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California’s Previously Uninsured After The ACA’s Second Open Enrollment Period

Introduction
  1. Kaiser Family Foundation analysis of 2013 ASEC Supplement to the Current Population Survey.

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  2. Kaiser Family Foundation, California’s Uninsured On The Eve Of ACA Open Enrollment, September 2013, http://kff.org/health-reform/report/californias-uninsured-on-the-eve-of-aca-open-enrollment/.

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  3. Kaiser Family Foundation, Where Are California’s Uninsured Now? Wave 2 Of The Kaiser Family Foundation California Longitudinal Panel Survey, July 2014, http://kff.org/health-reform/report/where-are-californias-uninsured-now-wave-2-of-the-kaiser-family-foundation-california-longitudinal-panel-survey/.

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  4. DHHS Centers for Medicare & Medicaid Services, “Medicaid & CHIP: May 2014 Monthly Applications, Eligibility Determinations and Enrollment Report,” July 11, 2014 http://medicaid.gov/AffordableCareAct/Medicaid-Moving-Forward-2014/Downloads/May-2014-Enrollment-Report.pdf. DHHS Office of the Assistant Secretary for Planning and Evaluation Issue Brief, “Health Insurance Marketplace: Summary Enrollment Report For The Initial Annual Open Enrollment Period,” May 1, 2014 http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Apr2014/ib_2014Apr_enrollment.pdf. The California Department of Health Care Services estimates 1.9 million people have enrolled in Medi-Cal since open enrollment started, http://news.coveredca.com/2014/04/covered-californias-historic-first-open.html.

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  5. Covered California 2015 End of Open Enrollment Report, http://www.coveredca.com/PDFs/end-of-open-enrollment-report.pdf

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Section 1: Coverage Gains Among The Previously Uninsured
  1. For the purposes of this report, the ‘eligible uninsured’ are California residents who said they had been uninsured for at least two months in the baseline survey and would be eligible for participation in the ACA coverage expansion based on their self-reported status as a citizen, permanent resident, or lawfully present immigrant. See the “About The Terms In This Report” Section for more details.

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  2. The total share with non-group coverage, including those in Covered California, remained stable between the spring 2014 survey and the spring 2015 survey. In addition to an actual enrollment increase, there may be other reasons why more report in Wave 3 that they have Covered California specifically. For example, more people may be familiar with “Covered California” and thus better able to self-report their source of coverage. In addition, the follow-up question for those who report purchasing coverage on their own was modified for Wave 3. See topline for more information.

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  3. For the purposes of this report, undocumented immigrants are defined as those that reported in the baseline survey that a) they were not born in the United States, and b) they came to this country without a green card, and c) they have not received a green card or become permanent residents since arriving. See the “About The Terms In This Report” Section for more details.

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  4. Regression results are available on request.

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  5. The analysis of the dynamics of health insurance excludes those who were unable to be contacted in spring 2014 and focuses exclusively on those who completed the survey after both open enrollment periods (roughly 8 in 10 of those who were interviewed in spring 2015). Including all the previously uninsured who participated in the most recent survey after the second open enrollment period, the results are similar.

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  6. Examining only those who completed both the spring 2014 and spring 2015 surveys results in a slight discrepancy in the shares recently insured and remaining uninsured – 69% and 31% instead of 68% and 32% when the analysis considers everyone who completed the survey in spring 2015 after the second open enrollment period. This is due to the fact that some previously uninsured adults who completed the survey this year did not complete the survey after the 2014 open enrollment period and therefore we are unable to determine their insurance status at that time and they are excluded from the analysis on the dynamics of health insurance.

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Section 4: The Remaining Uninsured
  1. See endnote 8 or the “About The Terms In This Report” Section for more details.

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  2. US Census Bureau, California State & County QuickFacts http://quickfacts.census.gov/qfd/states/06000.html

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Methodology
  1. Those who had been uninsured for less than two months were excluded from the survey since they may be experiencing a short period of uninsurance (i.e. someone who is between jobs), and the goal of the survey was to capture the experiences and views of those who have been without insurance for a longer period of time and are poised to experience the new coverage provisions of the ACA.

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  2. M. Brodie, “Sensitization Effects in a Study of the Impact of a Nationally Broadcast Special on Health Care Reform,” in Doctoral Thesis: Political Institutions, Participation, and Media Evaluations— Influences on Health Care Policy (Boston, Mass.: Harvard University, 1995).

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.