NCPA - National Center for Policy Analysis

Uninsured In California By Choice

August 22, 2000

Lack of insurance is not merely an issue for the poor. Approximately 40 percent of the uninsured have family incomes at least twice the federal poverty level, and 25 percent have family incomes at least 300 percent of poverty.

A recent California survey of the uninsured with incomes over 200 percent of poverty found:

  • Forty percent owned their own homes and more than half owned a personal computer.
  • Twenty percent worked for an employer that offered health benefits, but half of them (10 percent of the total) declined coverage for which they were eligible.
  • However, this group was not opposed to insurance in general as 90 percent had purchased some form of insurance (auto, home or life) in the past.
  • About 43 percent felt that health insurance was not a good value for the money, and rising insurance premiums will only increase this number.

People will only purchase health insurance when its perceived value is commensurate with its cost. Overall, survey participants believed health coverage costs about twice what they were willing to pay; even though most respondents' perceptions often exceeded the actual cost.

However, even if everyone in the survey who was willing to purchase health insurance did so, almost half would remain uninsured. While some of this group might be persuaded by tax incentives, the majority have higher incomes and are unworried about health crises. This group remains uninsured by choice and are unlikely to enter the market voluntarily.

Source: Jill M. Yegian, et al., "The Nonpoor Uninsured in California, 1998," Health Affairs, July/August 2000.


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