Review of New Data from the American Community Survey on rates of insurance for Alaska Natives and American Indians

Transcription

1 Review of New Data from the American Community Survey on rates of insurance for Alaska Natives and American Indians

2 Census: Decennial and Annual American Community Survey 2010 Census is official census: WA 198,998 AIAN alone and in combination OR 109,223 alone and in combination 2010 ACS estimates: 192,000 estimate by ACS for Washington 2010 Roughly 80,000 live on or near reservations 105,000 estimate by ACS for Oregon 2010 About 40,000 live on or near reservations Little is known about variations in health insurance status between reservation areas and urban areas. Comparing Eastern OR Eastern WA to statewide

3 Eastern OR and WA Largest reservations in both states are on the East side of Cascades WA, Yakama and Colville have largest tribal membership in the State Over 20,000 members of WA tribes live in Eastern WA of over 40,000 AIANs who live in Eastern Washington. Klamath, Warm Springs, and Umatilla each have about 4,000 tribal members, many live on reservations, with exception of Klamath, a terminated tribe, who lost 1 million acre reservation in the 1950s. Over 12,000 members of OR tribes live in Eastern OR over population of over 20,000 AIANs in Eastern Oregon.

4 Health Insurance Non-metropolitan Eastern WA Compared to Washington State Uninsured 18% 28% IHS 26% 38% MEDICAID 29% 32% MEDICARE 10% 12% PRIVATE 40% 50% 0% 10% 20% 30% 40% 50% 60% PRIVATE MEDICARE MEDICAID IHS Uninsured E Washington 40% 12% 32% 38% 28% Washington 50% 10% 29% 26% 18%

5 12 % difference in Access to IHS 40% IHS 38% 35% Axis Title 30% 25% 20% 15% 26% 10% 5% 0% Washington E Washington IHS 26% 38%

6 3% Difference in Medicaid Coverage: Unknown Difference in Take-up rates Axis Title 33% 32% 31% 30% 29% 28% 27% 26% MEDICAID 29% Washington 32% E Washington MEDICAID 29% 32%

7 10% Difference in Private Insurance Coverage 60% 50% 40% 50% PRIVATE 40% Axis Title 30% 20% 10% 0% Washington E Washington PRIVATE 50% 40%

8 Uninsurance Rate: 10% difference between Eastern WA and Statewide Rate 30% 28% 25% 20% 18% Axis Title 15% 10% 5% 0% Washington E Washington Uninsured 18% 28%

9 Comparing Health Insurance Status in Eastern OR to Oregon State-wide Uninsured 27% 29% IHS 20% 42% MEDICAID 26% 29% MEDICARE 9% 10% PRIVATE 43% 48% 0% 10% 20% 30% 40% 50% 60% PRIVATE MEDICARE MEDICAID IHS Uninsured E Oregon 43% 10% 29% 42% 29% Oregon 48% 9% 26% 20% 27%

10 22% difference in access to IHS services: 42% in Eastern Oregon 45% 40% 35% 30% IHS 42% Axis Title 25% 20% 15% 10% 5% 20% 0% OREGON E OREGON IHS 20% 42%

11 3% difference in Medicaid coverage: 29% in Eastern Oregon MEDICAID 29% 26% OREGON E OREGON

12 5% difference in Private Insurance: 43% in Eastern Oregon 49% 48% 48% PRIVATE 47% Axis Title 46% 45% 44% 43% 43% 42% 41% OREGON E OREGON PRIVATE 48% 43%

13 2% difference in rate of uninsurance Uninsured 29% 27% OREGON E OREGON

14 Comparing Eastern OR and Eastern WA to State-wide Health Insurance Status in OR and WA Uninsured 18% 29% 28% 27% IHS 20% 26% 38% 42% MEDICAID 29% 26% 29% 32% MEDICARE 10% 12% 9% 10% PRIVATE 40% 43% 48% 50% 0% 10% 20% 30% 40% 50% 60% PRIVATE MEDICARE MEDICAID IHS Uninsured E Oregon 43% 10% 29% 42% 29% E Washington 40% 12% 32% 38% 28% Oregon 48% 9% 26% 20% 27% Washington 50% 10% 29% 26% 18%

15 Overall Assessment: Variation Across OR and WA The impact of Health Care Reform On or Near Oregon s and Washington s Indian Reservations 1. Great variation between State-wide and Eastern areas 2. Uninsured and IHS access vary widely, but Medicaid keeps rates lower in areas with lower private insurance 3. Medicaid high (and similar to statewide) in all areas, but may have lower take up rates given poverty rates 4. IHS access higher in rural areas near reservations. 5. Private insurance low in eastern parts of both states. 6. Outreach and education should consider differences.

16 References U.S. Census Bureau. American Community Survey (ACS) 2008,2009, 2010, 3 year American Community Survey accessed through Factfinder2 for 3 year reports for years 2008, 2009, 2010

17 ACS question on insurance coverage

18 Eastern Oregon Pumas

19 INDIAN RESERVATIONS WASHINGTON

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