This indicator measures the percentage of adults aged 18 to 64 years with health insurance.

Everybody should have access to medical care when they need it and to keep their bodies healthy with regular check-ups. Research indicates that health insurance dramatically improves health outcomes by allowing people to access necessary care. One study found that people without health insurance had a 25% higher risk of mortality than insured individuals. Insurance allows people to receive ongoing, consistent care and establish ongoing relationships with medical providers. It also enables regular screenings and check-ups—helpful for early diagnosis and reduced mortality for cancers and other diseases. People with insurance are far more likely to get medicines to control chronic diseases. Insurance access also has community wide impacts, reducing the spread of communicable diseases. In addition, health insurance helps families save money on expensive medical care. Indeed, almost 50% of bankruptcies in the U.S. are due to medical expenses, and one study found that uninsured families can afford to pay for only 12% of hospitalization costs.^14,70

California has made great strides in improving insurance coverage, increasing the number of people with insurance by 3.4 million between 2012 and 2015.⁷⁴ However, as of 2015, over one in ten Californians was still not covered, with far higher rates in Asian and Latino communities. Undocumented people face special challenges due to ineligibility for many programs and fear of deportation—and consequently represent a third of those still lack insurance.⁷⁴ For Californians overall, research indicates that eligibility and cost are the primary barriers to coverage.

Improving insurance coverage therefore requires addressing these barriers, as well as helping people understand the options that are available. Jurisdictions wishing to improve health insurance coverage should first Conduct Proactive Education and Outreach, especially in communities with lower rates of coverage, and Maximize Enrollment Opportunities to ensure that as many people as possible are enrolled. In the longer term, jurisdictions should Expand Coverage options for people who are not eligible for or face barriers to current coverage options, and Provide Quality Care for Uninsured or Underinsured People, with an emphasis on improving care and reducing costs by providing primary and preventative care.

Jurisdictions can also help people afford insurance premiums, or gain coverage through their work, with policies intended to support economic opportunities for workers. This includes efforts to Raise Wages and Benefits, Build Workforce Development and Pathways, Build Wealth, and Develop Community Economic Capacity.