In Missouri, an estimated 835,000 people don't have health insurance – that's about 14 percent of the state's population. But in the next couple of years, that figure is going to change. Now that the U.S. Supreme Court has upheld most of the federal health care law, about half a million Missourians will join the rolls of the insured – either through Medicaid, the private insurance market, or with the help of subsidies provided by the federal government. The percentage of uninsured will drop to five percent of the population.
All that is according to a new report released by the Missouri Foundation for Health and the Health Care Foundation of Greater Kansas City. The report estimates county-by-county how many people will gain health insurance by the year 2014. It shows wide disparities among counties, with some rural areas currently having more than double the rate of uninsured as more urban counties.
Here in mid-Missouri, Boone County currently has one of the lowest rates of uninsured in the state, at 12.8 percent of the population. By 2014, that number will drop to 4.3 percent, or 5,870 uninsured. Compare that to rural Knox County, in northeast Missouri, or Ozark County in southern Missouri, where more than 22 percent of the population goes without health insurance. The uninsured rate in those rural counties will drop to around eight percent, according to the report's projections.
"We know generally that rural areas tend to be more of the small businesses, tend to be more family farmers," said Jessica Hembree, with the Health Care Foundation. "Most folks who are going to work for large companies do end up getting insurance through their employer, but when you get to some of these rural areas, where there's just not the density of large employers that there are in urban or suburban communities, that's where you see a higher rate of uninsured."
She said the report's county-level data is important because it illustrates the impact the health care law will have in local communities.
"We're not talking in broad theoretical terms, we can talk about specific counties, and what they stand to gain in terms of more people being covered by health insurance."
Hembree said many of Missouri's most rural counties, with the lowest health insurance rates, stand to benefit the most, in terms of the percentage of people who will gain insurance.
"That's new college grads, that's people who've been laid off, that's family farmers, that's people with pre-existing conditions. So behind this whole debate is very real people facing very real problems."