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Open Access Publications from the University of California

The State of Health Insurance in California: Long-Term and Intermittent Lack of Health Insurance Coverage


This report, based on data from the 2001 California Health Interview Survey (CHIS 2001), examines long-term and intermittent health insurance coverage, and the sources and consequences of resulting periods of uninsurance. Sharp differences in the duration of un-insurance and health insurance coverage were found by race and ethnicity, by family income, and by citizenship and immigration status. These differences in the duration of health insurance coverage and uninsurance are due overwhelmingly to the lack of affordable private health insurance, which most Americans get through their own or a family member's employment. The study found that 4.5 million Californians were uninsured for six months or longer in 2001 out of the total 6.3 million who lacked health insurance for all or part of a year. Over half of uninsured Californians -- a total of 3.3 million -- lacked coverage for longer than one year. Employees who were uninsured all year were most likely to have worked for establishments with fewer than 10 employees (32.3%), while workers uninsured part of the year were most likely to have been employed in large firms with 1,000 or more employees (35.6%). Among currently uninsured children who are eligible for either Medi-Cal or Healthy Families, seven in 10 were uninsured all year. Among adults who were Medi-Cal eligible, eight in 10 lacked coverage for all of the past 12 months. Among California adults with heart disease, just over one-fourth of those uninsured the entire year (27.5%) take medications for the disease, less than the 44% who have job-based coverage all year. A similar pattern holds for those with high blood pressure (29.8% for the uninsured versus 54.6% for those with job-based coverage) and for diabetes (57.0% versus 76.5%). And among both adults and children with asthma, those uninsured all year are also less likely to be taking medications. For all but one of these chronic diseases examined, individuals with Medi-Cal and Healthy Families are more likely than those with job-based insurance to take medications for their illnesses.

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