State Health Watch News Briefs California’s 6.5 million uninsured often forgo necessary medical care LOS ANGELES—The 6.5 million Californians who lack health insurance are much more likely to delay or forgo necessary medical care than those with coverage, according to a study issued in February by the UCLA Center for Health Policy Research. The gap in accessing care cuts across all nonelderly age groups, both men and women, and applies to all types of medical care, including treatment of an acute problem, monitoring of a chronic illness or preventive screenings. Among the most significant findings: • Nearly one-third of uninsured children (29%) lack a usual source or provider for medical care, a rate seven times higher than for insured children. • Four out of 10 uninsured children (41%) did not make a physician visit within the last year, compared with 20% of insured children. • During a one-year period, 13% of uninsured children delayed or didn’t get needed medical care. In contrast, only 2% of insured children delayed or didn’t get needed medical care. • Some 51% of uninsured adults report that they have no usual source of care, compared with 10% of insured adults. A separate policy brief issued by the UCLA Center last month reports that 2 million California men ages 18-39, 34% of all men in this age group, are uninsured. That compares with an uninsured rate of 23% of women in the same age category and is nearly double the uninsured rate for men ages 40-64. To obtain a free copy of Policy Brief 98-2 on uninsured men or Policy Brief 98-3 on the consequences of being uninsured, fax your request to 310-825-5960. LA, NY, Miami, Philadelphia, Chicago best areas for Medicare risk MINNEAPOLIS—The most attractive markets for continued Medicare managed careexpansion are likely to be in those areas in which managed care competition, including development of Medicare programs, is well established, according to a new report by Interstudy Publications. Based on current penetration, AAPCC rates, and size of eligible population, the top five areas for expansion of Medicare programs are Los Angeles-Long Beach, New York, Miami, Philadelphia and Chicago. Interstudy also found that areas that have low managed care penetration, recently had increases in AAPCC rates, may also be attractive markets. This group includes Greenville, NC; Jackson, MS; Montgomery, AL; Sheboygan, WI; and La Crosse, WI-MN. To purchase a copy of The InterStudy Competitive Edge: the Regional Market Analysis, call 1-800-844-3351.