The economic recession that the state and nation are currently experiencing has had significant impacts on the employment and health coverage of Californians. Employers and employees struggled to afford quality health coverage before the economic downturn, and now it is even more difficult. Since the economy first began its decline about 18 months ago, almost one million more Californians have become unemployed and the number continues to grow. As a result of rising unemployment, an additional half a million Californians are now also uninsured. There would be even more uninsured if it were not for public programs like Medi-Cal. Uninsurance is associated with significant health and financial consequences for families and communities, so one of the most important ways to help the economy and Californian families recover is to expand coverage and invest in health care and health reform.