Sept. 14--When it comes to health insurance, Kansas is bucking a national trend.

The number and percentage of people without health insurance nationally dropped for the first time in three years in 2011, according to Current Population Survey data released Wednesday by the U.S. Census Bureau.

In Kansas, those numbers went up.

For the state, a two-year average of about 365,000 people of all ages, or about 13.1 percent of the population, didn't have insurance in 2010-11. That's up from the average of 350,000, or 12.8 percent, in 2009-10. The numbers also are the highest in Kansas since at least 1999.

Nationwide, 48.6 million people, or 15.7 percent, didn't have insurance in 2011. Those figures were down from 49.9 million and 16.3 percent in 2010.

"Whatever impact the Affordable Care Act has had on health insurance coverage nationwide has not been seen quite as strong in the state of Kansas," said Scott Brunner, a senior analyst with the Kansas Health Institute. "Part of the reason for that is that the economy in Kansas hasn't improved at the same rate as it has in other parts of the country or if you look at national statistics on a whole. And that's not unusual, either. Kansas tends to lag a little bit entering a recession and coming out of a recession.

"I think the other important indicator is that there's a big variation when you look at uninsurance among kids up to age 19," Brunner said. "There's been more kids insured through public programs like Medicaid and CHIP that have made up for the loss of employer-sponsored coverage."

"But for the core of adults 19 to 65 or so, as employers have either stopped covering or the coverage is reduced, more people if they have a job, they don't have insurance available, and if they're unemployed they don't have insurance as well. That core of people in the middle of the population is what's keeping that uninsured number higher in Kansas."

Brunner said he and another senior analyst at KHI, Ivan Williams, would be delving deeper into the numbers to determine the impact in Kansas of one health care reform provision that already has taken effect -- a rule allowing parents to keep their children on their family insurance through age 26 instead of age 23.

The Center on Budget and Policy Priorities in Washington, D.C., citing Centers for Disease Control data, said earlier this week that the largest increase in the number of people who now have insurance nationally is in adult children who have remained on their parents' insurance.

Other breakdowns

In Kansas as well as nationally, the number and percentage of people covered by private and employment-based insurance is trending downward while the numbers for government insurance -- such as Medicare, Medicaid and CHIP (the Children's Insurance Program) -- are tending upward.

In Kansas, according to the Current Population Survey Data, 67 percent of the population was covered by private insurance in 2011. That's down from 70.5 percent in 2010 and 79 percent in 2000. Some 55.7 percent of Kansans had employment-based coverage in 2011, down from 57.8 percent a year earlier and 66 percent in 2000.

On the other hand, the percentage of Kansans covered by government insurance was 33 percent in 2011, compared with 31.6 percent a year earlier and only 25.8 percent in 1999.

The percentage covered by Medicare has grown as the baby boom population has started aging into retirement. But Medicaid coverage has likewise grown as people have lost their jobs. In 2011, 12.9 percent of Kansans were covered by Medicaid. That's a record, up from 12.4 percent the year before and 6.8 percent in 2000.

"Particularly for kids who are under 242 percent of the federal poverty line, the scenario is as the parents lose their job and their income goes to zero or close to zero, they don't have insurance, but there is a public option for kids," Brunner said. "They can get them enrolled in CHIP or Medicaid and at least the kids have insurance, but the parents are without."

Added Williams: "The data makes it look like the kids are going to CHIP or Medicaid but the parents are going to be uninsured."

The Current Population Survey found that a two-year average of only 8.8 percent of Kansas children age 18 and younger aren't covered by insurance. The two age brackets with the highest percentage of uninsured Kansans were ages 19-25 (23.1 percent) and 26-34 (22.1 percent).

Brunner agreed that those numbers reflect the fact that some of those uninsured may still be in school, they may not have a job yet, or they may not be eligible for or able to afford employment-based insurance yet. Some also are the "young invincibles" who are gambling that they will remain healthy and choose to spend their money in other ways.

Those 65 and older, and eligible for Medicare, have the lowest uninsured rate in Kansas, 0.1 percent.

Poverty and race also are strong factors in whether people have insurance. In Kansas, 24 percent of those in families with less than $25,000 in income don't have insurance, compared with 14.6 percent of those in families with income $25,000 to $49,999, 7.1 percent of those in families with income of $50,000 to $74,999, and only 6.1 percent of those in families with income over $75,000.

Only 11.1 percent of non-Hispanic whites don't have insurance, compared with 15.7 percent of black people, 22.2 percent of American Indians, 14.6 percent of Asians and 28.6 percent of Hispanics in Kansas.

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