With more than 33,000 residents lacking health insurance, San Juan County has the third-most uninsured residents of any county in the New Mexico, behind only Bernalillo and Doña Ana counties, according to a Census Bureau report released Wednesday.
Only sparsely populated Catron, Harding and McKinley counties had a higher percentage of uninsured residents per capita, the Census Bureau reported.
In New Mexico, 22.6 percent of adults under age 65 were without health insurance in 2010. San Juan County was among the highest in the state, with 28.9 percent uninsured.
Los Alamos County was easily the lowest, with only 4.9 percent of residents uninsured. That area is home to many federal employees.
The data does not include senior citizens, who are universally covered by the federal Medicare program.
The high number of uninsured is costing taxpayers in San Juan County, where many impoverished residents receive assistance from the county's Indigent Health Care Program. Use of that program has steadily increased in recent years.
In the 2012 fiscal year, 2,058 people accessed indigent health care funds, said Liza Gomez, program director. Those people submitted $9.8 million in claims for the fiscal year, which ended June 30.
Uninsured patients cost everybody, Gomez said.
"Uninsured folks contribute to the rising cost of health care," she said, adding that caring for uninsured patients results in higher premiums on residents who are insured.
The problem is multifaceted, Gomez said.
"We have a lot of children who aren't covered. That's not a good thing," Gomez said. "There are a lot of young working adults who choose not to partake in their employer's insurance."
There was a 75 percent increase in the cost of the health care program from the 2011 fiscal year, and the trend is expected to continue.
The county budgeted $16 million for the Indigent Health Care Program for the current fiscal year. The health care program now has the largest operating cost of any program in county government, surpassing the sheriff's office and the detention centers, according to county documents.
Even higher costs are expected.
"I don't think we've peaked," Gomez said.
Substance-abuse treatment is often included when indigent people access public money for health care, Gomez said. The DWI treatment facility, Four Winds Recovery Center and a meth treatment program receive the most indigent health care funds.
There are a variety of reasons why a person doesn't have health insurance.
Many San Juan County residents without health insurance are children who are depending on parents for their coverage. No health insurance among adults rose in recent years when unemployment increased, Gomez said.
San Juan Regional Medical Center sees all patients regardless of their ability to pay. CEO Rick Wallace said while the hospital will continue treating the uninsured, it can place a strain on the bottom line.
"There is an increase that we're starting to see with the uninsured," he said.
Many are younger adults who lack health insurance.
"You do see a lot of the younger population that has a job, but the job doesn't provide adequate benefits or any benefits," he said. "That is an expensive part of their budget that they can't afford."
Young people come in when they are in accidents, or pregnant women come in for prenatal care, he said. The hospital also sees many residents in older middle age who are not yet eligible for Medicare.
The Affordable Care Act stands to dramatically expand insurance coverage, but also reduce hospital reimbursements, he said.
"In its present form, I do believe as health reform continues to take form, one of the provisions is to provide coverage to everyone that wants it or needs it," he said. "That is going to improve the uninsured market that San Juan Regional Medical Center supports."
Wallace, however, said he is concerned about reduced reimbursements under the federal law.
"It is also challenging hospitals to provide those needed services because it decreases reimbursement," he said.
Wallace warned, "Eventually, It could threaten the health of the hospital."