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California Reached Health Coverage Milestone With 94% of People Insured in 2020, but Access to Care Remains a Challenge During the COVID-19 Pandemic

September 22, 2021

Policy Brief

Author: Sean Tan, MPP

Summary: Ninety-four percent of Californians were currently insured in 2020, a record high for the state since the California Health Interview Survey (CHIS) began surveying respondents about health care coverage in 2001. However, barriers to health care utilization and the COVID-19 pandemic presented challenges to achieving equitable access to care. 

Findings: About 11% of Black or African American Californians reported not having a usual place to go when sick or needing health advice in 2020, a 36% increase from 2019, and despite 88.2% being insured. Among Californians who had delayed care, more than half had forgone or had not eventually received the necessary medical care in 2020, and 1 in 5 who had delayed care cited COVID-19 concerns as a reason. While COVID-19 was a rising concern, the high cost of medical care or lack of insurance remained pivotal reasons for going without care in 2020. Using newly released 2019 and 2020 CHIS data, this brief examines changes in access to care in 2020 amid the COVID-19 pandemic. Indicators for access to care used in this brief are health care insurance status, usual place to go when sick or needing health advice, delays in medical care and forgoing care, and time of last dental visit. These indicators are typically used to assess access to care, while dental visits provide an expansive view of what is considered to be health care. This brief also looks into differences in health care access through various determinants of health.

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