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Higher proportion of California children uninsured and enrolled in public health insurance than in U.S., USC analysis shows

Compared to the nation, a higher proportion of children in California are uninsured, one in every 10 children or more than 1.1 million in 2011.

More of California’s children have public health insurance and fewer through their parents’ employer. And, over the past three years, a decade of advances in California children’s public insurance enrollment has stalled, as coverage in Healthy Families (California's children’s health insurance program) declined as a result of reductions in state government funding.

These are just a few of the findings in a new report from the California HealthCare Foundation developed by the Keck School of Medicine of USC and Diringer and Associates that provides an overview of trends in children's health insurance coverage and insurance programs in the state.

Other findings include:

California’s proportion of children without health coverage is higher than the national average and most other states. Nevada has the highest proportion of uninsured children and Massachusetts has the lowest.

Of California residents aged 18 or younger, 56 percent had private insurance, 38 percent had Medi-Cal (the state’s Medicaid program, which provides health coverage for people with low incomes) or Healthy Families, and 11 percent were uninsured in 2011.

Public coverage through Medi-Cal and Healthy Families expanded 46 percent from 2002 to 2011, while employer-based coverage declined by 16 percent.

Medi-Cal continues to fill the gap in coverage created by the decline in private insurance. In 2011, almost 3.7 million children were enrolled, up from about 2.6 million in 2001.

Uninsured children are far more likely than those with coverage to have needed care delayed or to not receive care.

“Our findings have direct relevance to the health reform issues covered during the Presidential campaign,” said Michael Cousineau, lead author of the report and associate professor in the departments of Family Medicine and Preventive Medicine at the Keck School. “With full implementation of the new Patient Protection and Affordable Care Act more certain, there are new opportunities for many of these children to gain coverage and, more importantly, access to care including immunizations, annual checkups, and care for acute and chronic health problems. Even children of some small business employees might benefit since small employers are eligible for a subsidy to help provide insurance for their employees and their families."

As many as 1 million uninsured children may be eligible for Medi-Cal or private coverage through the new California Health Benefits Exchange. Not all children will be covered, however—undocumented immigrant children will not be eligible and will have to rely on safety net clinics and public hospitals such as the Los Angeles County+USC Medical Center for care.

The report was published as part of the California HealthCare Foundation’s California Health Care Almanac, an online clearinghouse for key data and analysis examining California’s medical system.

For a copy of the study, go to

Alison Trinidad | EurekAlert!
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