CHA News Article

Report Examines Affordability and Eligibility Barriers for California’s Uninsured

A new report titled Affordability and Eligibility Barriers Remain for California’s Uninsured explores the characteristics of the uninsured in California. Published by the UCLA Center for Health Policy Research and the UC Berkeley Center for Labor Research and Education, the report includes the reasons for remaining uninsured among those who are undocumented and ineligible for coverage under the Affordable Care Act due to their immigration status, as well as those who are eligible for coverage but did not enroll. The findings show that major barriers to coverage are costs and ineligibility due to documentation status. The report uses data from the 2014 California Health Interview Survey (CHIS).

Key report findings include:

  • Enrollment in Medi-Cal grew by 3.9 million individuals from mid-2013 to November 2015. As of June 2015, 1.3 million individuals were enrolled in Covered California. On average across 2014, 5 million Californians were uninsured according to the CHIS.
  • In 2014, most of the uninsured were eligible for coverage under either Medi-Cal (28 percent) or Covered California (40 percent).
  • The uninsured undocumented population was overwhelmingly Latino (91 percent). Latinos were a smaller share (53 percent) of uninsured citizens and lawfully present immigrants.
  • A majority of uninsured adults were working at least 30 hours per week — 52 percent of the undocumented and 53 percent of citizens and lawfully present immigrants. The rest were either part-time employed, unemployed or not in the workforce.
  • The majority of the undocumented who were excluded from the ACA coverage options reported ineligibility, especially due to immigration and citizenship, as the most common reason for being uninsured. Almost one in three undocumented residents reported affordability as a barrier, which the report notes may reflect the high cost of insurance given the lack of free or low-cost options for comprehensive insurance.
  • The affordability concerns expressed by citizens and lawfully present immigrants who are eligible for Medi-Cal may indicate lack of knowledge that the program is free (or low-cost for some children at higher incomes).

The report outlined three avenues for addressing affordability: increasing the awareness of availability of financial assistance, implementing policies to expand affordability, and extending coverage options for the undocumented could help close these remaining gaps in coverage.