CHA News Article

Report Highlights California’s Previously Uninsured After ACA’s Second Open Enrollment Period
Findings reveal affordability and access issues remain even for those who gained coverage

The Kaiser Family Foundation (KFF) has released its California Longitudinal Panel Survey, a series of surveys tracking the experiences and views of a randomly selected sample of Californians who were uninsured prior to the major coverage expansions under the Affordable Care Act (ACA). The most recent survey, the third in the series, followed up with the group after the second open enrollment period to find out whether more have gained coverage, lost coverage, or remained uninsured; what barriers to coverage remain; how those who now have insurance view their coverage; and to assess the impacts that gaining health insurance may have had on financial security and access to care. A fourth survey in the series will keep tracking these individuals as the expansions and changes in California continue under the ACA. The surveys are designed and analyzed by researchers at KFF, and the full report is available on the KFF website

Key report findings reveal:

  • 68 percent of Californians who were uninsured prior to the first open enrollment period now report that they have health insurance. This share is up from 58 percent after the first open enrollment period in the spring of 2014. 
  • The largest share of California’s previously uninsured, 34 percent, say they have coverage through Medi-Cal, up from 25 percent after the first open enrollment period.
  • 32 percent report being currently uninsured, referred to in this report as the “remaining uninsured.”
  • Those who have gained insurance are much less likely than they were in the baseline survey to report problems paying for medical bills in the past 12 months (23 percent now, compared to 45 percent in 2013) or difficulty affording health care (49 percent now, compared to 86 percent in 2013). 
  • Those who have remained uninsured report having difficulty affording care, paying for medical bills, meeting their health needs or having a usual source of care at rates similar to those of the baseline survey.
  • While most of California’s recently insured (76 percent) report positive experiences with their current plan and say they are satisfied with their plan’s choice of primary care doctors (79 percent), hospitals (75 percent), and specialists (67 percent), some say they have experienced problems accessing care in the past year. 
  • Many of California’s remaining uninsured have had little interaction with the health insurance system in the years prior to the ACA implementation. Four in 10 (41 percent) of the remaining uninsured are undocumented immigrants who are not eligible for Medi-Cal or assistance through Covered California, and 43 percent are likely eligible for coverage but had been without coverage for two years or more or never had insurance as of the baseline survey.