Is Cost Putting Health Insurance Out of Reach?

When Perry Forrest started working as a truck driver and groundsman for Pike Electric Corp. last month, he and his wife, Jonnie, decided not to take the healthinsurance plan offered by his new employer. "We just can't afford it at this time," Jonnie Forrest said. "Eighty-five dollars a week is a lot of money when you are raising two teenagers." The children -- 16-year-old E.T. and 15-year-old Ashley -- have federally supported health insurance through the state's Family Access to Medical Insurance Security plan, or FAMIS. But the couple have been without health insurance since they both lost their jobs -- and she lost their employer-subsidized family health insurance -- in 2006.

Perry Forrest was unemployed for 18 months. During that time, his wife was self-employed, cleaning houses and taking care of an elderly woman to make ends meet. She's now a stay-at-home mom. They are among the growing number of Virginians without health insurance. According to a report released last month by the Robert Wood Johnson Foundation, there were more than 964,000 Virginians without healthinsurance in 2005, up 28 percent from more than 752,500 in 2001. Nationally, a total of 47 million Americans don't have health insurance. For those in Virginia who still had insurance, the price that they were paying increased 27 percent in five years, while the median income increased just 8 percent, according to the foundation's report, "Squeezed: How Costs for Insuring Families Are Outpacing Income." Nationally, the out-of-pocket cost for health insurance increased 35 percent from 2001 to 2004.

"Most states are in a similar boat, where family incomes are not at all keeping up with the rising cost of health insurance premiums," said Brian Quinn, foundation program officer. "It makes it clear what employees have known: Paying for their health insurance is taking a bigger bite out of their income. "And as the cost continues to rise, it will be further and further out of reach for many people." In Virginia, the total average family premium rose from $8,104 in 2001 to $10,292 in 2005. Employers picked up three quarters of the premium cost, and employees paid for the rest. Nationwide, the greatest increase was in Oklahoma, where the total cost of premiums paid jumped 50 percent in five years. Premiums aren't the only costs that are going up. "There's co-pays for doctors visits, higher-tiered prescriptions," said Kay Bradley, executive director of the Gloucester-Mathews Free Clinic in Hayes. Some insurance companies recently adopted a new pricing structure for some prescriptions.

Now, instead of paying a low set price, patients are being charged a percentage of the cost of some higher-priced drugs. General spending on health care has consistently grown faster than the economy since the 1960s, according to the Kaiser Family Foundation, a nonprofit that provides information and analysis on health care issues. In 2007, the United States spent more than $2.2 trillion -- an average of $7,500 a person -- on health care. That's up from $75 billion --about $356 a person -- in 1970. The effects of the increase in health care costs and health insurance premiums are being felt by the 50 free medical clinics across the state serving Virginians who earn less than 200 percent of the federal poverty level -- about $41,000 a year for a family of four. In the first half of 2007, the wait for a new patient to get an appointment doubled to as much as four weeks at some sites, said Lou Markwith, executive director of the Virginia Association of Free Clinics. The association expects the trend to continue.

"Anecdotally, we are seeing a significant increase already in the first quarter of 2008 in the number of people seeking services," Markwith said. He said the data aren't complete yet. In the first three months of 2008, one Hampton Roads area clinic reported seeing more than 340 new patients, he said. In 2007, the Gloucester-Mathews clinic saw 2,105 patients, up from 1,800 the previous year, Bradley said. The clinic is prepared to take in 30 new patients each month. "We average 25 new patients a week that are calling for service, so you can imagine how long the wait list is," she said. A striking number of those calls are coming from working people. "We are seeing rising numbers of working people, people who are working for a company that does offer group insurance," Bradley said. "But the cost that's being passed on to them makes it not an option."

According to the Johnson Foundation report, 88 percent of Virginia employers offered health insurance in 2005, down from about 91 percent from 2001. And of the 150,000 patients seen by free clinics in the state, 70 percent have full-time jobs, Markwith said. And 13 percent are working part time. "These are people who are working, and they still cannot afford health insurance," he said. People like Perry Forrest, who leaves on Sunday evenings for his job with the electric company in southern Maryland and returns Thursdays. He and his wife have been patients at the Gloucester-Mathews clinic for about a year.They figure that they'll stay with the clinic for now, rather than pay the weekly premium needed to buy health insurance from his employer.

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