Since the beginning of California’s open enrollment last fall, an estimated 3.4 million Californians that were previously uninsured have gained health coverage, according to a new study by the Kaiser Family Foundation.
The longitudinal study, which examined the effects of the Affordable Care Act on health-care coverage in the state, found that of the residents who were uninsured prior to open enrollment, 58 percent signed up for insurance and 42 percent remained without coverage. A full quarter of those newly insured got coverage through Medi-Cal, California’s Medicaid program, which was significantly expanded under the Affordable Care Act. Another 9 percent used Covered California, the state’s insurance exchange marketplace, and 12 percent gained coverage through an employer.
California was an early proponent of health-care overhaul and has been proactive in its implementation. It is one of about half the states in the country that decided to expand Medicaid, and one of only 17 states, including the District of Columbia, to implement their own insurance marketplace.
But despite the millions of Californians who are now covered, millions more are still without insurance. According to Drew Altman, CEO and president of the foundation, reaching these uninsured demographics is not so easy a task. “Expanding coverage gets harder from here,” Altman wrote in a press release regarding the study.
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Among those who remain uninsured, despite the expansion of Medicaid, the roll-out of the Covered California website, and the state-certified Assisters who help people navigate the application process, almost 40 percent have never had health coverage, and an additional 45 percent have been uninsured for at least two years.
Immigration status was also found to be a major obstacle to enrollment. Aside from the nearly 30 percent of the uninsured who are barred from coverage because they are in the United States illegally, many other immigrants have decided not to sign up out of fear that enrolling will attract attention to an undocumented relative.
As Altman wrote in a column for the Wall Street Journal, the government has in the past tried to mitigate this worry. In a town hall meeting, President Obama said that information gathered during insurance enrollment would not be used as the basis for deportation or investigation of immigration status. This policy is echoed in a Department of Homeland Security internal memo, written last October.
According to the Public Policy Institute of California, 10 million immigrants live in California—more than in any other U.S. state—some 27 percent of whom are undocumented.
In addition to those who decided not to enroll this past year, many people have tried to apply for Medi-Cal coverage but haven’t yet received their coverage. Due to a massive backlog in Medi-Cal application processing, some 900,000 Californians, many of whom are eligible, are still waiting for final notifications on their coverage.
The next open enrollment period in California will start this fall.