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In California and the Nation: Many in Middle Class Willing But Unable to Obtain Insurance
Two New Reports Document the Problem
By Hanh Kim Quach
Health Care Policy Coordinator
Health Access California
An article in this month's Health Affairs (subscription required) breaks down why the U.S. Census Bureau's statistic pointing out that one-third of "higher income'' Americans is uninsured is misleading. The Census statistics are an important source for health coverage data and is also used by the federal government to allocate funds.
In 2006, according to Census statistics, more than one in every three Americans (37.8%) lived in a household with income higher than $50,000.
But, the Health Affairs article points out"...many of the uninsured who live in higher income households do not fit a profile of "financially able but unwilling."
Moments when income is "high" could be a temporary, as with self-employed or transient workers. So are moments of uninsurance, when a person is between jobs.
Additionally, "households'' does not equal "one family.'' Many of these "households" have many generations living under one roof: adult children at home who are contributing to the family income, but are not allowed to glom onto their parents' policy; parents living with their adult children, who need to purchase separate policies. Adults in "high income'' households could also be in roomate situations, and therefore need separate policies. So if you separate out the individual family units, earnings are far below the $50,000 to $75,000 mark.
That's why the debate about affordability of health care in this year's reform efforts is so essential. Policymakers need to find a way to help this middle-income group, sandwiched between super-poor and super-rich find affordable and meaningful health coverage.
As the report shows, being uninsured is not a symptom of being "young, invincible'' and brazen as many would like to believe, but more because insurance simply costs too much for people who are trying to survive by pooling their resources and huddling under one roof.
Meanwhile, the California HealthCare Foundation released its annual "Snapshot: California's Uninsured" this week and it's grim.
Middle-income families are becoming uninsured faster than any other income-bracket in the state, the report says. Since the beginning of the decade, the number of families earning between $50,000-$75,000 and are uninsured has increased by 3.1%.
This is a really important point because $75,000 is between 350% to 450% of poverty (depending on family size) -- the level at which policymakers are discussing cutting off eligibility for tax credits to help keep the cost of health care affordable. The guv wants he cut-off at 350%, the Democrat leaders want it at 450%. This latest information, to me, makes a convincing argument for the higher threshhold. If the trend continues, as we expect it to, we can only expect more and more middle-income people to be uninsured in future years if something is not done.
Other interesting -- and sobering factoids:
• Since the beginning of the decade, 5.9% fewer Californains are getting their health coverage through work. Instead, they're getting it primarily from really expensive individual policies (up 2.6%), Medi-Cal (up 2.1%), Medicare or are uninsured.
• Young adults -- ages 25-34 -- experienced the biggest jump in uninsurance since 2000.
• Latinos are three ties as likely as whites to be uninsured.
Hanh Kim Quach is the Health Care Policy Coordinator for Health Access California. Before joining the organization, she worked as a journalist for nearly 9 years, covering issues in California. Health Access California is a statewide health care consumer advocacy coalition of over 200 groups. This article has also been published on the Health Access Weblog.
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