County Residency and Access to Care for Low- and Moderate-Income Californians

Publication Date: March 2004

Publisher: UCLA Center for Health Policy Research

Author(s): E. Richard Brown; Shana Alex Lavarreda; Ying-Ying Meng; Ronald M. Andersen

Research Area: Health

Keywords: Medi-Cal; Healthy Families; health insurance

Type: Brief

Coverage: California

Abstract:

Where Californians live within the state plays an important role in determining their access to health care. This policy brief uses data from the 2001 California Health Interview Survey (CHIS 2001) to examine differences in four key measures of access to care related to the county in which a person with low- to moderate-household income resides. These measures are the percent of the county population who: 1) have a usual source of care, 2) use community or government clinics as their usual source of care, 3) are uninsured for all or part of a year, and 4) delayed any type of care because of cost or insurance issues.

The study also found that health insurance played a major role in determining access to care. The study’s findings have significant implications for the ongoing political debate over potential cutbacks in the Medi-Cal and Healthy Families programs.

These findings demonstrate that, for moderate-to-low income children and adults, counties differ in the levels of access experienced by their low- and moderate-income populations. Additionally, both persistent uninsurance and intermittent coverage reduce access to care and place a larger burden on community, public, and hospital-based clinics. The demands on this already-stretched safety net will likely rise with any increase in the number of uninsured people, whether that lack of coverage is short-term or long-term.