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Funded by a grant from the Health Resources and Services Administration, U.S. Department of Health and Human Services
Definitions for Uninsured
- Uninsured at any time during year (all inclusive): Persons with no health insurance coverage for all or some part of a year.
- Currently Uninsured: Persons with no health insurance at a specific point in time.
- Chronic Uninsured: Persons with no health insurance at a specific point in time and not insured for the previous 12 months.
Source: SC Household Insurance Survey
South Carolina Uninsurance 2002
| Uninsured Status |
Percentage |
Number of People |
| Uninsured At Any Time During Year |
19.4 |
796,794 |
| Currently Uninsured |
11.6 |
474,380 |
| Chronic Uninsured |
8.3 |
342,128 |
Source: SC Household Insurance Survey
Demographic Characteristics of the Uninsured
Insurance Status by Race/Ethnicity in 2000
| |
White |
Black |
Hispanic |
Other |
| South Carolina Total Population (#) |
2,714,848 |
1,207,512 |
98,572 |
86,250 |
| Has Insurance |
81.87 |
80.65 |
57.72 |
62.10 |
| No Insurance |
18.13 |
19.35 |
42.28 |
37.90 |
Source: SC Household Insurance Survey. U.S. Census Bureau.
Hispanic Population In South Carolina
- 42% of the Hispanic population is uninsured, which makes up 5% of the uninsured population.
- There are 109,197 Hispanic people in South Carolina according to the latest 2002 estimate. This is up 13.6% from 2000, which makes South Carolina the nation's sixth fastest growth rate.
- From these numbers there are an estimated 46,234 uninsured Hispanics in South Carolina.
Insurance Status By Age
| |
Average Age |
| Total South Carolina Population |
35.4 |
| Uninsured (At Any Time During the Year) |
32.8 |
Source: SC Household Insurance Survey. U.S. Census Bureau.
Insurance Status By Gender
| |
Male |
Female |
| Total South Carolina Population |
48.6 |
51.4 |
| Uninsured (At Any Time During the Year) |
48.8 |
51.2 |
Source: SC Household Insurance Survey. U.S. Census Bureau.
Employee Income Brackets
| Average Salary of Full-Time Employees |
Uninsured Percentage |
Insured Percentage |
| Less than $5,000 |
2.38 |
1.82 |
| $5,000 to $7,499 |
2.31 |
1.1 |
| $7,500 to $9,999 |
3.86 |
2.18 |
| $10,000 to $12,499 |
3.92 |
2.08 |
| $12,500 to $14,999 |
6.4 |
2.5 |
| $15,000 to $19,999 |
6.99 |
4.65 |
| $20,000 to $24,999 |
7.57 |
4.38 |
| $25,000 to $29,999 |
4.55 |
5.22 |
| $30,000 to $34,999 |
6.52 |
4.29 |
| $35,000 to $39,999 |
5.61 |
4.38 |
| $40,000 to $49,999 |
8.99 |
8.15 |
| $50,000 to $59,999 |
5.02 |
7.67 |
| $60,000 to $74,999 |
5.68 |
12 |
| $75,000 or more |
12.26 |
21.26 |
| Don't know |
9.44 |
6.65 |
| Refused |
8.5 |
11.65 |
Source: SC Household Insurance Survey.
Income Distribution
- Over 44% of the Uninsured in South Carolina have incomes of $30,000 or less.
- Only 28% of the Insured population in South Carolina have incomes of $30,000 or less.
Source: SC Household Insurance Survey.
Family Composition
| |
Family Size |
| Total South Carolina Population |
3.0 |
| Uninsured (At Any Time During the Year) |
3.4 |
Source: SC Household Insurance Survey. U.S. Census Bureau.
Uninsured Perceived Health Status
| Health Status |
Percent Uninsured Responding |
| Excellent |
35.81 |
| Very Good |
25.80 |
| Good |
23.33 |
| Fair |
10.79 |
| Poor |
3.39 |
| Did Not Answer |
0.89 |
Source: SC Household Insurance Survey.
