Advertise Here

Deliver your message to thousands of readers every day.

Our readers are influential opinion makers - politicians, journalists and activists.

Our latest headlines

As Another Special Session on Budget Looms, Senator Asks if California Can “Bail Out Ourselves” By Retirement System Purchase of State’s Short-Term Debt
Schwarzenegger Thinks Jerry Brown Has Best Shot at Being Next California Governor if Obama Wins Presidency
Governor Schwarzenegger Should Call Special Session on California’s Mortgage and Foreclosure Crisis Linked to Our Budget Problems
If It Were up To Them We’d Still Be in the Depression
Schrag: The Problems with Prop 4 on Parental Notification
With Friends Like New York Times Columnists Thomas Friedman, Maureen Dowd And Frank Rich – Does Barack Obama Need Enemies?
California Budget Crisis – Again-- Possible Special Session on State Budget

About Us

The California Progress Report is published by Frank D. Russo, a longtime observer of and participant in California politics.

About Frank Russo.
About California Progress Report.

Got a news tip? Want to write a guest column? Contact Frank here.

Books

An Unhealthy Trend in Health Insurance and Also in the Individual Market

By Hanh Kim Quach
Health Care Policy Coordinator
Health Access California

75 million adults -- that's 42% of working age adults in the US -- had no insurance or really bad insurance (the kind that makes you pay up the nose anytime you sneeze) in 2007.

That's up from 35% of working age adults that were uninsured or underinsured in 2003, the first time Health Affairs did this analysis. A new analysis -- out today!-- updates the study from five years ago.

Among the findings:

• 25 million people who were technically "insured'' actually have really crappy insurance (that amounts to one-fifth of the entire "insured'' population)
• The number of adults earning between $40k and $60k who were underinsured nearly tripled from 5% to 13%.
• The number of adults earning more than $100k and were underinsured (meaning that they spent more than 10% of their income on out-of-pocket medical expenses) increased from 1% to 7%.

The series of studies is important because until recently, most analyses only tracked the number of people without coverage and how lack of coverage impacts a person's ability to stay healthy. Just as important now, though, is this tracking the number of people with inadequate insurance. High deductibles, high co-pays, high co-insurance and high out-of-pocket costs cause patients to behave in similar ways to a person who is uninsured -- they forgo care because of the expense.

Insurance companies like to argue that these low-quality, low-premium plans are at least a backstop to keep people from going into bankruptcy. But as our previous studies have shown, people don't have much in the way of assets -- and a $5,000 deductible would wipe out the savings of 40% of Americans. From our perspective, being underinsured means you're paying premiums to be functionally uninsured.

The Individual Market

As we continue to struggle with how to get more people coverage, I'd suggest a look at this Kaiser Family Foundation report from February. The study looks at people who can't get public coverage and aren't offered insurance through their jobs.

Among the findings:

• At 400% of poverty, the outer limit of an income that could qualify for subsidies in California (under last year's health reform discussions), only 25% of family purchased coverage on the individual market.
• At 1000% of poverty, fewer than half (49%) of families purchased coverage.

Self-employed families, who receive tax credits on the premiums took up coverage at ever-so-slightly higher rates:

• At 400% of poverty, about 30% purchased coverage
• At 1000% of poverty, 58% took up coverage

The study, however, did not take into consideration the regulatory atmosphere -- whether individuals wanted to buy coverage, but were denied because of pre-existing conditions, or priced out because of their health histories -- all important factors as we go forward.

So the upshot is this: health coverage on the individual market isn't that attractive to lots of people and policymakers are going to have to find a way to make it more so, including subsidies that "may need to extend higher up the income scale than some policymakers may prefer.''

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.

Posted on June 10, 2008

Comments

Unable to get insurance I can afford because of a pre-existing condition I am not worried in the slightest.

I just do what President Bush advised.

Head for the emergency room.

And I'm not worried about the bill. Do you know how many hours my attorney will put in fending off the blood-suckers of the hospital and doctors who will treat me for 50K? 100K?

A lot.

Look if society tells me to just drop dead 'cause no will sell me affordable health insurance I got the answer for 'em.

'Okay, but I'm staying in the hospital on your dime until I do.

Simple, eh?

Posted by: A.Citizen at June 10, 2008 04:55 PM

The reason I can't afford it is every year more crap gets mandated in my plan STOP HELPING ME PLEASE. 2 new things I don't want or need this year. I just raises my rates
AB1887(Beall) to expand the requirement on insurer to cover mental health services.
* AB1962(De La Torre), to require insurers to cover maternity benefits.

Posted by: Jeff at June 10, 2008 05:10 PM

CA is the only state that does not allow companies to exclude pre-existing conditions. I have a bad knee and was denied. I did not care about my knee the surgery was done. I needed insurance for everything else. I think this is one of the problems with health insurance in california. I kept my insurance from Texas.

Posted by: Chris at June 10, 2008 05:35 PM

Get Email Updates

Want the California Progress Report by email? Once a week, we'll send you the latest and greatest headlines.

Stat tracker