides assistance to adults who cannot work because of disability and are not eligible for other programs.

We all hope that if we become disabled or struggle with a mental illness, we will have the economic security and support we need to recover, get back to work, and maintain a modest quality of life. The General Assistance-Unemployable program provides that for thousands of people in our state.

Washington lawmakers have proposed eliminating or reducing the state's GA-U program as a cost-saving measure. But what will happen in Washington if there is no General Assistance for adults with disabilities?

Recipients of GA-U have serious health problems that require ongoing medical care. The GA-U program offers health benefits in the form of fee-for-service medical coupons, or in Pierce and King Counties, a managed care plan. Without these benefits, GA-U clients are more likely to seek care in hospital emergency rooms and community health clinics which are required to provide health care regardless of a patient's ability to pay. This is not a cost-efficient choice for the state: Non-reimbursed health care in a hospital ER, for example, costs the state up to four times as much as an average doctor's visit.

The loss of medical benefits is also likely to lead to a worsening of physical and mental problems for GA-U clients. At the very least, this will prolong the time they are unable work and at worst, could lead to dire outcomes for clients.

What about eliminating the cash assistance provided to GA-U clients? Currently GA-U recipients receive $339 per month to help pay for basic needs. This includes rent for low-income housing, food, and medicine. With no income, some GA-U clients are likely to lose their ability to maintain housing, which will have an impact on their health and future employment status.

Eliminating General Assistance is not the right way for our state to go. Oregon, which got rid of its GA program in 2003, is in the process of reinstating its General Assistance program with support of the Governor’s office. Without assistance, disabled Oregonians found themselves in emergency rooms and on the streets, unable to become healthy and work. We are likely to see the same outcomes here in Washington.

Four Facts About GA-U#3: GA-U Benefit Has Not Changed in 18 Years

Today is the third installment in a special series on General Assistance-Unemployable, a state program that provides assistance to adults who cannot work because of disability and are not eligible for other programs.

GA-U financial assistance provides modest help in meeting immediate needs for housing, food, and other basic necessities. The stipend offered by the state is $339 per month; an amount that has not changed since 1991 and does not account for the increased cost of living over that 18-year span.


As a way of comparing the GA-U benefit with the rising cost of living, the graph above shows the $339 monthly stipend compared to the fair market rent for a studio apartment in Pierce County. In 1991, the stipend would have been enough to pay the rent on a modest studio apartment. In 2009, it would cover just over half the cost.

Four Facts About GA-U#2: In Fact, Other States Do Have GA-U Programs

Today is the second installment in a special series on General Assistance-Unemployable, a state program that provides assistance to adults who cannot work because of disability and are not eligible for other programs.

Yesterday, we talked about how GA-U fills an essential role in our state's health care infrastructure. Today, I want to point out (again) that similar programs exist in most other states. In fact, thirty-one states have statewide programs and another nine states have programs that are available in some counties, but not others. In total, only 11 states do not provide similar assistance.

We've blogged on this before, but I feel the need to do it again because lawmakers continue to claim that Washington’s program is unique. On Tuesday, for example, a State Representative claimed in an executive session debate that Washington is “one of very few states" that have a GA-U program. He then went on to say that "no surrounding states have this program."

Let's be clear about this:

• Almost every Western state has a similar program. California, Nevada, Idaho, Utah, Arizona, Colorado, and New Mexico all have programs statewide and Montana has county-level programs.
• In the Great Plains: Kansas, Nebraska, and South Dakota all have statewide programs and North Dakota has county programs.
• Every state north of the Mason-Dixon Line has general assistance (Wisconsin being the only one without a fully statewide program).
• Six Southern states have county-level general assistance programs: Kentucky, Tennessee, Virginia, North Carolina, Georgia, and Florida.
• Alaska, Hawaii, and DC all have general assistance.
• Twenty-nine states also provide medical assistance along with basic living assistance.

To be honest, I've never understood why the idea that other states do not have general assistance would be an effective argument against our state’s program, even if it were true. The parent in me wants to ask, "If all your friends jumped off a bridge . . ." We should do the right thing in Washington State because it’s consistent with our values, not because most everybody else is doing it. (Even though most everybody else is doing it.)

Four Facts About GA-U#1: GA-U is an Important Part of Our Health Care System

Today is the first installment in a special series on General Assistance-Unemployable, a state program that provides assistance to adults who cannot work because of disability and are not eligible for other programs.

State investments in health and economic security ensure that everyone can meet basic needs in times of financial hardship. The General Assistance-Unemployable (GA-U) program provides temporary assistance to Washingtonians that are unable to work due to disability. The program plays an important role in the state’s health care and economic security infrastructure by providing medical benefits and modest financial assistance to those who are not served by other public assistance programs.

The medical benefits provided to GA-U clients are part of a larger systemic effort in Washington to broaden access to health insurance. This effort includes lower-income workers who receive benefits through Basic Health to children who are covered under the state’s Apple Health for Kids. Maintaining funding for GA-U reflects our state’s long term goal of expanding access to the uninsured to improve health outcomes and better manage costs.

GA-U clients range from those who suffer from physical ailments stemming from injuries to others with debilitating mental illnesses. Health issues are a primary concern for clients in the GA-U program, many of whom suffer from co-existing physical, mental, and substance abuse problems. There are 21,000 people enrolled at any given month in the GA-U program and clients can be found in every county of the state.

Importantly, GA-U fills gaps that would otherwise exist in our state’s health care infrastructure. Eligibility for other assistance programs is very limited for adults who do not have children at home, even if they are unable to work to support themselves. And federal programs do not cover adults whose disability is considered to be temporary. For these Washingtonians, GA-U provides access to much-needed medical help and the chance to avoid deep poverty and homelessness.