Study Finds Big Gap in Workers’ Health Coverage

Nearly half of the people covered by Medi-Cal are employed full or part time but do not receive health insurance from their employers, according to a new UCLA study.

Providing health care to these uninsured workers costs taxpayers at least $4 billion per year, E. Richard Brown told the state’s Task Force on Health Care Reform in Sacramento on Wednesday.

The total number of uninsured in the state has also been growing, reaching 6.3 million people in 1992, the most recent year for which figures are available, he said. One of every six uninsured people in the United States lives in California, and the number of uninsured residents is growing more than twice as fast as the number with insurance.

The solution to the problem is straightforward, Brown told the task force headed by state Sen. Diane Watson.

“First of all, we need to require employers to provide a contribution to health coverage,” he said. “And we need to provide subsidies to both employers and low-income families to help pay for the cost of coverage. We do provide subsidies now, but they are not being distributed fairly.”

Four of every 10 uninsured Californians work for--or are dependents of an employee of--firms with fewer than 25 employees, according to the study published by the UCLA Center for Health Policy Research. Most such firms have historically been unable to provide health care coverage for employees because of low profit margins.

But one-fourth of the uninsured work for--or are dependents of an employee of--companies with more than 100 employees, which traditionally provide such coverage. “Many large and small firms increasingly hire contingent temporary and part-time workers, usually without benefits, only for peak work periods,” said Roberta Wyn, a co-author of the study.

“When an employer decides that he can’t, or doesn’t have to, provide coverage . . . then the costs of care are borne by other people--taxpayers,” Brown said.

Looking only at the non-elderly population because virtually all the elderly are covered by Medicare or other insurance, the study found that the number of uninsured in California rose by 422,000 between 1989 and 1992, a 6.6% increase. In contrast, the number of people with private insurance rose by only 164,000 during the same period.

The overall percentage of uninsured remained stable at 23% because Medi-Cal coverage of the non-elderly increased from 10% of the state population in 1989 to 12% in 1992.