National and South Carolina Comparison
Demographic Comparison of the Uninsured Population in South Carolina and the United States
| Demographic |
South Carolina % Uninsured |
United States % Uninsured |
| Total |
19.4 |
15.2 |
| Gender |
|
|
| Male |
19.9 |
16.7 |
| Female |
18.8 |
13.9 |
| Race |
|
|
| White |
18.1 |
14.2 |
| Black |
19.3 |
20.2 |
| Hispanic |
42.2 |
32.4 |
| Other |
|
|
| Age |
|
|
| Under 18 years |
17.6 |
11.6 |
| 18 to 24 years |
41.8 |
29.6 |
| 25 to 34 years |
30.5 |
24.9 |
| 35 to 44 years |
20.6 |
17.7 |
| 45 to 64 years |
14.4 |
13.5 |
| 65 years and over |
3.5 |
0.8 |
| Income |
|
|
| Less than $25,000 |
30.0 |
23.5 |
| $25,000 to $49,999 |
21.9 |
19.3 |
| $50,000 to $74,999 |
11.5 |
11.8 |
| $75,000 or more |
12.1 |
8.2 |
Source: SC Household Insurance Survey. Current Population Survey.
How Does South Carolina Compare with the Nation?
- Percent uninsured (19.4%) in South Carolina is higher than the Nation (15.2%).
- South Carolina percentages of uninsured for Whites and Hispanics are higher than the Nation.
- Regardless of gender or age, a higher percentage of South Carolinians are uninsured as compared to the nation.
Source: SC Household Insurance Survey. Current Population Survey.
Percent Uninsured by Region in South Carolina
| Demographic |
Low Country |
Midlands |
Pee Dee |
Upstate |
| Total |
19.1 |
18.2 |
21.2 |
17.1 |
| Gender |
|
|
|
|
| Male |
18.8 |
21.4 |
21.9 |
17.8 |
| Female |
20.6 |
17.0 |
21.5 |
18.0 |
| Race |
|
|
|
|
| White |
21.0 |
17.6 |
22.2 |
14.8 |
| Black |
14.2 |
20.1 |
19.1 |
23.9 |
| Hispanic |
50.2 |
30.0 |
43.8 |
50.6 |
| Age |
|
|
|
|
| Under 18 years |
15.1 |
16.4 |
24.8 |
17.0 |
| 18 to 24 years |
34.4 |
39.9 |
30.5 |
39.3 |
| 25 to 34 years |
35.1 |
33.6 |
26.3 |
25.4 |
| 35 to 44 years |
22.8 |
15.1 |
30.2 |
19.5 |
| 45 to 64 years |
11.5 |
14.2 |
19.8 |
13.3 |
| 65 years and over |
6.8 |
3.5 |
1.7 |
2.8 |
| Income |
|
|
|
|
| Less than $25,000 |
26.3 |
35.3 |
30.0 |
27.8 |
| $25,000 to $49,999 |
20.9 |
16.5 |
30.5 |
25.1 |
| $50,000 to $74,999 |
13.7 |
14.1 |
13.7 |
6.0 |
| $75,000 or more |
12.6 |
12.4 |
17.0 |
8.4 |
Source: SC Household Insurance Survey.
Employment
60% of the Uninsured are Hard Working Citizens of South Carolina
WHY THEY ARE NOT INSURED THROUGH PRIVATE INSURANCE PLANS:
- 74% of the uninsured list affordability as the reason they have not purchased health insurance
- 36% of the uninsured who are eligible for an employer-sponsored plan listed affordability as the reason they were not enrolled
WHY THEY ARE NOT COVERED THROUGH PUBLIC PROGRAMS:
- 62% of eligible individuals do not enroll in public programs because they do not want to receive government support or don't want government to provide health coverage
Source: SC Household Insurance Survey.
