booms but health insurance lags: More Californians lack coverage,
new UC report finds
Kathleen Scalise, Public Affairs
Despite booming economic conditions in the state, the number
of Californians without health insurance continues to grow at
an alarming rate, according to a new report issued today (Wednesday,
Jan. 19) by the Health Insurance Policy Program, a joint project
of the University of California, Berkeley, Center for Health
and Public Policy Studies, and the UCLA Center for Health Policy
additional 23,000 Californians fell off the health insurance
rolls each month from 1997 to 1998, according to the 124-page
report, which compares the most recent data available from 1999
and earlier. About 7.3 million Californians, or one in four
of the state's non-elderly residents, have no health insurance.
Of those, nearly half have been uninsured for more than five
years or have never been insured.
health insurance problems are bad and getting worse," said
Helen Schauffler, a UC Berkeley professor of health policy and
director of UC Berkeley's Center for Health and Public Policy
Studies, who co-authored the report with E. Richard Brown, a
UCLA professor of public health and director of the UCLA Center
for Health Policy Research.
having health insurance has serious long-term consequences for
the health of Californians," Schauffler said.
annual report is the fourth in a series that began in 1996,
covering the status of health insurance coverage in California.
This latest report will be presented to state legislators and
reporters at a Sacramento briefing on Thursday, Jan. 20, at
11 a.m. in the State Capitol Governor's Conference Room. The
report includes an overview and analysis of employer-sponsored,
public and private health insurance coverage; purchasing groups;
the integration of public health into California's health care
system; and comparisons to prior data and national data.
the findings, California's uninsured population increased by
276,000 newly uninsured persons during 1998 and accounted for
one in every three of the nation's newly uninsured. This is
three times its share of the nation's uninsured population.
drop in coverage is largely driven by a decline in Medi-Cal
enrollment, the researchers found. Since 1995, the percentage
of non-elderly Californians who relied on Medi-Cal fell from
14 percent to 11 percent. Meanwhile, rates of employer-based
or privately purchased health coverage remained flat.
increasing uninsured rate is a direct result of public policies
that have decreased Medi-Cal coverage," said Brown. "The
governor and legislature should act this year to expand eligibility
in Medi-Cal and the Healthy Families Program to cover more children
and their parents, and they should simplify and streamline these
researchers found that California continues to lead the nation
in the number of residents without health insurance. One in
six uninsured Americans lives in California. The state has a
significantly higher uninsured rate - 24 percent - than the
17 percent national average. Additionally, only 58 percent of
California workers have job-based insurance versus 69 percent
in the rest of the United States.
ranks dead last among the 50 states and the District of Columbia
in the proportion of non-elderly residents who have job-based
insurance," Brown said.
health insurance, people delay or fail to seek care when they
need it and lack access to important preventive care and health
promotion services," Schauffler said. "This can lead
to much more serious medical problems and results in poorer
health. The state should set a policy goal of achieving universal,
affordable, high-quality health coverage to improve the health
of all Californians."
"chronically uninsured" - the nearly half of Californians
without health insurance for at least five years or who have
never had coverage - are most likely to be male, Latino and
study makes clear that it is people of color, children, the
working poor and those unable to work who are bearing the brunt
of California's health insurance crisis," said Gary Yates,
president and CEO of The California Wellness Foundation, which
funded the report as part of its Work and Health Initiative.
"This is a public health problem with significant implications
for the health of the state's residents and the vitality of
its workforce and economy. This issue needs the immediate and
focused attention of policy makers in California."
report also found that:
Because of cost, one in three uninsured Californians did not
seek health care when they needed it in 1999. Twenty-one percent
of uninsured adults reported their health as fair or poor, as
compared to 10 percent of those with health insurance.
The uninsured have higher rates of preventable risk factors
such as smoking and obesity, and lower participation rates in
health promotion programs.
More than 2 million California children were without health
insurance in 1998, an increase of 150,000 from 1997. California's
children had a higher uninsured rate (21 percent) than did children
in the rest of the United States (15 percent), and received
less coverage from job-based insurance (54 percent vs. 66 percent).
California's uninsured rate for children grew from 17 percent
to 21 percent between 1995 and 1998. Medi-Cal coverage of children
declined dramatically, from 25 percent in 1995 to 20 percent
Virtually all population subgroups in California with the exception
of non-Latino whites saw an increase in the uninsured rate.
Most affected was California's burgeoning Latino population,
with an uninsured rate of 40 percent in 1998. Only 40 percent
of Latinos have job-based insurance, and Medi-Cal coverage of
Latinos dropped from 22 percent in 1995 to 17 percent in 1998.
new report also offers health policy recommendations for the
2000 California legislative session. These include:
Improving and expanding Medi-Cal and the Healthy Families Program
by streamlining the application process and integrating them
into a single, seamless, restructured program, removed from
the welfare system.
Expanding the state's high-risk pool to accommodate all eligible
Californians and to guarantee that all individuals who want
health insurance can purchase it.
Expanding prior small group market reforms to include firms
with only one employee.
Providing subsidies to individuals whose incomes fall below
250 percent of the federal poverty level to enable them to purchase
private insurance, participate in the high risk pool and buy
into expanded public programs.