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California dreaming

A new estimate out of UCLA suggests that health-care reform will extend coverage to more than four million Californians who wouldn't have had it otherwise. That means coverage will hit 93 percent in the most populous state in the nation, with most of the remainder composed of illegal immigrants who are ineligible for the program. For comparison's sake, California's uninsured rate was 18.5 percent in 2007, and it's probably a lot higher now that the recession has done its terrible work.

It's easy to dismiss this sort of thing, but four million people is a lot of people. It's more people, for instance, than live in any of the states represented by any of the members of the Gang of Six. Helping this many people would be a hell of an accomplishment.

By Ezra Klein  |  October 19, 2009; 3:03 PM ET
Categories:  Health Reform  
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Comments

Ezra, you've been the one most responsible for my willingness to support the relatively incremental reforms on the table rather than say "if it ain't single payer, screw it," which is tempting at times. Along the same lines as what you say above, if reform happens it seems we'll see something like 35 million people gain insurance who wouldn't have it otherwise. Compare that with Canada's entire population of 33,816,264 (according to Statistics Canada, one minute ago). So incremental reform may well bring more people into the US system than exist in all of Canada's single payer system.

Posted by: JonathanTE | October 19, 2009 3:34 PM | Report abuse

Agreed: Subsidizing the lifestyle of 4 million people in a bankrupt state is a hell of a thing.

Posted by: rmgregory | October 19, 2009 4:06 PM | Report abuse

As a Californian without insurance, I wish I didn't have to wait four years to get covered, but it's better than nothing.

Posted by: dave89 | October 19, 2009 4:26 PM | Report abuse

Glass half full... a couple million people will get Medicaid or heavily subsidized insurance. Plus, CA already has an abundance of good low-cost HMOs to care for them.

Glass half empty... a couple million people get inadequate subsidies and will take the 8% affordability exemption, and/or be very mad at Democrats. And then there's the problem of a couple million undocumented.

If you take the 2009 figure which is 23% uninsured, it's hard to imagine getting to more than ~85% coverage. Will this be enough to prevent a premium spiral? That's especially concerning because many people can barely afford their employee share of premiums now.

It's dicey enough that most consumer groups came out against Schwarzenegger's proposed health care reform two years ago. The public option would really help to keep down costs and keep people's frustrations in check.

Posted by: bmull | October 19, 2009 6:24 PM | Report abuse

"...four million people is a lot of people."

And hence the moral imperative of passing this legislation.

Posted by: leoklein | October 19, 2009 7:04 PM | Report abuse

But what if 2+ million of the 4+ million *don't want it* under the terms that are offered? That's enough to make a blue state red.

Posted by: bmull | October 19, 2009 11:58 PM | Report abuse

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