Under the Affordable Care Act (ACA) the percentage of Californians with health insurance has risen to 93%. The state is closer than ever to covering every Californian and is now considering various policies to cover the state’s remaining three million uninsured.

According to estimates from the UC Berkeley Center on Labor Research and Education and the UCLA Center for Health Policy Research (PDF), the remaining uninsured fall into four main groups:

• 1.8 million (59%) are ineligible due to immigration status. Many, although not all, would otherwise qualify for Medi-Cal based on their income.
• 550,000 (18%) are eligible to purchase coverage on Covered California, though they don’t qualify for federal ACA subsidies to bring down the cost of their premiums. Cost is the biggest barrier cited by this group to obtaining coverage. The high cost of living in California likely contributes to many in this group not being able to fit health coverage into their budgets.
• 401,000 (13%) are eligible to purchase coverage on Covered California and their incomes are low enough to qualify them for federal ACA subsidies. This group also cites cost as the main barrier to becoming insured and California’s high cost of living is also likely a factor. Many who receive subsides are still not able to meet deductibles or afford their premium payments.
• 322,000 (11%) are eligible for Medi-Cal but not enrolled. This can be due to multiple factors, including people not knowing they are eligible, fear of enrolling in a government program, or difficulty with enrollment processes and procedures.