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1st appeared
14 December
1999 Report Advises How State Can Expand Health Care to Working Poor More than 7 million Californians who lack health insurance are low-income workers and their families — 85% of all residents who lack health insurance— according to a new University of California report. The state’s 700,000 hired farmworkers, their families, and most of the communities in which they live have the least access to health care.
The authors of "Expansion of Health Care to the Working Poor," a four-part report published by the California Policy Research Center, examine why increasing numbers of low-income workers are uninsured and suggest solutions for California that have broad applicability to the national debate about increasing health coverage. The California Policy Research Center is a University of California Office of the President program that applies the University’s research expertise to the analysis, development, and implementation of state policy as well as federal policy on issues of statewide importance Driving the increased number of uninsured residents are the decline in job-based health insurance over the past two decades, the high cost of coverage, and the lack of public subsidies to make health insurance affordable for low-income workers. In addition, many people who are eligible for public insurance do not apply because of the stigma and demeaning application process associated with public coverage. Thus, 50 percent of California’s adult workers in low-income families are uninsured, as are 60 percent of low-income workers in small businesses. In a foreword, State Senator Martha Escutia said that because both managed care and public insurance programs negotiate below-cost reimbursements, the uninsured "not only lose the price discount enjoyed by insured members, but also have to pay inflated rates that make up for the savings realized by the insured." She added, "The uninsured . . . pay more than 18% of all health expenditures annually, or approximately $25 billion." The inconsistency between the lack of any health insurance subsidy for low-income workers and the significant subsidy the government provides to insured workers by not taxing employer contributions to their health coverage is noted by two of the report’s authors, UC San Diego professor Richard Kronick and research associate Todd Gilmer. This subsidy amounts to approximately $111 billion nationwide. Kronick and Gilmer examined model programs developed by other states to subsidize coverage for uninsured workers, and found that "When states make subsidized insurance available, substantial numbers of people purchase coverage." They think California "should actively evaluate options to expand health insurance subsidies to low-income workers," and say "there are many opportunities for using federal funds to support such expansions." In the final paper of the report, Professor E. Richard Brown, director of UCLA’s Center for Health Policy Research, articulates a vision for a new Healthy Californians Program that would provide a universal system of affordable coverage for uninsured children and adults, take health care out of welfare, and integrate all public coverage programs to form a seamless system. The strategy he describes involves implementing incremental structural reforms, which may have a chance of overcoming the political barriers to comprehensive reforms. "Expansion of Health Care to the Working Poor," also includes reports by Lucien Wilson Jr., project director of Insure the Uninsured Project in Santa Monica, and Don Villarejo, executive director of the California Institute of rural studies.
For the complete report contact CPRC at (510) 642-5514. A summary is available on the web. Links: California Policy Research Center Full press release from California Policy Research Center Expansion of Health Care to the Working Poor – Report Summary |
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