Employee Perspective
Employment Status for South Carolina's Population Uninsured at Any Point During the Year (All Inclusive)
| Employment Status |
Percent |
| Self employed or own your own business |
13.85 |
| Employed by someone |
49.07 |
| An unpaid worker for family business, farm, or home |
1.18 |
| Retired |
3.82 |
| Unemployed |
24.16 |
| Don't know |
7.63 |
| Refused |
0.29 |
Source: SC Household Insurance Survey.
Uninsured Compared to Insured by Industry Type for Selected Individuals
| Industry |
% Insured |
% Uninsured |
| Agriculture |
1.35% |
1.29% |
| Construction |
5.23% |
18.71% |
| Manufacturing |
17.04% |
7.74% |
| Retail Trade |
7.47% |
13.55% |
| Professional, related services |
14.95% |
14.19% |
| Government |
18.24% |
4.52% |
| Hotel, motel, etc. |
2.99% |
8.39% |
| Medical |
8.97% |
5.16% |
| Other Industry |
2.69% |
4.52% |
| Education |
4.33% |
5.16% |
| Communication |
0.75% |
0.00% |
| Utilities company |
0.90% |
0.65% |
| Financial, Insurance |
3.44% |
2.58% |
| Retirement |
0.15% |
0.00% |
| Church |
1.20% |
0.65% |
| Service Industry |
2.09% |
3.23% |
| Auto Industry |
0.30% |
0.00% |
| VFW Post |
0.15% |
0.00% |
| Transportation |
1.94% |
4.52% |
| Sales |
0.45% |
0.65% |
| Computers |
0.30% |
0.00% |
Source: SC Household Insurance Survey.
Where are the Uninsured Employed?
Over sixty percent of the uninsured are employed in the following industries:
- Construction
- Professional, related services
- Retail Trade
- Hotel, motel, etc.
- Manufacturing
Over sixty percent of the insured are employed in the following industries:
- Government
- Manufacturing
- Professional, related services
- Medical
- Retail Trade
Source: SC Household Insurance Survey.
Reasons for Being Employed and Uninsured
Why He/She Is Not Included In Employers Insurance Plan (Uninsured at any time during the year, all inclusive)
Could not afford/too expensive: 40.42%
DO NOT work enough hours in a week: 6.59%
Have NOT worked there long enough: 34.22%
Benefit package didn't meet needs: 3.78%
Other: 12.05%
Refused: 1.36%
Don't Know: 1.59%
Source: SC Household Insurance Survey.
Small Employers Not Offering Health Insurance
- 53% of small employers with 1-10 employees do not offer group-sponsored health insurance to their employees.
- 39% of small employers with 11-20 employees do not offer group-sponsored health insurance to their employees.
- 8% of small employers with 21-50 employees do not offer group-sponsored health insurance to their employees.
- 8% of small employers with 51-100 employees do not offer group-sponsored health insurance to their employees.
Source: SC Household Insurance Survey.
Size of Employer
Businesses Not Offering Insurance
| Business Size |
Frequency |
Percent of Businesses Not Offering Insurance |
Percent of All Businesses |
| 2-50 |
140 |
73.30 |
5.61 |
| 51-100 |
51 |
26.70 |
2.04 |
Businesses Offering Insurance
| Business Size |
Frequency |
Percent of Businesses Offering Insurance |
Percent of All Businesses |
| 2-50 |
155 |
20.86 |
6.21 |
| 51-100 |
588 |
79.14 |
23.56 |
Source: SC Household Insurance Survey.
South Carolina Small Employers by Insurance Offer
| Business Size |
% Total Businesses |
Offers Insurance |
Does Not Offer Insurance |
| Agriculture |
0.96% |
55.56% |
44.44% |
| Construction |
11.98% |
75% |
25% |
| Government |
1.39% |
100% |
0% |
| Hotel, Motel, Restaurant, or Entertainment |
12.94% |
76.67% |
23.33% |
| Manufacturing |
14.12% |
92.42% |
7.58% |
| Medical |
7.59% |
83.10% |
16.90% |
| Professional and Related Services |
25.35% |
73% |
27% |
| Retail Trade |
21.82% |
82.67% |
17.33% |
| Other |
3.85% |
75% |
25% |
Source: South Carolina Employers Survey.
