A Profile of Georgia’s Low-Wage Uninsured Workers by Joan Alker and Alexandra Corcoran April 2021 The recently enacted American Rescue Plan Act of 2021 (ARP) includes new large financial incentives for states to extend health insurance coverage to low-wage workers and other adults earning less than $17,775 a year.1 These incentives apply to regular spending in a state’s Medicaid program and offer a five-percentage point across the board increase in the federal share for a 24-month period after the state extends coverage. The Kaiser Family Foundation estimates that Georgia’s budget would see a net gain of $710 million over a two-year period if the state expanded Medicaid.2 Approximately 452,600 uninsured non-elderly adults, or 39 percent of the state’s The Georgetown University Center for Children and Families (CCF) is an uninsured adult population, would gain health insurance.3 independent, nonpartisan policy and This fact sheet examines which workers and industries would benefit from expansion research center founded in 2005 with a of Medicaid coverage.4 The top three industry sectors employing low-wage uninsured mission to expand and improve high- workers are hospitality, retail, and administrative, support, and waste management, quality, affordable health coverage for America’s children and families. CCF is accounting for approximately 44 percent of those working without insurance; these based in the McCourt School of Public industry sectors include businesses such as restaurants, general merchandise stores Policy’s Health Policy Institute. (such as warehouse clubs and supercenters), and building services (such as janitorial services) (see Table 1). The most common jobs for low-wage, uninsured workers are cashiers, cooks, maids and housekeeping staff, waiters/waitresses, and freight and stock laborers (see Table 2). Table 1. Top Industry Sectors in Georgia For Low-Wage Workers For Low-Wage, Uninsured Workers Retail 15.7% Accommodation and food services 17.5% Accommodation and food services 15.6% Retail 17.0% Health care and social assistance 10.9% Administrative, support, and waste management 9.8% Manufacturing 8.7% Construction 9.4% Administrative, support, and waste management 8.5% Manufacturing 8.5% Educational services 6.3% Health care and social assistance 7.9% Construction 5.9% Other services (except public administration) 6.1% Other services (except public administration) 5.6% Transportation and warehousing 3.5% Transportation and warehousing 4.9% Educational services 3.4% Professional, scientific, and technical services 3.0% Professional, scientific, and technical services 2.3% Table 2. Top Occupations in Georgia For Low-Wage Workers For Low-Wage, Uninsured Workers Cashiers 5.5% Cashiers 6.8% Cooks 4.1% Cooks 5.0% Laborers and freight, stock, and material movers, hand 3.2% Maids and housekeeping cleaners 3.8% Waiters and waitresses 3.1% Waiters and waitresses 3.7% Customer service representatives 3.0% Laborers and freight, stock, and material movers, hand 3.5% Maids and housekeeping cleaners 2.8% Construction laborers 3.4% Retail salespersons 2.8% Retail salespersons 3.0% Janitors and building cleaners 2.6% Customer service representatives 2.9% Driver/sales workers and truck drivers 2.4% Janitors and building cleaners 2.6% Construction laborers 2.1% Driver/sales workers and truck drivers 2.4% Note: Workers with no occupation are not listed. Source: Georgetown University Center for Children and Families analysis of US Census Bureau American Community Survey (ACS) 2019 Public Use Microdata Sample (PUMS). Demographics of uninsured low-income adults Our analysis finds that women make up a disproportionate share of low-income, non-elderly Georgians (60 percent) and account for 54 percent of low-income, non-elderly citizens who are uninsured. In Georgia, 48 percent of uninsured low-income citizens are White, 46 percent are Black, and the remainder describe themselves in other categories including American Indian, Asian/Pacific Islander, or multi-racial. Approximately six percent of low-income citizen non-elderly adults identify as Hispanic/Latino.5 As Figure 1 illustrates, different areas of the economy have different racial compositions for low-wage uninsured workers. Figure 2 shows that women make up the majority of the top two industries for low-wage, uninsured workers, hospitality and retail. Figure 1. Race of Low-Wage, Figure 2. Gender of Low-Wage, Uninsured Workers in Top Industry Sectors Uninsured Workers in Top Industry Sectors Accommodation 44.5% Accommodation 41.7% 58.3% and food services 49.3% and food services Retail 52.0% Retail 39.0% 61.0% 42.2% Administrative, Administrative, 41.4% support, and waste 49.9% 50.1% support, and waste management services 53.6% management services 62.7% Manufacturing 53.9% 46.1% Construction 28.3% Other services Manufacturing 40.4% (except public 40.3% 59.7% 55.7% administration) WhiteBlack MenWomen Source: Georgetown University Center for Children and Families analysis of Source: Georgetown University Center for Children and Families analysis of U.S. Census Bureau American Community Survey (ACS) 2019 Public Use U.S. Census Bureau American Community Survey (ACS) 2019 Public Use Microdata Sample (PUMS).6 Microdata Sample (PUMS). 