More Georgians uninsured in 2009

William S. Custer, a Georgia State University professor who is an expert on insurance coverage, said the jump in Georgia's uninsured population was driven by the economic downturn.

"Georgia has more small employers and small employers are much more likely to go out of business or be affected by the economic downturn," Custer said.

Nationally, the number of Americans lacking insurance hit 50.7 million in 2009, representing 16.7 percent of the population. That rate is up from 46.3 million people in 2008, when 15.4 percent of Americans were not insured.

Almost every strata of the population feels the repercussions of Georgia's large and growing number of uninsured residents. Sick patients without insurance have difficulty getting care. Hospitals are treating more charity cases in their emergency rooms. And businesses are facing dramatically higher costs to provide insurance to their employees, as hospitals charge paying patients more to try to cover their losses.

"Hospitals are losing millions of dollars treating uninsured patients in the emergency room," said Kevin Bloye, a spokesman for the Georgia Hospital Association. "There's got to be some way to recoup those costs and allow hospitals to keep their doors open. The only way they're able to do that is to shift those costs to the people with health insurance."

Bloye said every hospital in the state is burdened by the wave of uninsured patients.

About 40 percent of Grady Memorial Hospital's patients are uninsured, said Grady spokesman Matt Gove. The massive safety-net hospital provided about $200 million in uncompensated care in the 12-month period ending in March. To cover the costs, the hospital relies primarily on federal dollars doled out to hospitals that serve large numbers of uninsured patients as well as tax dollars from Fulton and DeKalb counties, Gove said.

Piedmont Healthcare incurred $27.4 million in actual costs for care extended to uninsured patients at its four hospitals in the 2009 fiscal year, said Piedmont spokesman Jim Taylor.

Mark Mullin, director of planning for Gwinnett Medical Center, said the rise in the number of uninsured people in the northeast suburbs not only crowds the emergency room with sick people who lack coverage. It has also meant a drop in business in other parts of the hospital, as people without insurance put off preventive care, avoid elective surgeries or delay plans to have a child.

"Not only is it non-payment for services, it's reduced levels of services," Mullin said.

Piavazelle Jerome, a 60-year-old resident of DeKalb County, is among Georgia's uninsured residents. Jerome said she had always had insurance through employers, but she said she lost coverage when she lost her job three years ago. She quickly became unable to afford to pay for her own coverage and hasn't been able to find a new job.

She said she avoided seeking care after losing her insurance, in spite of having serious problems with her knees.

"I went without seeing a doctor when I needed to see a doctor very badly," she said. "The pain would be so bad there would be days I could not walk. I was in tears."

A friend who had seen her suffering pushed Jerome to resort to Grady Memorial Hospital and she said the decision to seek charity care was humbling. But the Atlanta native said she was pleasantly surprised to get what she believes is excellent care from doctors at Grady. A medical appointment usually costs her about $10, she said.

Jerome is now building her own business as a seamstress doing high fashion, window treatments and alterations, as well as doing accounting and other services for small businesses. And she said when she is once again able to afford insurance, she'll continue to go to Grady for care. She said she never imagined herself as someone who would need charity care and she said it's changed her perspective on those who do.

"There comes a time when you can be made to realize you are not in control of everything that can happen to you in this life," she said.

Timothy Sweeney, a  health care analyst at the Georgia Budget and Policy Institute, said Georgia's increasing population of uninsured residents will lead to "further strain on our safety net that is already underfunded in many parts of the state."

Sweeney said working-age adults are the group of Georgians most likely to be uninsured. Children and elderly have relatively high rates of coverage, because of government programs set up to serve them. Sweeney said the portion of adults between 18 and 64 without coverage has increased dramatically in the past decade.

Cindy Zeldin, executive director of the non-profit Georgians for a Healthy Future, said the nation's new health care law will extend coverage to many of Georgia's uninsured by 2014.  In the meantime, she said, many Georgians make too much money to qualify for Medicaid, the government health insurance program for the poor, but too little money to afford to buy their own coverage.

Hospitals will continue to be burdened with providing care to people who can't afford to pay for it, said Custer, the Georgia State professor.

"The forecasts for this recession are not for a fast recovery," he said. "So what is caused by an economic condition may not go away in the short term."