25% of Californians Uninsured

For hospitals and physicians in particular, such an increase in the federal match means that the care hospitals classify as unreimbursed or charity will now become eligible for payment in a way that it didn't before. "It will take some of the burden away," Lavarreda says.

One revelation in the UCLA report is how lopsided the burden of uninsured is distributed throughout the state. In 2009, for example, Bay Area counties, including San Francisco, Santa Clara, Alameda, San Mateo, Marin, and Napa and counties in the Sacramento area all had less than 20.4% uninsured.

However, among counties in Southern California and the San Joaquin Valley and smaller counties in the Northern California and Sierra regions nearly all exceeded 25%.  The Central Coast had percentages of uninsured higher than the Bay Area, but lower than in Southern and Northern California and the San Joaquin Valley.

The UCLA policy brief says that job loss, foreclosures, and loss of insurance coverage has combined "to make families vulnerable to prolonged financial as well as health problems.  "Given the ongoing effects of the recession throughout California, every effort should be made to help families in need even sooner than 2014."

Major elements of healthcare reform aimed at helping middle and lower-income families will not go into effect until 2014. Included among these provisions are federal subsidies for purchasing health insurance through a state-based health insurance exchange and a federally funded expansion of Medi-Cal.