Government Picks Up Health Tab of Uninsured Workers

FRIDAY, May 2 (HealthDay News) -- Working people and their families who don't have employer-based health insurance cost the American public $45 billion a year, a new study reveals.

This includes $33 billion in the costs of Medicaid and the State Children's Health Insurance Program, and $12 billion in uncompensated care expenses, which are paid by federal, state and local governments and shifted to other payers.

In addition, one-third of low-paid workers do not have health insurance, an increase of 9 percent since 1996, another study finds. Both reports were released Friday by The Commonwealth Fund.

"There's a lot of government money going to pay for workers and their family members who are employed," said Sherry Glied, co-author of both reports and a professor of health policy and economics at Columbia University.

"We usually think that government money goes to pay for health care of people who are unemployed, but a lot of that money is actually going to people who are working, and that amount is going up all the time," Glied said.

The first report,Who Pays for Health Care When Workers Are Uninsured, shows how much the U.S. health-care system depends on employer money to cover health-care costs, Glied said. "Public programs are really vulnerable if that money disappears," she noted.

Even though many employers offer health insurance, the costs of publicly paid health care for full-time workers and families increased from $31 billion in 1999 to $45 billion in 2004. This includes an increase in public insurance costs from $21.2 billion to $32.5 billion, and an increase in uncompensated care costs from $9.4 billion to $12 billion, according to the report.

Glied noted that it is mostly small companies that don't provide their workers with health insurance, thereby shifting the burden to public money.

But large companies also play a role. In fact, 1.6 million people at companies with more than 100 employees were uninsured in 2004, compared with 1.2 million in 1999, a 33 percent increase, according to the report.

"We need to think about how to use public money in the most efficient way," Glied said. "We need to find ways to supplement what employers are doing and how to keep employers in the game."

The second report,The Widening Health Care Gap Between High- and Low-Wage Workers, shows that low-wage workers do not have the same access to health care as high earners.

"This is really a very depressing report," Glied said. "What it really says is that the good things that are happening in our health-care system are only happening to higher-wage people. Low-wage people really don't see much gain at all from all the extra good stuff we are spending on health care -- they're just getting shut out of it."