Health Coverage Dips Further : Insurance: Study shows 6.5 million in state are without protection, reflecting an ongoing drop. At the same time, the number of workers whose employers do not provide health benefits is up.
Reflecting an ongoing decline in health coverage in the state, the number of Californians without health insurance reached 6.5 million in 1993, while the number of workers receiving health coverage from employers continued to fall, a UCLA study being released today shows.
The two trends, which helped feed last year’s ultimately unsuccessful efforts at state and national health care reform, contributed to a big jump in 1993 in the number of people enrolled in Medi-Cal, the state’s public health assistance program.
The study by the UCLA Center for Health Policy Research shows that employers paid 51.5% of the health insurance in the state, down from 56% in 1989.
As a result, 188,000 fewer Californians had employer-funded health care insurance in 1993 than the year before, said E. Richard Brown, the author of the study and director of the center.
Research has shown that those with health insurance tend to get better medical care, at an earlier point, than those without, and tend to do better in surviving serious illnesses.
Brown, who has been tracking the problem of Californians without health insurance for several years, called the drop in employer-funded coverage “a pretty significant decline.”
In all, 273,000 more Californians were without any kind of public or private health insurance in 1993.
The researcher said the recession-plagued economy contributed to the year-to-year dip, but he also noted a long-term pattern.
“We are seeing an increasing reliance on Medi-Cal to provide coverage, and I believe we are going to rely more and more on it because employers are not providing health insurance in low-wage service, retailing and light manufacturing sectors of the economy,” Brown said in an interview.
Responding to the study, a health policy expert for Gov. Pete Wilson placed greater blame on the economy.
“We were at the height of the recession (in 1993), and when people are losing their jobs you are going to see a reduction in employer-paid coverage,” said Kathryn Lowell, a health policy adviser with the state Health and Welfare Agency. “It is unclear whether that trend . . . extends into 1994 and 1995.”
Last year, two health care reform plans attempted to deal with the insurance problem. But President Clinton’s effort ran into a roadblock in Congress. And, in California, a ballot initiative that would have provided universal health insurance, Proposition 186, was soundly defeated.
Lowell said that in California this year the Wilson Administration is expanding health programs for children under 5, is continuing to support a program that expands Medi-Cal benefits for women and infants, and hopes a state-supported insurance program for relatively small employers will help cut into the ranks of uninsured.
David Langness, a spokesman for the Healthcare Assn. of Southern California, a group of large hospitals and health care providers, said he was dismayed by the new study.
“He keeps updating his figures and they keep getting worse,” Langness said of Brown’s research.
Langness said that the governor’s programs notwithstanding, he saw “nothing on the horizon” comparable to the kind of sweeping reform proposed by Clinton last year.
For his part, Brown said that since 1993, the last year for which he had complete data on insurance coverage, nothing has happened to indicate that the gap was narrowing.
The study will be released today at a special state Senate Health Committee hearing on proposed health care cuts being considered by Congress. Federal lawmakers are considering changes that would bundle federal health care programs for those under 65 into block grants of financial aid and then let states set the rules on spending the money.
Brown said the problem of the uninsured will only get worse if Congress makes deep cuts in health care because Medi-Cal eligibility may be further tightened.
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Growing Insurance Gap
The number of Californians without health insurance reached 22.8% of the population under 65 in 1993, well above the national average of 18.3%. In part, the increase is a result of the fact that more working Californians are not receiving insurance from their employers.
California employers provide health insurance for their workers at a rate well below the national average of 58.2%. Job-funded insurance: 51% Uninsured: 23% Medi-Cal: 14% Privately purchased: 10% Other public: 2% *
More than eight in 10 of the uninsured are workers and their families. Full-time employee: 42% Full-time part-year: 17% Nonworking family: 16% Part-time employee: 13% Self-employed: 12% *
Nearly half of Medi-Cal recipients are in working families. Nonworking family: 54% Full-time part-year: 17% Full-time full-year employee: 15% Part-time employee: 12% Self-employed: 2% *
If job-funded health insurance had continued at the 1989 level, 1.3 million more Californians would have such coverage today.
Source: UCLA Center for Health Policy Research
