This report provides estimates of program participation expressed as the ratio of children who are enrolled in either the MC or the HF programs to the total number who are eligible to participate in the programs and who do not have private or employer sponsored health insurance coverage. Program participation rates are provided by geographic region and by county (where sample size permits). Because parents are the decision makers regarding children's health insurance enrollment, this report also highlights the disparities in children's enrollment by parental characteristics including ethnicity, immigration status, English language proficiency and language spoken in the home. By learning about the parents of uninsured eligible children, we can better target them with outreach programs. The report also provides the most frequent reasons parents give for not enrolling their eligible children in the programs, by ethnicity.

Between 2001 and 2003, both children and adults lost employment-based health insurance coverage. For children, increased enrollment in Medi-Cal and Healthy Families resulted in a lower uninsured rate. For adults, however, the decline in employment-based insurance coverage from 2001 to 2003 resulted in a slight increase in the uninsured rate. Using data from the 2003 California Health Interview Survey, this policy brief provides a profile of nonelderly Californians' health insurance coverage and describes how these rates have changed since 2001. In 2003, 6.6 million nonelderly Californians were uninsured at some time during the year -- the majority of whom were uninsured for at least the entire year. In fact, one in four nonelderly adults and one in ten children under age 18 experienced a lack of coverage for all or part of the year. In addition, this study found that three-fourths of uninsured nonelderly Californians are in working families. Over 80% of uninsured employees have no access to employment-based insurance coverage because they either worked for an employer that did not offer health insurance, or they were not eligible for benefits from their employer. While more than half of uninsured children in California were eligible for enrollment in Medi-Cal or Healthy Families, only 6% of uninsured nonelderly adults, ages 18-64, were eligible for these public programs. Overall, rapidly rising health insurance costs and a still-slack labor market have reduced employment-based insurance in California since 2001. However, Medi-Cal and Healthy Families have proven their effectiveness in covering children, underscoring their potential for offsetting at least some of the loss in job-based insurance.

This policy brief explores differences in access to health care services for the moderate- and low-income, nonelderly population residing in 29 metropolitan statistical areas (MSAs), focusing on the effects of insurance status on access to services. The moderate- and low-income population is defined here as those with family incomes below 250% of the federal poverty level, that is, below approximately $31,500 for a family of three in 1996. The data used in this study are from the 1995 and 1996 National Health Interview Surveys, the most recent years for which data are available for urban areas.

In 1999, 6.8 million nonelderly Californians were uninsured, down from 7.3 million the previous year. This drop in the number of uninsured was the result of a 2.3-percentage point gain in employment-based health insurance coverage and a slower decline in Medi-Cal coverage compared to the previous several years. California’s recent upturn in coverage follows years of persistent and rising rates of uninsurance, despite the booming economy during this period.

Individually and collectively, the five chapters that make up this report present a grim portrait of life in South-Central Los Angeles and other places like it, and they constitute a remarkable indictment of mainstream society for its indifference and neglect. The chapters lay out a detailed bill of specifics as to the nature and causes of the crisis in South-Central Los Angeles, together with various policy recommendations for dealing with some of the most troubling aspects. In Chapter 1, Ong describes the depth and range of economic deprivation in both South-Central Los Angeles and other parts of the wider metropolitan area. Leavitt and Heskin then take up the issue of the housing situation in South-Central. Brown, et al. describe a number of alarming failures of public health and health care delivery in Los Angeles. Darby, et al. point to the striking breakdown of education in Los Angeles in general and South-Central in particular. In Chapter 5, Estrada and Sensiper bring the proceedings to a conclusion with a discussion of the many different social cross-currents and the concomitant difficulties of political mobilization that mark South-Centra

More than ever before, uninsured children in low-income families are eligible for low-cost health care coverage. But enrollment is lagging in California in both private-sector programs and public programs such as Healthy Families and Medi-Cal. The reason may be that low-income families whose earnings place them above the poverty line often struggle with the cost of unsubsidized health care coverage, to the point where many choose not to obtain coverage. That was the main conclusion drawn from focus groups designed to study the attitudes, perceptions, and opinions of low-income Californians about the value of health insurance for their children. On behalf of its Kaiser Permanente Cares for Kids initiative, Kaiser Permanente commissioned the study of Latino and non-Latino white parents with incomes between 200% and 275% of the federal income guidelines (family incomes ranging from $27,000 to $48,000 for a family of four in 1999). The goal of the study was to learn more about this population’s beliefs and values regarding children’s health care coverage, and to share those findings with policy makers, advocates and other interested parties.

U.S. metropolitan areas are characterized by pronounced disparities in rates of health insurance coverage and access to care. While it has been well documented that people with lower incomes run a greater risk of being uninsured than those with higher incomes, this study also finds a strong relationship between a city’s rate of employer-sponsored health coverage and its overall rates of health coverage and access to care. We examined health insurance coverage and access to health care among moderate- and low-income, nonelderly residents of the nation’s largest metropolitan areas.

On behalf of the Universal Coverage for California’s Children Coalition, Kaiser Permanente Cares for Kids (KPCK) asked the UCLA Center for Health Policy Research (the Center) to study the attitudes, perceptions, and opinions of Californians with incomes between 200% – 275% of the federal poverty level about the value of health insurance for their children. Focus groups were conducted with Latino and non-Latino white (white) adults living in Los Angeles who were married, with at least one parent working full- time for the year, and who were fluent in English. These populations were selected because they are the most likely to have uninsured children.