The number of people in Washington state without health insurance has risen sharply since the end of 2008 and is expected to reach 1 million by the end of the year, according to a new report from state Insurance Commissioner Mike Kreidler.
About 14.5 percent of state residents — most of them working-age adults — have no coverage, and many more are underinsured, the report says. In 31 of 39 counties, the percentage of uninsured grew over the past two years.
Meanwhile, hospitals and health-care providers across the state are spending about $1 billion per year on uncompensated care, which includes both charity cases and bad-debt write-offs. Those losses ultimately are passed along to those who have insurance, adding an estimated $1,017 to an average family's annual premium, the report says.
The $1 billion includes a 36 percent increase in charity-care costs from 2008 to 2010.
This grim picture — which Kreidler attributes to stagnant incomes, continued high unemployment and health-care costs that continue to outpace inflation — would be even worse but for that group that usually is blamed for everything: baby boomers.
The oldest boomers, born in 1946, have started to peel off commercial health insurance and onto Medicare, the federal insurance program. Nearly all state residents age 65 and older have health insurance through Medicare.
Retirees and college students likely helped six counties buck the trend, actually improving the percentage of residents with health insurance.
In Clallam, Cowlitz, Jefferson, Wahkiakum, Whatcom and Whitman counties, a higher proportion of residents were insured than in 2008, a change Kreidler attributes to high numbers of retirees on Medicare and college students insured on their parents' plans through a federal health-overhaul provision.
In contrast to the older-than-65 group, nearly 30 percent of people aged 18 to 34 have no health coverage and make up nearly half of the state's uninsured. While some blame the "young invincible" mindset, the report says people in that group often must weigh expensive health insurance against typically lower wages, concluding they can't afford the coverage.
Because the cost of health care has continued to rise steeply, Kreidler said, health insurance is unaffordable to many working people even when employers offer it. About half of those without health insurance in the state are employed, the report notes.
In addition, the report estimates as many as 25 percent of state residents were spending more than 10 percent of their pretax income on health care, with average co-pays and coinsurance rising 15 and 10 percent respectively from 2008 to 2010.
Kreidler says his calculations for uncompensated hospital care were very conservative, and, in fact, those numbers could be nearly double. The Washington State Hospital Association said its numbers show more than $1.1 billion in uncompensated care for 2010, with not all hospitals reporting.
Kreidler said Washington isn't among the worst states in rates of health coverage. Texas topped the nation in 2010 with 24.6 percent of residents uninsured, while the U.S. average was 16.3 percent, according to the U.S. Census Bureau.
Still, Kreidler added, he doesn't expect the trend in Washington state to change soon.
"In two more years, it's going to be just the same," Kreidler said. "We know that we're going to have more uninsured and more people struggling to hold onto what they have. We're going to have to do something different."
Carol M. Ostrom: 206-464-2249
On Twitter @costrom.