7 Which parts of the state have higher proportions of uninsured workers? The map on the right shows that the uninsured Uninsured Rate for Non-Elderly Workers rate for all non-elderly adult workers varies Above 20% considerably across the state of Georgia, ranging Between 10-20% from 6.8 percent in Harris County to 35.1 percent Lower than 10% in Atkinson County. Table 3 lists the nine counties with the highest proportion of uninsured workers, Note: Includes all workers ages 19-64 each with between one-quarter and one-third of regardless of income or citizenship status. Source: Georgetown University Center for non-elderly employed adults lacking insurance. All Children and Families analysis of US Census of these counties are rural counties underscoring Bureau American Community Survey (ACS) 2015-2019 Table DP03. Grey counties other research findings that Medicaid expansion indicate that estimate is suppressed due would greatly benefit rural areas.8 to high margin of error and low-reliability. Contact authors for more information on the methodology. Table 3. Nine Counties with the Highest County Uninsured Rate County Uninsured Rate Rates for Non-Elderly Adults United States 11.0% Berrien 31.5% Note: Includes all workers ages 19-64 regardless of income or Georgia 15.8% Gilmer 31.0% citizenship status. Atkinson 35.1% Colquitt 30.1% Source: Georgetown University Center for Children and Families Wheeler 35.1% Decatur 27.2% analysis of US Census Bureau American Community Survey (ACS) 2015-2019 Table DP03. Out of Georgia’s 159 counties, 12 county Candler 34.6% Jeff Davis 27.1% estimates were suppressed due to high margins of error and low- Treutlen 33.5% reliability. Suppression rules did not affect the top nine presented in this figure. Contact authors for more information on the methodology. April 2021 CCF.GEORGETOWN.EDU georgia’S low-wage, uninsured workers 2 Endnotes 1 For more information on the provisions of the law, see E. Park and 5 The American Community Survey measures race and ethnicity as two S. Corlette, “American Rescue Plan Act: Health Coverage Provisions separate facets of an individual’s identity. Hispanic/Latino individuals Explained” (Washington DC: Georgetown University Center for Children can be of any race. and Families and Center on Health Insurance Reform, March 2021), 6 Estimates for the share of low-wage workers in each industry sector available at https://ccf.georgetown.edu/2021/03/11/american-rescue- who are American Indian/Alaska Native, Asian/Native Hawaiian plan-act-health-coverage-provisions-explained/. or Pacific Islander, and Two or More Races/Some Other Race are 2 R. Rudowitz, B. Corallo, and R. Garfield, “New Incentive for States to suppressed due to small sample sizes and low-reliability. Contact Adopt the ACA Medicaid Expansion: Implications for State Spending” authors for more information on the methodology. (Washington DC: Kaiser Family Foundation, March 2021), available at 7 Construction industry and health care and social assistance industry https://www.kff.org/medicaid/issue-brief/new-incentive-for-states-to- suppressed due to small sample size and low-reliability in one category. adopt-the-aca-medicaid-expansion-implications-for-state-spending/. Contact authors for more information on the methodology. 3 Kaiser Family Foundation, “Who Could Medicaid Reach with 8 J. Hoadley, J. Alker, and M. Holmes, “Health Insurance Coverage Expansion in Georgia?” (Washington DC: Kaiser Family Foundation, in Small Towns and Rural America: The Role of Medicaid Expansion” February 2021), available at https://files.kff.org/attachment/fact-sheet- (Washington DC: Georgetown University Center for Children and medicaid-expansion-GA. Families, September 2018), available at https://ccf.georgetown. 4 Contact authors for more information on sources of data and methods. edu/2018/09/25/health-insurance-coverage-in-small-towns-and-rural- All data are derived from the American Community Survey (2019) most america-the-role-of-medicaid-expansion/. from the Public Use Microdata Sample; county data calculated from American Community Survey five-year (2015-2019) prepared tables. April 2021 CCF.GEORGETOWN.EDU georgia’s low-wage, uninsured workers 3