Job-based health coverage – the bedrock of the US health insurance system – is fractured and uneven throughout California and particularly scarce in some of the state’s largest and lowest-paying industries, a new study reveals.

The study by the Center on Policy Initiatives (CPI) found wide disparities in employer-provided health coverage among the state’s 17 major industries.  Overall, less than half of working adults in California get health insurance through their jobs.  In the hotel and restaurant industry, it’s only 20%.

The erosion of employment-based health coverage leaves almost 5 million California workers dependent on publicly funded health programs or completely uninsured, according to the study results.

"The findings are stark, that some industries are trying to do their fair share and others are putting the burden onto taxpayers and other employers," said Murtaza Baxamusa, CPI Research and Policy Director. “The healthcare crisis is exacerbated when industries add large numbers of jobs with low rates of employer-provided insurance.”

An embargoed copy of the full report, “The Working Uninsured: An analysis of worker health coverage among California industries” is available here.

CPI, a nonprofit research and advocacy organization located in San Diego, analyzed data from the California Health Interview Survey (CHIS) 2005, a survey of 45,000 households, and from the California Employment Development Department.

The UCLACenter for Health Policy Research, which conducts the CHIS survey every two years, plans to release its biennial report on “The State of Health Insurance in California” on Wednesday.  The report will be available at www.healthpolicy.ucla.edu.

The CPI study provides the only industry-specific analysis of the data, exposing stress points in the state economy where workers are least likely to have health insurance and the cost of their medical care is shifted to the public through taxes and higher hospital and premium charges.  The major findings include:

·Most uninsured adults in California are workers.

·The proportion of workers with employer-provided health coverage ranges from 20% to 74% across California industries.  Only three major industries cover more than 60% of their workers: Education, Information and Public Administration.

·Some of the state’s largest industries have the lowest rates of employer-provided coverage. In Retail Trade, the largest private industry, more than 1 million workers do not receive health coverage through their jobs.

·Low-wage workers, who are least able to afford medical expenses on their own, are least likely to have employer-provided health coverage. 

·More than one in four (28%) of working adults in the state receive their medical care through means funded directly by taxpayers or indirectly by all healthcare purchasers.

The report concludes public policies must be implemented to ensure job growth improves access to affordable, comprehensive health insurance.  Effective policies may include economic development strategies, the use of government purchasing power as leverage to require healthcare standards of contractors, and state legislation setting an equitable employer contribution to fund healthcare coverage.

“This report confirms what is so obvious to the majority of Californians: our health care system is broken and requires reform,” said Robert K. Ross, M.D., president and CEO of The California Endowment.

The study is part of CPI’s Healthcare Initiative, which is funded by grants from The California Endowment, James Irvine Foundation, Marguerite Casey Foundation, McKay Foundation, New World Foundation, Nathan Cummings Foundation, French American Charitable Trust, Rosenberg Foundation and the Unitarian Universalist Veatch Program at Shelter Rock.

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