Assessing Health Care Services for California's Uninsured

Nationwide, the increasing number of adults and children without health insurance is a major source of concern, and California is no exception. More than 6.5 million Californians—a little more than 20 percent of the state’s population—were uninsured in 2002. We are studying a number of issues related to the health care needs of this population.

California’s major public insurance programs—Medi-Cal and Healthy Families—aim to improve access to physician and other health care services for low-income and other vulnerable subgroups of the population. We examined access issues for the California HealthCare Foundation and found that:

• Enrollees in Medi-Cal and Healthy Families enjoy substantially better access to physician services than people without insurance, although, people with intermittent coverage experience worse access.
• Generally, adult beneficiaries experience more problems with access than children; however, children with special health care needs face extensive access problems.
• Access to physician care is uneven across the state.

In a related project, we looked at access to specialty care, finding widespread problems with access and many communities facing a worse situation than two years ago. Although local efforts are helping to chip away at the problem, major obstacles will remain unless local health leaders and state policymakers take additional steps.

We are also evaluating the state’s efforts to expand health insurance coverage for children through the Santa Clara Children’s Health Initiative and a major initiative in San Mateo County.

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