Employee Income Brackets
| Average Salary of Full-Time Employees |
Doesn't Offer Insurance |
Offers Insurance |
| Less Than $10,000 |
5.49 |
0.14 |
| $10,000 to $15,000 |
22.53 |
3.48 |
| $15,001 to $20,000 |
21.43 |
12.93 |
| $20,001 to $25,000 |
21.43 |
22.81 |
| $25,001 to $50,000 |
25.27 |
56.61 |
| $50,001 to $75,000 |
3.3 |
3.89 |
| More Than $75,000 |
0.55 |
0.14 |
Source: South Carolina Employers Survey.
Impact of Offering Insurance on Hiring
| Business Type |
% Employers Impacts Hiring |
Uninsured Workers |
| Agriculture |
2.50% |
1.29% |
| Construction |
13.75% |
17.20% |
| Government |
0% |
3.66% |
| Hotel, Motel, Restaurant, or Entertainment |
12.50% |
10.54% |
| Manufacturing |
5.00% |
7.31% |
| Medical |
8.75% |
5.38% |
| Professional and Related Services |
38.75% |
12.90% |
| Retail Trade |
11.25% |
12.69% |
| Other |
7.50% |
29.03% |
Source: South Carolina Employers Survey.
Places of Care for the Uninsured
Where Patients Usually Go for Medical Service
| Location |
Uninsured |
Insured |
| Doctor's Office |
69.89 |
89.87 |
| Clinic |
16.67 |
5.60 |
| Emergency Room/Urgent Care |
10.22 |
2.55 |
| Military/VA Hospital |
2.69 |
1.97 |
Source: South Carolina Household Insurance Survey.
Type of Clinic Patients Usually Go To
| Clinic Type |
Uninsured |
Insured |
| Public Health, Community, or Free Clinic |
51.61 |
32.35 |
| Private Clinic |
35.48 |
29.41 |
| Hospital |
9.68 |
27.94 |
| Military/VA Hospital |
3.23 |
7.35 |
Source: South Carolina Household Insurance Survey.
Uninsured Hospital Use
- 1 out of 4 uninsured visit the ED annually.
- 1 out of 10 uninsured has an inpatient admission annually.
Source: South Carolina Household Insurance Survey.
Uninsured Hospital Visits
| Group |
Emergency Room Discharges |
Inpatient Discharges |
Percent Admitted |
| Total |
341,464 |
20,821 |
6.10% |
| Adults (Ages 18-64) |
303,469 |
20,207 |
6.66% |
| Children |
37,995 |
614 |
1.62% |
Source: South Carolina Hospital Inpatient and Emergency Room Data.
Cost of Uninsured Hospital Visits
| Group |
Emergency Room Discharges |
Inpatient Discharges |
| Adults (Ages 18-64) Total Charges Self-Pay |
$321,984,482 |
$512,249,672 |
| Children Total Charges Self-Pay |
$14,874,178 |
$19,328,956 |
Source: South Carolina Hospital Inpatient and Emergency Room Data.
Top 5 Reasons and Average Charges for Emergency Room Visits Indigent for Children (0-17): Calendar Year 2002
- Ear ache: $249
- Urinary tract: $266
- General symptoms: $597
- Open wound to head: $536
- Sore throat: $254
Source: South Carolina Hospital Inpatient and Emergency Room Data.
Top 5 Reasons and Average Charges for Emergency Room Visits Indigent for Adults (18-64): Calendar year 2002
- Respiratory symptoms: $1,849
- Sprain of neck: $1,757
- Abdomen/pelvic symptoms: $1,166
- Back/neck disorder: $1,251
- Symptoms involving head/neck: $1,798
Source: South Carolina Hospital Inpatient and Emergency Room Data.
