The number of California residents under age 65 who were uninsured for all or part of a year increased from nearly one in five to nearly one in four between 2007 and 2009, according to a report from the UCLA Center for Health Policy Research.
While 6.4 million of the 32.88 million non-elderly residents in the state were uninsured in 2007, by 2009 their numbers had risen to 8.36 million of 34.38 million non-elderly people.
Many of the counties hardest hit in these last two years were some of the largest. For example, Los Angeles County saw its uninsured population grow by about 600,000, from 22.9% of its 9.1 million people under age 65—or 2.083 million people in 2007—to 28.9% of its 9.3 million people, or 2.687 million by 2009.
Orange, San Bernardino, and Riverside Counties also saw percentage point increases between 3.5% and 6%, or an increase of 303,000 uninsured for all three counties combined.
The data is critically important for health providers and county public health programs to understand because they have been the ones helping many of these patients when they need care, says Shana Alex Lavarreda, director of Health Insurance Studies and UCLA Research Scientist.
"In 2007, the recession hadn't happened yet, and in the time since they have seen their caseload grow as more and more people become uninsured," she says. "This data highlights the plight that these counties are in, and that some are having to deal with it more than others."
The statistics on the increase in numbers of people who had no health insurance for portions or all of the year is also significant as California readies its application for submittal next month to draw down more matching federal dollars for the Medicaid program, called Medi-Cal in California. The federal waiver request is called "Bridge to 2014," as the state makes efforts to ramp up its Medi-Cal program.
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.