NASE News

Geography Impacts Likelihood Of Being Insured

According to recently released Census data, state laws, population makeup and jobs can mean that Americans in some geographic areas are many times more likely to be uninsured than others. Americans in large areas of the Southwest are much more likely to lack health insurance than those in areas of the Northeast and upper Midwest.

America’s Health Insurance Plans (AHIP) notes that the portion of uninsured residents in the nation’s 435 congressional districts ranges from a high of 40.1 percent in Representative Gene Green’s district in Houston, Texas, to a low of 3.4 percent in Representative Jim McGovern’s district near Worcester, Mass.

The reasons for these geographical disparities are manifold, including state regulations and the jobs available in and the demographic characteristics of certain areas.

Medicaid eligibility varies between states. States that are more generous in their eligibility requirements for Medicaid, the federal health program for lower-income families, have lower rates of uninsured residents than states with more stringent requirements.

Areas with more residents working in certain industries, more nonunion workers, greater numbers of lower wage earners, fewer government workers, and more residents between the ages of 20 and 24 or 60 and 64 are more likely to have a larger proportion of uninsured.

Residents working in farming, fishing, hunting, mining, construction, real estate, support positions such as secretary or janitor and hotel and food service workers are more likely to be without insurance coverage. While construction workers in heavily unionized areas of the United States, such as the Northeast, Chicago and California, are more likely to have health coverage than in right-to-work states in the South and Southwest, Bureau of Labor Statistics data showed that 80 percent of union workers in private industry had health insurance benefits in 2006, while only 49 percent of nonunion workers did.

Wages and the availability of government jobs can also predict access to health insurance, as more than 90 percent of the nation’s highest wage earners had access to health insurance, while little more than 25 percent of the nation’s lowest wage earners did, and just under 75 percent of the nation’s workers had access to health insurance, but the access rate rose to 88 percent for government workers.

People between the ages of 20 and 24 may be least likely to have health insurance out of all age groups because they don’t have jobs, have jobs that don’t include health insurance or have aged out of parents’ health insurance coverage. Another age group in which people are less likely to be insured is the 60 to 64 age group, likely because they are making too much money to qualify for public insurance but can’t afford private insurance, or are early retirees whose company didn’t provide health insurance in retirement, but are too young to qualify for Medicare.