THE STATE'S UNINSURED STUDY FINDS MANY CALIFORNIANS NOW LACK HEALTH COVERAGE.

Byline: Chris Sieroty Staff Writer

Nearly 25 percent of California residents do not have health insurance and half of them have been uninsured for five years or have never had coverage, according to a study that will be released today.

The report for the Health Insurance Policy Program found that California now accounts for one in three of the nation's uninsured, three times its share of the nation's population.

The report, The State of Health Insurance in California, 1999, is based on U.S. Census Bureau data from 1995 to 1998. During that time the number of uninsured increased by 23,000 each month, it said.

Particularly troubling to the authors was the continued rise in the rate of uninsured children in California. More than 2 million children statewide were without health insurance in 1998, an increase of 150,000 from the year before.

The figures show California is home to one in five of the nation's uninsured children.

Another factor contributing to the problem is the increasing number of noncitizens who lack health insurance. Fifty percent of noncitizens did not have benefits in 1998, the study said.

The biggest impact is on California's growing Latino community. Forty percent of California's Latino population was uninsured in 1998, the report said. Many in the Latino community don't enroll in Medi-Cal or other insurance programs because they are not sure of their immigration status or have fears of enrolling in public programs, said Helen Schauffler, director of the University of California at Berkeley Center for Health and Public Policy Studies.

That center, along with UCLA Center for Health Policy Research, conducted the survey and their work was financed by the California Wellness Foundation, which is funded by Health Net, the big HMO.

Not having the safety net of health insurance can lead to severe consequences later on.

``The uninsured usually delay or fail to seek care when they need it, and (they) lack access to crucial preventive care and health promotion services. This can lead to more serious medical problems, poorer health and increased costs for treatment,'' said Schauffler.

Researchers also attributed the rise in the state's uninsured population to a decline in Medi-Cal coverage. Since 1995, the percentage of nonelderly Californians who rely on Medi-Cal has decreased from 14 percent to 11 percent. Meanwhile, the number of employer-based or privately purchased health coverage plans remained flat.

Not surprisingly, Woodland Hills-based Foundation Health Systems supports efforts to extend coverage to more residents, said company spokesman David Olson.

``It's critical to make sure that people can afford health care,'' said Olson. ``They have to create an health insurance product that is affordable and comprehensive.''

For California workers and their families, the remarkable trend between 1995 and 1998 was that coverage declined while the economy prospered. According to the report, 23 percent of working families were uninsured in 1998, a percentage unchanged from three years earlier.

Richard Brown, director of the UCLA research center, said some possible solutions to the problem are:

--Expand the Medi-Cal and the Healthy Families Program by streamlining the application process and integrating them into a single, seamless, restructured program that enables individuals and families to buy into them. These programs should also be taken out of the welfare system, said Brown.

--Expand the state's high-risk pool to accommodate all eligible residents and guarantee that all individuals who want health insurance can purchase it.

--Expand the small group market reforms to include firms of one employee.

--Provide subsidies to individuals whose incomes fall below 250 percent of the federal poverty level to enable them to purchase private insurance, participate in the high risk pool and buy into expanded public programs.

"The issue of access to health care is one of the most critical health issues facing us today," said Alan Puzarne, senior vice president of Blue Shield of California.

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