"I think this is clearly a growing problem. All the evidence is, it's going to get worse, not better, if left to the whims of the marketplace, and that government really needs to step in and take stronger action to help control both the growth of health care costs and also to help provide health care coverage for the 6.7 million Californians who have no access to health insurance," Brown said.

More than two-thirds of the uninsured are in low-income families, but about a fourth are in the upper-half of income distribution in the state, Brown said.

"When you look at the costs of family coverage and what in many workplaces the employer requires employees to pay, it is understandable why so many employers don't offer coverage and why so many middle-class working families feel it's simply beyond their financial means," Brown said.

"It's over $10,000 a year for family coverage on average through employer plans in California today. The average worker is required to pay about a fourth of that and in many cases, required to pay considerably more," Brown said.

Center researchers used data from the 2003 California Health Interview Survey, where respondents indicated that they were uninsured for all or part of the previous 12 months.

The highest concentration of uninsured was Los Angeles City Council District 1, an area north of downtown Los Angeles that encompasses the Pico Union region, where 41 percent of residents were uninsured, the study said.

Los Angeles City Council District 9, which covers the downtown civic center area and part of south Los Angeles, had an uninsured rate of 39 percent, followed by the South Los Angeles areas of Lennox and Florence-Graham, both at 38 percent, the study said.

Areas with the lowest uninsured rates included Palos Verdes Estates, Rolling Hills Estates, and La Ca ada Flintridge, at about 6 percent, Frost said.

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