A new report from the UCLA Center for Health Policy Research shows that job-based health insurance coverage - the backbone of the state's system of health insurance - is declining. While job-based family coverage plummets, children's coverage is protected by public insurance programs, such as Medi-Cal and Healthy Families.
"We are seeing a shift to government programs, like Medi-Cal and Healthy Families, as employers fail to provide affordable health insurance for working families," said author E. Richard Brown, Ph.D., director of the UCLA Center for Health Policy Research and professor in the School of Public Health. "The data show that California's health insurance system is increasingly unstable and unable to provide for the basic medical needs of millions of residents."
While a majority of Californians are still insured through their jobs or those of relatives, those numbers are declining, specifically among dependents. Pushed by a dramatic 79.1 percent increase in the cost of job-based family coverage for the average worker, enrollment of dependents dropped 4 percentage points for children and 2 percentage points for adults from 2001 to 2003. All income groups and all racial and ethnic groups had significant decreases in job-based insurance.
Among children, however, these losses were balanced by a 5 percentage point increase in children's enrollment in Medi-Cal and Healthy Families, leading to an actual increase in children's insurance overall. Many adults shifted to privately purchased heath plans, and many of those bought high-deductible health plans, potentially risking bankruptcy and/or significant financial losses due to high medical bills. Approximately 50 percent of all personal bankruptcies in the U.S. are due to medical debt, according to a recent report by Harvard researchers.
The shrinking of job-based health insurance is just one of many trends identified in "The State of Health Insurance in California: Findings from the 2003 California Health Interview Survey." Other findings from the report include:
* More than 6.6 million Californians under age 65 (more than one in five nonelderly residents) went without insurance for at least part of 2003.
* More than 3.7 million lacked health coverage for the entire year.
* Nonelderly Latinos and American Indian/Alaska Natives report highest rates of uninsurance.
* Three out of four uninsured are in working families. Two-thirds of children in Medi-Cal or Healthy Families had at least one parent who was employed.
* Main reason the uninsured give for not having coverage is "I can't afford it."
* Those without health insurance were much less likely to have seen a doctor, gotten vital preventive screenings for cancer, or taken medication for high blood pressure.
The report was funded by grants from The California Endowment and The California Wellness Foundation. Findings are based on data collected in the 2003 California Health Interview Survey.
"We see more and more middle- and low-income workers priced out of job-based health coverage each year because they can't afford their share of the cost," said Robert K. Ross, M.D., president and CEO of The California Endowment. "Our state and national leaders on both sides of the aisle must work together to reform the system before all but the highest wage workers are priced out of health coverage."
"These numbers represent millions of people - our fellow Californians - whose lives can be devastated by illness or injury because they don't have the access to medical care that health insurance provides," said Gary L. Yates, president and CEO of the California Wellness Foundation.
The 2003 survey interviewed more than 42,000 households throughout the state. 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.