Summary
Published Date: January 21, 2016
The study looks at changes in health coverage for the safety-net population in California as a likely result of 2014 implementation of the federal Patient Protection and Affordable Care Act (ACA). The ACA expanded Medi-Cal eligibility to most adults with incomes up to 138% of the federal poverty level and established state health care exchanges that enabled individuals to purchase insurance, often with federal subsidies.
Authors primarily based on 2013 and 2014 California Health Interview Survey data. This study is part of the California Health Care Foundation's California Health Care Alamanc, an online clearinghouse for key data and analyses describing the state’s health care landscape.
Key findings:
- In 2014, 3 in 10 Californians could be considered part of the safety-net population because they were low-income and enrolled in public programs or were uninsured. A safety-net patient is someone who makes less than 300 of FPL ($35,000 for an individual in 2014).
- Public hospitals are much more reliant on safety-net funding sources, with 70% of their net patient revenue coming from Medi-Cal and county indigent programs, compared to 19% for private nonprofit hospitals.
- The safety-net population accounted for 83% of community clinic visits.
- While insurance coverage of the safety-net population increased from 21% to 24% from 2013 to 2014, access to care may continue to be a problem.
- The safety-net population spent more money out-of-pocket for health care as a percentage of median annual income (3.1%) than the non-safety-net population (1.6%).