Top 5 Reasons and Average Charges for Inpatient Admittances Indigent for Children (0-17): Calendar year 2002
- Live Birth: $2,112
- Asthma: $5,892
- Pneumonia: $5,697
- Bronchitis: $4,422
- Appendicitis: $13,699
Source: South Carolina Hospital Inpatient and Emergency Room Data.
Top 5 Reasons and Average Charges for Inpatient Admittances Indigent for Adults (18-64): Calendar year 2002
- Respiratory symptoms: $8,236
- Diabetes: $11,479
- Diseases of the pancreas: $15,533
- Heart disease: $27,283
- Heart attack: $35,368
Source: South Carolina Hospital Inpatient and Emergency Room Data.
Hospital Charges for the Uninsured for Chronic Conditions: 2002
| Condition |
Emergency Room Charges |
Inpatient Charges |
Total |
| Asthma |
$3,328,879 |
$5,316,035 |
$8,644,913 |
| Diabetes |
$387,885 |
$10,076,687 |
$10,464,572 |
| Congestive Heart Failure |
$1,435,520 |
$12,471,420 |
$13,906,940 |
| Hypertension |
$1,165,751 |
$5,418,870 |
$6,584,621 |
| Total |
$6,318,035 |
$33,283,011 |
$39,601,046 |
Source: South Carolina Hospital Inpatient and Emergency Room Data.
Hospital Discharges for the Uninsured for Chronic Conditions: 2002
| Condition |
Emergency Room Discharges |
Inpatient Discharges |
Total |
| Asthma |
4,471 |
604 |
5,075 |
| Diabetes |
1,614 |
1,097 |
2,711 |
| Congestive Heart Failure |
281 |
573 |
854 |
| Hypertension |
1,640 |
498 |
2,138 |
| Total |
8,006 |
2,772 |
10,778 |
Source: South Carolina Hospital Inpatient and Emergency Room Data.
Hospital Average Charges for the Uninsured for Chronic Conditions: 2002
| Condition |
Emergency Room Average Charge |
Inpatient Average Charge |
| Asthma |
$745 |
$8,801 |
| Diabetes |
$889 |
$11,369 |
| Congestive Heart Failure |
$1,380 |
$17,586 |
| Hypertension |
$711 |
$10,881 |
| Total |
$3,725 |
$48,637 |
Source: South Carolina Hospital Inpatient and Emergency Room Data.
Inpatient Admission from ER, Uninsured
- Overall, 6% of the ER visits by the uninsured result in an inpatient admission.
- For Chronic Conditions, the percent of uninsured inpatient admissions is much higher than the overall.
| Condition |
% Admitted Inpatient |
| Asthma |
10.0% |
| Diabetes |
34.7% |
| Congestive Heart Failure |
59.9% |
| Hypertension |
19.0% |
Source: South Carolina Hospital Inpatient and Emergency Room Data.
How Much Health Care Do the Uninsured Use and How Much Does it Cost?
Uninsured South Carolinians Used $778,865,648 for Health Care Services in 2002
| Health Care Services |
% Total Used |
| Inpatient |
42.6% |
| Office Services/Med. |
22.9% |
| Prescription Drugs |
18.4% |
| Hospital Outpatient |
7.7% |
| Emergency Room |
6.5% |
| Other |
1.9% |
Uninsured South Carolinians Used $778,865,648 for Health Care Services in 2002
| Health Care Services |
Dollar Amount Used |
| Prescription Drugs |
$143,422,830 |
| Inpatient |
$331,665,295 |
| Emergency Room |
$50,795,586 |
| Hospital Outpatient |
$59,759,513 |
| Office Services |
$155,374,733 |
| Office Med. |
$22,907,813 |
| Other |
$14,939,878 |
Reimbursement for Uninsured Services
After applying the various payments to the amount of care provided to the uninsured:
- $272,602,976 dollars remain unreimbursed.
