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October 5, 2006
LOS ANGELES - Despite marginal improvements in job-based health insurance for adults and public program enrollment for children, one in five (6.5 million) Californians remain uninsured, according to a new report from the UCLA Center for Health Policy Research.
A second study found that more than half of the uninsured children in California are eligible for public programs, but are not enrolled, a further sign of the limitations in current health insurance arrangements. Researchers note that a measure on the November ballot, Proposition 86, would provide stable insurance for as many as 400,000 children who are currently ineligible for public programs.
The two reports rely on new data from the 2005 California Health Interview Survey (CHIS), as well as data from CHIS 2003 and CHIS 2001.
The first study shows that the percentage of adults who received health insurance through their employers increased to 56.2 percent in 2005, up from 55.1 percent in 2003. The authors credit the state's current tight labor market for this increase, but note that this figure is still behind the 2001 level of 57 percent. Moreover, they note that this improvement is unlikely to continue given the instability of employment-based insurance in the face of dramatically rising costs.
"Job-based insurance is driving the slight gains in coverage that we saw for adults in 2005, but it's still below 2001 levels," said co-author E. Richard Brown, Ph.D., director of the UCLA Center for Health Policy Research and professor in the School of Public Health. "If we now had the same rate of job-based coverage for adults and children that we had in 2001, an additional 645,000 Californians would be covered."
The percentage of children without insurance for all or part of the year was statistically unchanged from 11.3 percent in 2003 to 10.7 percent in 2005, although the percentage was significantly lower than the rate in 2001 (14.8 percent). Researchers attribute this decline in the uninsured rate to recent expansions of children's enrollment and retention in public insurance programs, which is more than compensating for a decline since 2001 in the percentage of children being insured through their parents' employer.
"Every Californian should have access to health care," said Gary L. Yates, president and CEO of The California Wellness Foundation, which funded the first report. "Key to that is health insurance. Yet despite an improving economy, millions of Californians are still without it. This continues to be a critical issue that policymakers need to address."
The number of children who were uninsured at the time of the 2005 interview was 763,000, a figure that remained stable from 2003, according to the second study. Reflecting the shift from employment-based coverage to public programs, Medi-Cal and Healthy Families covered nearly one in three California children all year in 2005 (30.9 percent), a statistically significant increase from 29.2 percent in 2003, and a 6.7 percentage point increase from 24.2 percent in 2001.
"Existing public/private programs to reduce the number of uninsured kids can only take us so far," said Robert K. Ross, M.D., president and CEO of The California Endowment, which provided funding for both reports. "This research confirms that in order for us to go the distance we must have a major additional source of revenue."
Since it was first conducted in 2001, the California Health Interview Survey has been an essential tool for policy makers, researchers and health advocates at every level needing a detailed snapshot of the complex health needs of California's diverse population. The survey is a collaborative project of the UCLA Center for Health Policy Research, the California Department of Health Services, and the Public Health Institute.
The UCLA Center for Health Policy Research was established in 1994 and is one of the nation's leading health policy research centers. It is also the premier source of key health policy information for California. The Center is based in the UCLA School of Public Health and is affiliated with the UCLA School of Public Affairs.
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