Letisia Marquez, UCLA
For the first time in a decade, the percentage of Californians who had health insurance through their own or a family member's employment fell below 50 percent in 2011, according to a new study from the UCLA Center for Health Policy Research.
At the same time, the percentage of non-elderly adults and children enrolled in Medi-Cal and the state's Healthy Families program increased, with one in five insured through these public health insurance programs for low-income Californians in 2011.
The study used new one-year estimates from the 2011 California Health Interview Survey (CHIS). (Learn more about how CHIS collects data.)
"We're seeing the toll of two years of high unemployment with the loss of job-based insurance for more than 1 million Californians," said Shana Alex Lavarreda, the study's lead author and director of the center's Health Insurance Studies Program. "With the state still reeling from a 10.2 percent unemployment rate, public health insurance enrollment has expanded to meet the increased need."
Employment-based coverage — rather than publicly funded programs or expensive individual policies — has long been the primary way Americans accessed health insurance.
When data for the first California Health Interview Survey was collected in 2001, 56 percent of non-elderly Californians had employment-based coverage. By 2011, that figure had declined by more than 6 percentage points, to 49.7 percent.
Eligibility for public programs grew dramatically during the recent recession, as many unemployed Californians' household incomes dropped below the federal poverty level, qualifying adults in those families for Medi-Cal. (In 2011, the federal poverty level was $14,710 for a two-person household and $22,050 for a family of four.)
In 2007, 15 percent of all non-elderly Californians had coverage through public insurance programs. Four years later, the proportion had surged to 19 percent.
Despite the increase in the number of Californians enrolled in government insurance programs, nearly 7 million state residents remained without health insurance in 2011.
Expanding Medi-Cal eligibility to individuals whose incomes are below 138 percent of the federal poverty level and providing access to a new health insurance exchange (both of which are Affordable Care Act provisions due to take effect in January 2014) should help many more people obtain coverage, the researchers noted.
"It's clear that the job-based model just doesn't work for everyone in an age of high unemployment and rapidly changing job markets," Lavarreda said. "When the major insurance expansions occur in 2014, the ACA should finally provide relief to the millions of Californians who for years have struggled to survive without health insurance."
The UCLA Center for Health Policy Research is one of the nation's leading health policy research centers and the premier source of health-related information on Californians.
