​This brief examines health care coverage rates and sources of coverage among nonelderly (under age 65) Californians based on the 2017 California Health Interview Survey (CHIS), with 2013 and 2016 CHIS data used for comparisons before and after expansion of the Patient Protection and Affordable Care Act. The authors focus on nonelderly Californians because those over 65 are nearly universally covered by Medicare. The major coverage expansions of the ACA were implemented starting in 2014, and by 2016 the uninsured rate among nonelderly Californians fell from 15.5 percent in 2013 to a historic low of 8.5 percent in 2016 and stayed at that level in 2017. For ease of presentation, this is referred to in the text as the “uninsured rate.” 

The tremendous gains under the ACA largely persist, including historic progress in closing racial/ethnic disparities in coverage. However, lagging progress among Latinos, persistent variation across regions, and the fact that many Californians are still uninsured point to the need for further work to ensure all Californians can get access to health insurance.