- 74% of this amount is for the chronic uninsured.
Regional Differences
Percent Medicaid Eligible in 2002 By Region
- Upstate: 15.9%
- Midlands: 17.9%
- Pee Dee: 25.5%
- Low Country: 20.0%
Source: South Carolina Department of Health and Human Services
Small Businesses Offering Insurance by Region: 2002
| Region |
Offers Insurance |
Does Not Offer Insurance |
| Upstate |
84% |
16% |
| Midlands |
78% |
22% |
| Pee Dee |
74% |
26% |
| Low Country |
73% |
27% |
South Carolinians Uninsured by Region: 2002
| Region |
Insured |
Uninsured |
| Upstate |
82% |
18% |
| Midlands |
81% |
19% |
| Pee Dee |
78% |
22% |
| Low Country |
80% |
20% |
Employment Status of Uninsured: Upstate Region
| Region |
Insured |
Uninsured |
| Self-Employed |
8.83 |
16.67 |
| Employed by Someone |
50.95 |
38.67 |
| Unpaid Worker, Family, Farm |
0.27 |
2.00 |
| Retired |
25.00 |
6.00 |
| Unemployed |
10.33 |
32.00 |
| Full-Time Student |
4.62 |
4.67 |
| Don't Know |
0 |
0 |
| Refused |
0 |
0 |
Employment Status of Uninsured: Midlands Region
| Region |
Insured |
Uninsured |
| Self-Employed |
7.98 |
12.89 |
| Employed by Someone |
57.50 |
55.67 |
| Unpaid Worker, Family, Farm |
0.48 |
1.03 |
| Retired |
20.00 |
5.15 |
| Unemployed |
9.76 |
20.62 |
| Full-Time Student |
4.05 |
4.12 |
| Don't Know |
0.12 |
0 |
| Refused |
0.12 |
0.52 |
Employment Status of Uninsured: Pee Dee Region
| Region |
Insured |
Uninsured |
| Self-Employed |
6.68 |
18.69 |
| Employed by Someone |
48.16 |
42.99 |
| Unpaid Worker, Family, Farm |
0.46 |
0 |
| Retired |
28.80 |
1.87 |
| Unemployed |
11.06 |
30.84 |
| Full-Time Student |
4.84 |
5.61 |
| Don't Know |
0 |
0 |
| Refused |
0 |
0 |
Employment Status of Uninsured: Low Country Region
| Region |
Insured |
Uninsured |
| Self-Employed |
7.85 |
14.40 |
| Employed by Someone |
54.12 |
48.80 |
| Unpaid Worker, Family, Farm |
0.40 |
2.40 |
| Retired |
22.33 |
4.00 |
| Unemployed |
11.07 |
19.2 |
| Full-Time Student |
4.02 |
11.20 |
| Don't Know |
0 |
0 |
| Refused |
0.20 |
0 |
149,080 people in South Carolina fall within our target population.
What will be the impact of expanding Medicaid with a Waiver?
Policy Option Target Population
Number of People Eligible: 149,090
Estimated Cost of Care: $145,725,7000
Estimated Revenue: $149,090,000
South Carolina Business By Employee Size
| Class SIze (# of Employees in Class) |
# of Employees by Class |
# Businesses by Class |
Percentage |
| 0 to 4 |
98,720 |
73,785 |
62.14% |
| 5 to 9 |
128,197 |
19,429 |
16.36% |
| 10 to 19 |
164,481 |
12,224 |
10.29% |
| 20 to 49 |
249,057 |
8,242 |
6.94% |
| 50 to 100 |
195,152 |
2,831 |
2.38% |
| 100 to 249 |
236,309 |
1,576 |
1.33% |
| 100 to 249 |
|
654 |
0.55% |
Note: Does not include self employed or government employers.
Source: Employment Security Commission, March 2003.
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