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Who Can Participate in the California Health Benefit Exchange?

May 1, 2011

Policy Brief

Authors: Nadereh Pourat, PhD, Christina M. Kinane, Gerald F. Kominski, PhD

This policy brief finds that about 1.71 million nonelderly Californians were uninsured for all or part of 2009 and are estimated to be eligible to participate and receive subsidies in the new California Health Benefit Exchange marketplace under the Patient Protection and Affordable Care Act (ACA) of 2010. Another 737,000 are currently insured with individual policies and will also be eligible for participation in the Exchange based on their employment, income and citizenship status. Using 2009 California Health Interview Survey (CHIS) data, the authors examine the characteristics of these Exchange-eligible with subsidies groups and find they are often single, young working-age adults, and are employed in small firms. Most are healthy and the prevalence rates of most chronic conditions are similar to those with employment-based insurance. However, several indicators show poorer access to care for those who are uninsured. The characteristics of the Exchange eligible with subsidies are likely to change by 2014 when the major provisions of the ACA are implemented. Nevertheless, these data indicate that the California Health Benefit Exchange is likely to improve access to care for the uninsured, and has the potential to improve coverage and access to care of those with individual policies.

This policy brief is accompanied by a break-down of key health statistics related to this newly-eligible population.

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