The eighth edition of The State of Health Insurance in California, published every two years since 2002, evaluates the first year of the Patient Protection and Affordable Care Act (ACA) of 2010. Using data from the 2013-2014 California Health Interview Survey (CHIS), the authors find that in 2014, the uninsured rate significantly declined. ACA health insurance expansions played a large role in this, giving Californians more options for coverage than ever before. The number of uninsured Californians ages 64 and under fell from 5.32 million in 2012 to 4.46 million in 2014 ― a decline of 16 percent.
The report shows the expansion of health care under the ACA played a significant role reducing the population of uninsured Californians due to two main factors: Expansion of Medi-Cal to previously excluded groups and provision of federal subsidies that helped people afford to buy private insurance on Covered California. The report also details that concerns about the ACA ― such as that it would reduce employer-based insurance ― were unfounded.
The ACA also resulted in a nearly 9 percentage point decrease in uninsurance among the self-employed. Access to care also increased for those with employer-based insurance, although there was a decrease for those with public insurance. Racial and ethnic disparities in access to care persist.
The report was funded with support from The California Endowment.