While passage of patients’ rights legislation is seen as a boon for health care consumerism, it does nothing for people without health insurance. And their numbers are growing. In Virginia, an estimated 14.9 percent of the population, or more than 1 million people, are uninsured, up from 858,000 five years ago.

And it’s not just a problem for the unemployed. Full-time employees account for 67 percent of the people who go without health insurance in Virginia, and part-time workers account for another 10 percent. "That’s especially interesting coming off such a boom economy," says Deborah D. Oswalt, executive director of the Virginia Health Care Foundation. The foundation is a public/private partnership started by the General Assembly and its Joint Commission on Health Care. It has done two surveys measuring access to health care in 1996 and the spring of this year.

Data: Virginia Health Care Foundation. *Figures based on a telephone survey with error margins in the range of 2 percent for statewide estimate and 2 to 5 percent for regional estimates.

One possible explanation for this year’s increase in the number of working uninsured could be the so-called "young immortals" — young healthy employees who sometimes skip company health plans. Another possible explanation is that there are more service-job workers who typically aren’t offered health coverage. Oswalt says that of those uninsured workers with full-time jobs, 70 percent said their employer did not offer them insurance. The remaining 30 percent said they hadn’t met the eligibility requirements of company-sponsored plans or couldn’t afford the cost.

The state is trying to help with its new Family Access To Medical Insurance Security Plan (FAMIS), which began last month. The program replaces the state’s nearly three-year-old Children’s Medical Security Insurance Plan. Under FAMIS, the state will subsidize employer-sponsored health plans that contribute 40 percent of the costs of family coverage. On October 1, the state begins enrolling uninsured workers for coverage effective in November. Louis F. Rossiter, state secretary of health and human resources, says he’s focusing on the retail, fast food and health industries, noting that many smaller doctor’s offices or even hospitals and nursing homes don’t offer insurance to all employees. FAMIS also will enroll uninsured people directly, whether employed or not. The state has set up a help line to assist employers and the uninsured. Eligibility for FAMIS is an income of up to 200 percent of poverty level, or $35,300 for a family of four in Virginia.

Local agencies are stepping up to help increase enrollment in these state-sponsored programs. In Charlottesville, the Insurance for Children Project is spreading the word on the Children’s Medical Security Insurance Plan. In one year, the program has enrolled 750 local children and sent information to 3,000 area employers. "We have many small employers and it’s common for them to offer insurance coverage for employees, but they can’t offer dependent coverage," says Jon Nafziger, United Way-Thomas Jefferson Area director of community services. Statewide, the CMSIP program has enrolled 33,000 children and has served 52,000 since it began, Rossiter says.

Across the state, hospitals and businesses are funding programs to close the gap. One successful example is Potomac Hospital in Prince William County which has two mobile units. This year the units will see nearly 8,000 patients. Since the program’s start five years ago, nurses have performed more than 3,000 school physicals and given more than 12,000 immunizations — mostly to uninsured and Medicaid patients.

Contact information: To find out more about enrollment in either FAMIS or CMSIP, state subsidized insurance programs for lower income workers, call the FAMIS hotline: 1-866-87FAMIS (1-866-873-2647)