State studies ask why uninsured lack coverage

Department plans to conduct health insurance research

Posted: Monday, January 15, 2007

ANCHORAGE - The state Department of Health and Social Services is working to get a better handle on access to health-care facilities and on the numbers of Alaskans who have no health insurance.

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The department this month issued two requests for proposals seeking contractors to conduct interviews with various groups to discuss insurance coverage and to hold talks about access to health care facilities.

The insurance study is part of a two-year $964,000 federal grant. The goal is to gather data on health insurance coverage and to identify options for making affordable health insurance available to Alaskans who are currently uninsured.

"We want to understand the dynamics of why people are covered or not," said Pat Carr, manager for health planning and systems development. "People have coverage sometimes and not at other times. We want to understand why."

In 2005, some 18 percent of all Alaskans had no health insurance, the department said. Young adults, males and Alaska Natives were more likely to be uninsured. Alaska Natives are provided medical services through Indian Health Service and Alaska Native Tribal Health Consortium facilities, but those benefits are not always transferable or accessible outside Alaska.

Most uninsured have jobs. Only one in 10 Alaskans without insurance are unemployed.

The big question is why.

Work done in the first year of the grant included conducting an employer survey and holding several forums with select groups, such as small business representatives and low-income Alaskans. A household survey asking about coverage is nearly completed, Carr said.

Common themes as to why employers don't offer health insurance or why individuals don't have it so far seem to be the costs of coverage and its lack of availability, Carr said.

The key interviews sought in the RFP will focus on discussions with representatives who offer health care, such as the military, nonprofits and tribal organizations, as well as business leaders and policy makers that could affect future coverage availability.

Cost for this study has a maximum budget of $30,000.

Carr and others in the department will spend much of the spring summarizing the data to distribute around the state. The study will also feature an economic analysis of the various plans or strategies that could expand coverage, and the economic impacts to the state.

Ideas could include allowing more companies to enter into insurance pools or expanding public programs, such as Medicaid and Medicare, or through partner benefits.

The full report should be completed this summer. The grant doesn't give money to implement any suggestions.

The state is also trying to determine accessibility to health care. The department is seeking a contractor to develop a report that identifies and analyzes the communities, areas and populations that have the greatest unmet need.

The report largely will assimilate current data into one document, said the department's Alice Rarig. The report should be completed in March.

"Alaskans have a lot of challenges in getting access to services," she said. "Part of it is the cost of care, or people postpone treatment because they don't have the resources to get to a facility. We hope legislators, policy makers and program planners can use this information to improve services in their areas."

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