The bad news is the number of those without health insurance in the US has grown to over 46 million. The good news is that a few states have seen a reduction in the number of uninsured; the really bad news is a few have gotten even worse.
Several states are doing well. One is Iowa, where the uninsured population actually decreased last year, as the percentage of those without health insurance dropped from 10.4% in 2004 to 9.1% in 2005. Part of this success is due to increased enrollment of kids in the state’s Hawk-I program, which more than doubled over five years to 34,600 in 2005. This parallels an increase of 200,000 enrolled in various government-funded programs over the same period.
Maine’s one of the better off states, with a population of uninsured that is significantly lower (10.5%) than the national average of 15.7%. The state’s Dirigo health plan, an effort to increase coverage among Mainers by targeting small employers and kids, has failed to meet enrollment goals but generated significant savings. It is tough to tell if the program has had an impact on the uninsured rate, as it is very new.
One that is not experiencing the same level of success is Arizona, with 20% of the population uninsured after an increase of 225,000 in the number of uninsured in 2005. To address the problem, the state is seeking to implement a revamped Medicaid program under a Federal waiver that focuses on the lower-income workers employed at businesses with fewer than 25 employees. There are over 200,000 businesses in the state that meet the size criterion.
As bad as the situation is in Arizona, it is worse in Texas, where almost a quarter of the population lacks health insurance.
What does this mean for you?
A closer examination of individual states may help us understand drivers of and solutions to the problem of uninsurance.

Okay, here’s a kind of out-of-left-field diversion from our usual diet of policy, insurance, managed care and industry news. Lets talk about motorcycle helmets.
When jurisdictions have mandatory helmet laws, the number of fatalities goes down. By most measures, that is a good thing. However, it does mean there are fewer organs to be transplanted, which is a bad thing.
One of the “bad” things is the increase in medical costs. When Florida dropped its mandatory helmet law, hospital costs for motorcycle injuries jumped from $21 million in the thirty months prior to the change to $44 million for the same period post-enactment.
Readers with good memories will recall that Florida also has a lot of folks without health insurance; 81% of these folks are of working age.
EMTALA laws require hospitals to treat patients, including injured motorcyclists without insurance, who show up at the emergency room.
So society is paying for motorcyclists who want to exercise their free right (choice of words intentional) to suffer brain injuries by riding without a helmet. But I don’t want to pay for their health care.
Do you?