The number of Californians who have no public or private health insurance coverage has grown to 7.3 million residents — 24 percent of the nonelderly population — in 1998. Eight in 10 (82 percent) uninsured Californians are workers or their dependents, whose poor access to job-based insurance and low to moderate incomes place health insurance coverage out of each. In the absence of voluntary decisions by employers to provide generous contributions for their employees’ coverage, the most effective way to make health insurance affordable to uninsured working families is to expand eligibility in public health care programs.

In the past few years, California has expanded income eligibility, mainly for children, in Medi-Cal and the Healthy Families Program. The fiscal year 1999-2000 budget act expanded children’s eligibility in the Healthy Families Program by raising the income limit to 250 percent of poverty, allowing deductions from income that are used in the Medi-Cal program, and providing one year of state funding to cover recent immigrant children. The budget act also modestly expanded Medi-Cal coverage for parents of eligible children.

This report estimates the number of uninsured parents and children who are eligible for Medi-Cal or Healthy Families coverage as a result of changes made under the 1999-2000 budget act — and the number who would become eligible for these programs under four different policy proposals to simplify and expand eligibility. Report to the California Assembly Health Committee Based on Research Funded by a Technical Assistance Grant from the California Program on Access to Care.