Uninsured Healthier Than Current Medi-Cal Beneficiaries

Helen Lee was surprised by a few of the findings in a study released last week by the Public Policy Institute of California.

“We find a relatively young population among the uninsured,” the PPIC policy fellow said. “In fact, more than half were in the 19 to 40 group.”

Up to three million Californians will join the ranks of the insured under the expansion of coverage in 2014 mandated by the federal Affordable Care Act. So it’s important to know the demographic makeup of all of those potential enrollees, Lee said.

For instance, she said, age matters.

“As people age, particularly as people enter older age, you see an emergence of chronic conditions,” Lee said. “So this is really good news.”

The younger age and relative health of potential enrollees makes for a more-attractive insurance pool, which could mean lower rates can be negotiated by the exchange board.

“Perhaps the most salient questions of interest involve the potential health care demands on delivery systems,” Lee said. “In general, the uninsured were healthier than current recipients of Medi-Cal.”

Privately insured patients are healthier than the uninsured, so the overall pattern is that the health of potential new insurance enrollees falls somewhere between Medi-Cal and the privately insured, she said.

A majority of the uninsured are poor and the majority of those poor adults are Latino, as well as other minorities, Lee said, adding that poor doesn’t mean unemployed.

“Most of the uninsured are working,” Lee said, “both part time and full time.”

So the majority of the uninsured are poor, working, minority and relatively healthy — and one more thing, she said.

“We found that, somewhat surprisingly, they tend to be better educated, compared to those currently enrolled in Medi-Cal.”

The one category of concern, Lee said, came when researchers looked at four categories of chronic conditions: asthma, diabetes, hypertension and heart disease.

“About 25% of them report at least one chronic condition,” she said. “And smoking and obesity prevalence is high.”

That means the California Health Benefit Exchange board or the Legislature might want to make sure that smoking cessation and obesity counseling are important components of any new coverage, she said.

The report, released last week, is available here.

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