California’s Previously Uninsured After The ACA’s Second Open Enrollment Period
After two open enrollment cycles under the ACA, 68 percent of California’s previously uninsured report having health insurance, up from the share (58 percent) who said they had coverage after the first open enrollment period. The largest share reports having coverage through Medi-Cal (34 percent) and 12 percent say they have coverage through Covered California, similar to the 14 percent who say they have coverage through an employer. There have been considerable gains in access and affordability among those who have gained insurance compared to what they said in the baseline survey, while those who remain uninsured report difficulty affording care and that their health needs are being met at similar rates as they did nearly two years ago. Most of California’s previously uninsured who reported having coverage after the first open enrollment period continued to report having coverage, but some have since become uninsured, while some others who reported being uninsured after the first open enrollment period, now report having coverage. These dynamics indicate the potential challenges of getting and keeping coverage for the previously uninsured as well as potential opportunities for new enrollment gains among those who have potentially missed chances to enroll in the past. Future gains in coverage may be moderate, however, as the third (32 percent) of California’s previously uninsured who remain without coverage consists largely of harder to reach groups; those who are undocumented immigrants and therefore ineligible for coverage through the ACA and those who reported as of the baseline survey that they had been without coverage for two or more years or had never had health insurance. A fourth wave of the Kaiser Family Foundation California Longitudinal Panel Survey will continue to track this same, representative group of previously uninsured Californians to see how they are faring several years into the ACA’s implementation.