by Dr. Kelley Cullen
Access to health care is vital to public health, as insured residents are more likely to seek preventive care, manage chronic conditions, and receive timely treatment. This leads to healthier populations and less spread of infectious diseases. Additionally, health insurance allows people to stay productive in work and school and protects families from catastrophic medical bills. This financial security can help reduce poverty.
For these reasons, and more, it is important to consistently monitor both the number and rate of residents who lack health insurance in our communities.
WHAT DOES THE RECENT DATA SAY?
Both the number and share of residents who lack health insurance in the combined Chelan & Douglas counties have continued to tick upwards from its low in 2016, when the rate was 7%. According to data from the US Census American Community Survey (ACS) and presented in Chelan-Douglas Trends 5.4.1 Uninsured Population, in 2023, one in eight residents in Chelan & Douglas lacked health insurance (12.6%). This is twice the rate of the state overall (6.3%) and above the national average (7.9%) as well.
Because health insurance is often accessible through employment, the more urban areas of Spokane County (5% in 2023), along with Benton & Franklin Counties (8.8%), tend to have lower rates of uninsured. Nearby Yakima (20%) and Grant (15%), on the other hand, have higher rates than Chelan & Douglas.
FOR A LITTLE PERSPECTIVE, A LOOK BACK…
From 2009 to 2013, the number and rate of uninsured residents in Chelan & Douglas were on the rise to nearly 24,000 – at that time, nearly one of every five residents in the metro area! The Affordable Care Act further greatly improved accessibility, and from 2014 to 2016 there was a marked fall of the rate to just 7% (one-third the previous level) of the population lacking health insurance.
However, between 2016 and 2018, there was a jump in both the number and rate of uninsured to 10.6% and the rate continued to climb another two percentage points. But the number of uninsured in 2023 of just over 15,000 was still below what it was in 2011.
YOUTH RATES RISING MORE QUICKLY
Thanks to an additional Chelan-Douglas Trends indicator, 5.4.2 Uninsured Persons 18 & Younger, we can look at an important, vulnerable age group – our youth.
Starting in 2013, changes to the state’s Medicaid program, re-branded as Washington Apple Health, were implemented and greatly increased access for youth. During this time, in the combined counties, the rate of uninsured youth (18 and younger) fell dramatically, from 8.5% in 2012 to 2.2% in 2019. While the number of uninsured youths in the combined counties remained relatively flat through 2021, there was a rather large jump in 2022 and 2023 to 7.8%. The number of uninsured youths in 2023 was nearly three times what it was just two years earlier in 2021 and is just below the level back in 2012.
FUTURE IMPLICATIONS
With recent revenue forecasts calling for lower revenues at the state level and economic uncertainty around tariffs and inflation, resources for public health may become more constrained and access to health care for residents could decrease. It appears unlikely that the rate of uninsured will fall much in the current economic environment. For the local healthcare sector, for public health officials, and for employers, it will become important to essentially keep a lid on the rate of the uninsured to continue to foster a community where everyone has the opportunity to thrive.