Uninsured Population Hawai`i: Adults Age 19-64 Gerard Russo, Ph.D. Sang-Hyop Lee, Ph.D. Lawrence Nitz, Ph.D. Thamana Lekprichakul, Ph.D. Rui Wang, Ph.D. Candidate University of Hawai`i at Mānoa Kathleen Baker, Ph.D., Hawaii Department of Health HRSA SPG VII Technical Workshop 13 October 2005 This research is funded in part through a U.S. Health Resources and Services Administration, State Planning Grant to the Hawaii State Department of Health. Sub-Contract Research Corporation of the University of Hawaii. Research conducted by the University of Hawaii, Social Science Research Institute in collaboration with the Hawaii State Department of Health, Hawaii Institute for Public Affairs: Hawaii Uninsured Project and the Hawaii Health Information Corporation.

Age Distribution of Hawai`i’s Uninsured Population: CPS 2003-2005, 3-year Average 123,595 1,607 22,580 99,408 13 October 2005 Preliminary results. Revised October 2005. Subject to further revision.

Hawaii Uninsured Adults Age 19-64: CPS 2001-2005, 3-Year Moving Average Survey Years Persons/Rate Standard Error 95% Confidence Interval 2001-2003 Total Adults 719,951 11,190 698,007 741,896 Uninsured Adults 87,779 5,287 77,410 98,147 Percent Uninsured 12.19% 0.70% 10.83% 13.56% 2002-2004 734,066 7,965 718,448 749,683 92,794 4,599 83,776 101,812 12.64% 0.59% 11.48% 13.80% 2003-2005 746,450 8,209 730,353 762,547 99,408 4,863 89,872 108,944 13.32% 0.61% 12.12% 14.51% Source: The Current Population Survey (CPS), Annual Social and Economic (ASEC) Supplement, 2001-2005.Weighted tabulations, University of Hawai`i at Mānoa. 13 October 2005 Preliminary results. Revised October 2005. Subject to further revision.

Hawaii Uninsured Adults Age 19-64: CPS 2001-2005 Survey Year Persons /Rate Standard Error 95% Confidence Interval 2001 Total Adults 712,908 18,439 676,650 749,166 Uninsured Adults 86,149 11,194 64,138 108,160 Percent Uninsured 12.08% 1.53% 9.07% 15.10% 2002 728,444 13,691 701,576 755,313 82,646 7,807 67,325 97,967 11.35% 1.01% 9.36% 13.33% 2003 718,501 13,595 691,821 745,182 94,542 7,757 79,318 109,766 13.16% 1.02% 11.16% 15.16% 2004 755,251 13,991 727,794 782,708 101,195 8,323 84,861 117,528 13.40% 1.04% 11.36% 15.43% 2005 765,598 14,873 736,411 794,786 102,487 9,150 84,531 120,444 13.39% 1.10% 11.22% 15.55% Source: The Current Population Survey (CPS), Annual Social and Economic (ASEC) Supplement, 2001-2005. Weighted tabulations, University of Hawai`i at Mānoa. 13 October 2005 Preliminary results. Revised October 2005. Subject to further revision.

Uninsured Hawaii Adults Age 19-64: with 95% Confidence Intervals CPS Survey Years 2001-2005 13 October 2005 Preliminary results. Revised October 2005. Subject to further revision.

Percent Uninsured: Hawaii Adults Age 19-64 with 95% Confidence Intervals CPS Survey Years 2001-2005 13 October 2005 Preliminary results. Revised October 2005. Subject to further revision.

Uninsured Hawaii Adults Age 19-64: HHS 1997-2003 Year Uninsured Adults Standard Error 95% Confidence Interval Lower Limit Upper Limit 1997 35,693 2,292 31,199 40,187 1998 53,513 3,477 46,697 60,329 1999 53,168 3,156 46,980 59,356 2000 43,017 2,755 37,616 48,417 2001 49,385 2,768 43,958 54,812 2002 42,563 3,136 36,415 48,711 2003 52,041 3,436 45,305 58,776 Source: Hawaii Health Survey 1997-2003. Weighted tabulations University of Hawaii. 13 October 2005 Preliminary results. Revised October 2005. Subject to further revision.

Percent Uninsured Hawaii Adults Age 19-64: HHS 1997-2003 Year Percent Uninsured  Standard Error  95% Confidence Interval Lower Limit Upper 1997 5.20% 0.33% 4.59% 5.89% 1998 7.98% 0.51% 7.05% 9.03% 1999 7.91% 0.46% 8.86% 2000 6.34% 0.40% 5.60% 7.17% 2001 6.96% 0.38% 6.25% 7.75% 2002 5.94% 0.43% 5.15% 6.84% 2003 7.11% 8.07% Source: Hawaii Health Survey 1997-2003. Weighted tabulations University of Hawaii. 13 October 2005 Preliminary results. Revised October 2005. Subject to further revision.

48 Contiguous States & DC Annual Family Income 2005 US HHS Poverty Guidelines: Hawaii vs. 48 Contiguous States & DC Family Size Hawaii Annual Family Income 48 Contiguous States & DC Annual Family Income 1 $11,010 $9,570 2 $14,760 $12,830 3 $18,510 $16,090 4 $22,260 $19,350 5 $26,010 $22,610 6 $29,760 $25,870 7 $33,510 $29,130 8 $37,260 $32,390 Note: For Hawaii family size more than 8 persons add $3,750 for each additional person. For Mainland family size more than 8 persons add $3,260 for each additional person. Source: Federal Register, Vol.70, No.3. http://aspe.hhs.gov/poverty/05fedreg.pdf 13 October 2005 Preliminary results. Revised October 2005. Subject to further revision.

