The Health Uninsured

1. The Health Uninsured Some Statistical Information July 27, 2007 Charles Maxey, Ph. D.

2. In California

3. Uninsured in California - 2005 • 1,116, 000 children between the ages of 0 and 18, • Or, about 10.7% of that population. • 5,414,000 adults between 19 and 64, • Or, about 24.8% of that population.

4. Health Insurance Status of Californians 2005 CHIS

5. Those uninsured are more likely: To have access to care problems, To have no usual source of care, Not to see a doctor or have well-child visits as regularly. Among uninsured CA children: 34.5% had no usual source of care, About half had a well-child visit within the past year. And, “uninsurance” tends to be a long-term condition.” Why Does This Matter?

6. Slight decline in the proportion of uninsured. Larger decline for children than adults. Declines for both groups in Employer Based Insurance (EBI) Increases for both groups (but mostly for children) in government coverage. Increases in privately purchased coverage What Are the Recent CA Trends (since 2001)?

7. Recent Changes in Insurance Coverage for CA Children

8. Increases in SCHIP Programs in the U. S. and California

9. In Ventura County

10. Uninsured in Ventura County - 2005 CHIS Estimates • About 130,000 overall among the under 65 years old population. • This is 18.1% of the 0-64 population. • 27,000 of these are children (0-18).

11. How to Understand 27,000 • If lined up single file to sign up for health insurance, the line of Ventura County uninsured children would extend for 10.2 miles. • Fill 771 classrooms of 35. • Provide enough players for 3,000 AYSO U8 Soccer Teams. • Giving each child a basic one hour physical exam check-up would take 168 physicians a full month.

12. How Does Ventura County Compare? 2007 CA County Data Book County Rankings (of 58 Counties) • 7th - Family Economic Well-Being • 12th - Children in Low Income Families • 18th - Mothers with Pre-natal Care • 46th - Children with Health Insurance

13. So, how is it that Ventura County can be more affluent than many but have higher rates of uninsured children than most?

14. It’s Not Because the County’s Rate of Uninsured Eligibles (UEPP) is High; in fact, the County’s Rate is Among the Lowest.

15. It could be because the working poor lack access to public programs and are unable to afford available private employer offerings.

16. Children With Health Insurance - Selected Ethnic Groups

17. The Uninsured Are a Working Population More than 8 in 10 of the uninsured are workers and their family members.

18. Changes in CA Children’s Coverage 2001 -> 2005

19. Public Coverage for Children and Adults

20. CA Workers with EBI Coverage for Themselves and For Dependents by Level of Educational Attainment - 2005

21. About Employers • Most Americans obtain health insurance through employer sponsored plans. • Between 1995 and 2005, the share of employers offering coverage has declined modestly. • In the same period, costs to offering employers have risen 85%.

22. Share of U. S. Businesses Offering Health Insurance

23. Cost of Employer Premium Contributions

24. Insurance Coverage Rates For California Employees • Coverage Rates Have Three Elements • % of those who employers offer coverage • % of the first group who are eligible • % of those eligible who elect to take up the coverage. Or, • Offered x Eligible x Take Up = Coverage

25. Coverage Rates Among CA Employees

26. Employee Coverage Rates in 2005 by Educational Attainment

27. Graph of Coverage by Educational Attainment

28. Why Employees Were Uninsured - 2001 and 2005

29. So, If We Are Concerned About the Numbers of Uninsured, What Should We Pay Attention To?

30. Key Factors • The scope, coverage and funding of public programs. • Enrollment and retention rates. • The prevalence of private employer programs. • Their quality and cost. • The impacts and interactions among these factors as a function of what public policies are put in place and the dynamics of the economy.