An estimated 544,000 people in Kansas under age 65 — nearly one-fourth of the state's nonelderly population — have a diagnosed pre-existing medical condition that could lead to a denial of insurance coverage if they try to buy it on their own, according to a new report by Families USA.
They are among the 57.2 million people nationwide who could be denied insurance, the report claims.
Families USA is a Washington-based consumer advocacy group that supports the national health care reform law passed earlier this year. The law prohibits insurance companies from denying health coverage or charging higher premiums because of someone's medical history. That provision doesn't go into effect until 2014.
"The high numbers really don't surprise me," said Anna Lambertson, interim director of the Kansas Health Consumer Coalition.
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She and her organization increasingly hear stories of Kansans with pre-existing conditions such as diabetes, breast cancer and hepatitis contracted during hospital surgeries who can't afford health insurance, she said.
Suzanne Cleveland, senior policy analyst for the Kansas Health Institute, an independent, nonprofit health policy and research organization, said the general premise of the Families USA report is accurate: The new law will open coverage to people with pre-existing conditions who currently have trouble finding coverage.
But she hasn't seen any numbers from state agencies about the issue. Without further study, Cleveland said, "I'm not confident I can say one way or another whether their numbers are credible."
The Families USA report is based on data on health conditions from the federal Medical Expenditures Panel Survey and demographic data from the U.S. Census Bureau's Current Population Survey.
The Medical Expenditures survey, conducted by the Department of Health and Human Services' Agency for Healthcare Research and Quality, surveys individuals, families, medical providers and employers nationwide on health care and health insurance costs and usage.
According to the Families USA report, the problem gets worse with age.
Among its findings, Kansans with a diagnosed pre-existing health condition that could lead to a denial of coverage include:
* More than one in six adults aged 18 to 24 (16.9 percent).
* More than one-third of adults aged 45 to 54 (36.4 percent).
* And nearly half of adults aged 55 to 64 (46.9 percent).
The report also found that 50,300 Kansas children under age 18 have pre-existing conditions.
Families USA says its totals may understate how many people nationally and in Kansas have pre-existing conditions because the analysis only reflects those that have been diagnosed.
People who are uninsured or underinsured, and who can't afford care, often don't seek treatment, so their health conditions may not be diagnosed, the report says.
The uninsured and those who do not have access to job-based coverage are at greatest risk, but even those who have coverage at work could be at risk if they lose or leave their jobs and have to find coverage on their own, the report says.
The report says that Kansans with diagnosed pre-existing conditions range across all income levels.
Nearly one-quarter (23.3 percent) of people in families with incomes below 100 percent of the federal poverty level — less than $22,050 for a family of four — are affected, the report says.
About 21 percent of individuals in Kansas families with incomes between 100 and 199 percent of poverty —between $22,050 and $44,100 — are affected.
And 23.9 percent of Kansans in families with incomes above 200 percent of poverty, or more than $44,100 for a family of four in 2010, have such conditions.
"All of us need to open our eyes and see this isn't just about poor people," Lambertson said.