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California is home to more people without health insurance than any
other state, according to U.S. census figures for 2002 released today.
About 6.4 million Californians, or 18.2 percent of the state's population,
lacked coverage in 2002. Because of the state's large population, California
leads the country in the sheer number of people going without health care.
California ranks sixth in terms of the percentage of a state's population
without insurance.
Nationwide, 43.6 million Americans, or 15.2 percent of the country, are
living without health insurance, a number that jumped 6 percent from 2001 as
more people lost their jobs and insurance premiums continued to rise. In 2001,
about 41.2 percent or 14.6 percent of the population was uninsured.
The numbers come out at time when health care is playing a growing role on
both federal and state levels. In California, the state Legislature recently
passed a law that could force employers over a certain size to cover their
workers or pay into a state pool.
On the federal level, Medicare has taken center stage in congressional
health care debates and, judging from the Democratic hopefuls, will become a
major issue of the next presidential election.
"We know this is a huge national issue. There are millions who work hard
and play by the rules and don't get basic health care coverage," said Anthony
Wright, executive director of Heath Access, a California consumer group that
advocates expanding health care coverage.
Bucking the national figures, the percentage of uninsured in California
dipped slightly from 19.5 percent in 2001. Health experts attributed the
improvement to an increase in the number of people on government health
programs, a trend that is mirrored nationally but still doesn't compensate for
the overall increase in the uninsured.
The census numbers did not include state-by-state breakdowns other than the
overall uninsured numbers. But according to California's Managed Risk Medical
Insurance Board, the number of children covered by the Healthy Families
program increased by about 100,000 from fiscal year 2001-2002 to this past
fiscal year.
MEDI-CAL NUMBERS UP
In addition, the state Department of Health Services reported the number of
people on Medi-Cal, the state's version of Medicaid, increased by about 577,
500 from September 2001 to September 2002.
But based on the large number of uninsured Californians, many people are
falling through the cracks.
Cynthia Mason, of Alameda, has been uninsured since 1996 when an injury
forced her to leave her job running the housekeeping services for the Park
Hyatt hotel in San Francisco.
She relied on disability until it ran out last year and has managed to get
most of her health needs met for free through services such as Operation
Access and Berkeley Primary Care, two programs that provide health care to the
uninsured. Mason, 58, said she has tried to get a full-time job with benefits.
"I'm sure I'd be working if it were not for the economy," said Mason,
describing how she has joined lines of 500 people for a job. "I always had
health insurance. Everybody should have affordable health care. It's
ridiculous."
Diane Rowland, director of the Kaiser Family Foundation's Commission on
Medicaid and the Uninsured, said the 2002 census figures were worse than she
expected, and she thinks the numbers in 2003 will be even worse.
"We're looking at some hard times on the employment-based side and equally
hard times for government-funded programs, both of which translate into an
increase in the number of the uninsured," said Rowland, adding that she didn't
see any changes on the horizon that will reverse the trend.
The recorded increase in the number of people covered by Medicaid, the
government health program for the poor, accounted for the rise from 25.3
percent in 2001 to 25.7 percent in 2002 in the percentage of people covered by
government programs.
But Rowland did not believe Medicaid or other government programs will
continue to grow in light of outreach cutbacks and program changes because of
budget tightening.
BRIGHT SPOT NOT ENOUGH
Ellen Shaffer, director of the Center for Policy Analysis, a health
research organization based in San Francisco, said Senate Bill 2, the employer
health mandate now before the governor, is a bright spot in the state's
efforts. But it won't solve all of California's woes.
The bill, by Senate President Pro Tem John Burton, D-San Francisco, would
cover an estimated 1 million of the state's 6 million uninsured, The law, if
passed, won't start covering residents until at least 2006.
With premiums on the rise, employers, who provide coverage for most
Americans, are feeling the squeeze.
According to the national census statistics, the proportion of the insured
population covered by their employers dropped from 62.6 percent in 2001 to 61.
3 percent last year.
The consulting firm Towers Perrin released a survey on Monday estimating
employers will face a 12 percent increase in health insurance premiums next
year. While the increase was less than the 16 percent this year, the firm
projected the cumulative effect of five years of double-digit increases will
mean employees will continue to have to pay more out of their pockets for
their coverage.
Other national findings in the 2002 census report included the following:
-- The number of children without health care nationwide remained unchanged
at 11.6 percent nationwide or 8.5 million children.
-- Hispanics were less likely than any other ethnic group to have insurance,
with 32.4 percent uninsured. About 20 percent of African Americans and more
than 18 percent of Asians reported being uninsured compared to 14.2 percent of
whites.
-- People ages 18 to 24 years old were less likely than any other age
group to have health insurance, with 70.4 percent covered all or some of 2002.
Because of Medicare, an estimated 99.2 percent of people over the age of 65
had health coverage.
-- The likelihood of being covered rises with income. Among households with
an annual income of less than $25,000, 76.5 percent had health care insurance
compared to 91.8 percent for families who bring in $75,000 or more a year.
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E-mail Victoria Colliver at vcolliver@sfchronicle.com.
