Target Areas for Expanding Coverage: Uncovered
An estimated 50 percent of Hawaii’s uninsured, or more than 58,400 people, are on the job, according to the University of Hawaii Social Science Research Institute, which performed an extensive analysis of the 1996 to 2002 Current Population Survey conducted by the U.S. Census Bureau. Based on a 7-year average of the survey, the university derived these numbers. Uninsured sole proprietors and the self-employed represent about 11,800 workers.
Cost of Group Coverage: Businesses Carry the Burden
The cost of health insurance has escalated rapidly in recent years. According to the 2002 report “Health Care Costs: Trends and Relationships to Insurance Premiums,” issued by the University of California Academic Senate, “…insurers are now passing on to their policyholders cost increases that they might have absorbed in past years—and are adding to them in the process of improving their bottom lines.”
Because of Prepaid Health Care Act provisions, Hawaii employers pay the highest percentage of health insurance premium costs in the U.S. According to the Medical Expenditure Panel Survey – a national survey of health care use – the average Hawaii health care insurance premium in 2000 was $184 per month, of which the average employee contribution was $16 (8.6 percent). Nationally, the average total premium was $221 per month, with employees paying an average of $37 (about 17 percent).
Some businesses have sought to avoid paying for employee benefits, including health insurance, by increasing the size of their part-time workforce (employing more workers at less than 20 hours per week) and contracting more services to self-employed individuals.
Cost of Coverage: Individuals Carrying the Burden
The actual costs for privately obtained individual health insurance vary and are difficult to come by, except anecdotally, because insurance rate information is confidential.
The Hawai‘i Uninsured Project has assembled a committee of community leaders to develop affordable options that best serve the uninsured and employers. Solutions may include creating an affordable and easily accessible health insurance product.