This report provides a review of the major impacts ACA reforms have had on California children’s coverage through MediCal and Covered California since the passage of the ACA in 2010, as well as additional coverage reforms that the state chose to implement independent of the ACA during the same time period. 

The report also provides actionable recommendations for the future related to: eligibility for coverage, health care benefits for children, the affordability of coverage, how families enroll in and renew coverage, and how families are using their coverage and getting care for their children. 

In some cases, the major impacts affect children and adults similarly. In other cases, there are impacts specific to children and their unique health care needs. The report includes California and federal recommendations for advancing children’s coverage and care.

The report uses 2009, 2011–2014 California Health Interview Survey (CHIS) data on health insurance and on Medi-Cal eligibility, and CalSIM 1.91 estimates on undocumented immigrant children and on remaining uninsured Californians.