Hawai`i Uninsured Adults Age 19-64 by Income Eligibility Status for Calendar Years 2000-2003: CPS, BRFSS & HHS (4-year averages). Survey Years TANF 0-62.5% FPL CAP 62.5-100% 101-200% 201-300% 301%+ Total CPS 2001-2004 15,515 11,235 22,609 18,132 23,879 91,370 BRFSS 2000-2003 12,377 9,453 19,804 13,178 14,186 68,998 HHS 5,098 5,035 14,412 8,260 13,947 46,751 NOTES: Adults with family income at or below 62.5% of the U.S. Dept. of Health & Human Services federal poverty guidelines for Hawaii (1993) will meet the Medicaid-QUEST income eligibility criterion and will not be subject to the QUEST enrollment cap. Adults with children in this income group are normally eligible for Temporary Aid to Needy Families (TANF). Adults with family income greater that 62.5% FPL (1993) but less than or equal to 100% FPL are typically income eligible for free medical assistance under Medicaid-QUEST but are subject to the QUEST enrollment cap. Beyond 100% FPL only pregnant women in families with income less than or equal to 185% FPL are eligible for free medical assistance under Medicaid-QUEST. For the BRFSS and HHS, missing income data has been imputed and the categorical income variables are converted through a simulation method to a continuous distribution before the Hawaii specific federal poverty guidelines are applied. Income data in the BRFSS and HHS is based on the household unit. SOURCES: University of Hawaii weighted tabulations. Current Population Survey, Annual Social and Economic (ASEC) Supplement 2001-2004, Hawaii sample. Behavioral Risk Factor Surveillance System (BRFSS) Survey 2000-2003, Hawaii sample. Hawaii Health Survey 2000-2003. 13 October 2005 Preliminary results. Revised October 2005. Subject to further revision.

Percent Uninsured of Hawai`i Adults Age 19-64 by Income Eligibility Status for Calendar Years 2000-2003: CPS, BRFSS & HHS (4-year averages) Survey Years TANF 0-62.5% FPL CAP 62.5-100% 101-200% 201-300% 301%+ Total CPS 2001-2004 35.2% 24.1% 18.7% 13.7% 6.2% 12.5% BRFSS 2000-2003 25.3% 15.2% 11.5% 8.3% 4.7% 9.3% HHS 13.2% 11.7% 10.6% 3.9% 6.6% SOURCES: University of Hawaii weighted tabulations. Current Population Survey, Annual Social and Economic (ASEC) Supplement 2001-2004, Hawaii sample. Behavioral Risk Factor Surveillance System (BRFSS) Survey 2000-2003, Hawaii sample. Hawaii Health Survey 2000-2003. 13 October 2005 Preliminary results. Revised October 2005. Subject to further revision.

Uncovered Workers in Hawai`i—Part-Time, Full-Time and Self-Employed: Estimates from the Current Population Survey (CPS) 2001-2004 13 October 2005 Preliminary results. Revised October 2005. Subject to further revision.

Three Measures of Hours Worked: Current Population Survey Usual hours worked per week at all jobs held last year. Actual hours worked per week at all jobs held last week. Usual hours worked per week at main job held last week. 13 October 2005 Preliminary results. Revised October 2005. Subject to further revision.

Distribution of Uninsured Adults Age 19-64 by Employment: Summary Distribution of Uninsured Adults Age 19-64 by Employment Status: CPS 2001-2004 Hawaii Sample.   All Jobs Last Year All Jobs Last Week Main Job Last Week Self-Employed 1-99 hours 12,300 12,341 Part-Time Employee 1-19 hours 4751 5528 4190 Full-Time Employee 20+ hours 50,120 37,730 36,265 Zero Hours, Variable Hours, Unemployed or Not in Labor Force 24,199 36,778 40,814 TOTAL 91,370 NOTE: Constructed on three questions of hours worked, employment and health insurance status from the Current Population Survey (CPS) Basic Monthly Survey and Annual Social and Economic (ASEC) Supplement 2001-2004. For example: “How many hours do you usually work at your main job (held last week)?” SOURCE: University of Hawaii Weighted Tabulations CPS 2001-2004 Hawaii Sample, 4-year Average. 13 October 2005 Preliminary results. Revised October 2005. Subject to further revision.

91,370 Uninsured Adults Age 19-64 Start with Usual Hours Worked per Week at Main Job Held Last Week: Accurate Recall & One Job Exclude the Unemployed and Not-in-Labor Force Exclude Self-Employed Exclude Unpaid Workers Exclude the Public Sector PLEASE NOTE: The Uninsured Private Sector are Mostly Non-Union 13 October 2005 Preliminary results. Revised October 2005. Subject to further revision.

Percent Distribution of Uninsured Workers by Usual Hours Worked per Week at Main Jobs held Last Week: Paid Private Sector Employees NOTE: Probability density function computed from the CPS 2001-2004 Hawaii sample. 13 October 2005 Preliminary results. Revised October 2005. Subject to further revision.

This research is funded in part by Hawaii State Department of Health. Mahalo! This research is funded in part by U.S. Department of Health and Human Services Health Resources & Services Administration State Planning Grant Hawaii State Department of Health. 13 October 2005 Preliminary results. Revised October 2005. Subject to further revision.