CHA News Article

Survey: 3.4 Million Uninsured Adult Californians Obtained Coverage Since First ACA Open Enrollment

The Kaiser Family Foundation (KFF) has released the second in a series of surveys tracking the views and experiences of a group of Californians who were uninsured in the summer of 2013, prior to implementation of the Affordable Care Act’s (ACA) insurance market reforms and coverage expansions through Covered California and Medi-Cal. The longitudinal panel survey followed a randomly selected panel of uninsured Californians and found that 58 percent report getting health insurance since last summer. According to the report, that amounts to approximately 3.4 million previously uninsured adult Californians gaining coverage. The largest share of previously uninsured Californians gained coverage through the state’s Medicaid Program, Medi-Cal (25 percent), followed by those gaining coverage through an employer (12 percent) or Covered California (9 percent). Another 5 percent say they obtained other individual market coverage. KFF reports that some enrollment in these types of coverage may have been motivated by the ACA’s requirement to purchase insurance and some may be the result of normal movement within the marketplace.

Key findings from the survey include:

California’s newly insured

  • A majority of the newly insured say their plan is a good value for the amount they pay (73 percent) and report feeling well protected by their plan (64 percent). More newly insured report that gaining coverage has made them feel more financially secure than less (37 percent vs. 16 percent), but nearly half (46 percent) of those newly insured in plans other than through Medi-Cal say that paying for coverage is difficult.
  • Getting coverage went smoothly for many newly insured.  The majority said it was easy to find the information they needed about enrolling (80 percent) and to sign up for coverage (76 percent). 60 percent of those with coverage through Medi-Cal or Covered California say they had someone help them enroll.
  • Among the newly insured, 43 percent say they visited the website during the open enrollment period, and the majority of them found their visit at least somewhat helpful. And, for those who ultimately enrolled in a Covered California plan, 72 percent say they visited the website, including just over half who say they found it helpful (55 percent).
  • But some enrolling in Medi-Cal or Covered California report experiencing problems in confirming enrollment (29 percent and 42 percent, respectively) or determining if their income qualified them for Medi-Cal (19 percent) or financial assistance through Covered California (26 percent). Once enrolled, most newly insured report positive experiences with their plan so far (75 percent), and 43 percent say they have already visited a doctor or health provider.
  • The newly insured are split on whether they attribute their new coverage to the ACA or not – 45 percent say they got insurance because of the law, and 52 percent aren’t directly attributing their new coverage to the ACA and say it’s something they would have done anyway. Looking at the two types of coverage that are most directly related to coverage expansions under the ACA, 60 percent of the newly insured (or 34 percent of previously uninsured Californians overall) say they enrolled in Medi-Cal or through Covered California.
  • Most newly insured Hispanics say shopping was relatively easy. For those newly insured Hispanics who prefer to communicate in Spanish, 87 percent say it was easy to find information in Spanish, including 65 percent who said it was very easy.

California’s remaining uninsured

  • Many characteristics of the remaining uninsured indicate that they are a difficult-to-reach group with limited ties to health insurance. Nearly four in 10 (37 percent) say they have never had health insurance (compared to 20 percent who became insured), and an additional 45 percent say they have been uninsured for two or more years. Sixty-two percent are Hispanic, including 29 percent who are unable to take advantage of coverage expansions under the ACA due to their immigration status, and 70 percent who prefer to communicate in Spanish. In addition to those who are not eligible due to their immigration status, 39 percent have incomes that put them in the group likely eligible for Medi-Cal and another 24 percent are likely eligible for financial assistance through Covered California.
  • Roughly 7 in 10 (71 percent) of those who remain uninsured after the first open enrollment period say health insurance is something they need, but 34 percent say cost remains a barrier to getting coverage.
  • Just over one-third (36 percent) of those who remain uninsured say they tried to get coverage, but most say they did not enroll either due to the cost of coverage or difficulty completing the process.
  • Fifty-seven percent of those still uninsured think they will get coverage later this year, though most are unsure where they might get it.
  • Almost half of Hispanics who remain uninsured may not be eligible for coverage through Covered California or Medi-Cal under the ACA due to their immigration status, and 54 percent of remaining uninsured Hispanics are worried that enrolling in coverage would bring attention to their family’s immigration status. At the same time, Hispanics who remain uninsured largely feel that insurance is something they need (78 percent).

Additional waves of the panel survey over the next two years will continue to track this same group of individuals to capture their changing attitudes and experiences.