For most California residents, and the vast majority of the state’s lower income workers, the cost of health insurance has been running away from them for years. That’s hardly news to anyone who has actually used their health policy in the recent past.

But the health care squeeze is largely incremental — an increase in the cost of a doctor visit here, a hike in an X-ray price there. Though those costs almost never go down, they rise in such a gradual, consistent way that many people aren’t aware of just how dramatically they’ve escalated.

A new report from the UC Berkeley Labor Center puts those costs in context, and the result is breathtaking. In short, Californians have been absolutely hammered by insurers and providers over the past 20 years. As a result, many of the state’s residents either don’t use their health coverage even though they need it, or they go into debt trying to pay for the insurance and the medical costs their plans don’t cover.

“I think we know that health care is unaffordable, but to see how much that problem has gotten worse in 20 years is really something,” said Miranda Dietz, a policy research specialist at the center and co-author of the report. “The costs are taking up more and more of a family’s budget.”

The pinch hurts everywhere, but it’s most keenly felt among the state’s lower income workers, more than half of whom said they were carrying medical debt last year. In a 2023 survey, meanwhile, the California Health Care Foundation reported that 52% of residents said they’d skipped or delayed care sometime in the previous 12 months because of the cost — regardless of their income bracket.

It’s the 20-year trend that makes clear what is happening. From 2002 to 2022, the Labor Center’s researchers found, the chunk of workers’ money that had to be directed to cover health care premiums and potential deductible costs skyrocketed from 4% of median household income to more than 12%. In raw dollars, that cost was $1,996 in 2002 and $10,414 in 2022.

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