Study: More Residents Likely To Be Eligible for Medi-Cal Expansion

The number of Californians believed to be eligible for the Medi-Cal expansion under the Affordable Care Act might have been underestimated, in part because a disproportionate number of middle-aged residents lost health coverage during the recession, according to a study by the UCLA Center for Health Policy, Payers & Providers reports (Shinkman, Payers & Providers, 8/1).

Background on Medi-Cal Expansion

Medi-Cal is California's Medicaid program.

Under the ACA, a state expansion of Medi-Cal will allow individuals with incomes up to 138% of the federal poverty level, or $15,415 annually, to gain coverage.

The federal government will fund the expansion for the first few years, according to the ACA (California Healthline, 7/25).

Study Details

The study was developed in collaboration with the California Endowment and the California Wellness Foundation.

Researchers used economic data from the 2007 and 2009 California Health Interview Survey and the California Employment Development Department to create a "recession index" that examined:

• Increases in unemployment; and
• Decreases in household income (UCLA release, 7/31).

Study Findings

Researchers found that the uninsured rate in the state increased by more than 10% from 2007 to 2009, totaling 7.1 million residents (Payers & Providers, 8/1).

The number of uninsured middle-aged residents increased by 2% over the two-year period, the most of any group. According to the study, 24.4% of such residents were uninsured in 2009 (Smith, Contra Costa Times, 7/31).

Implications

In a statement, Shana Alex Lavarreda -- lead author of the study and director of health insurance at the UCLA center -- said that the data "sugges[t] the ax is first to fall on the baby boom generation," but added that researchers are unsure whether that is because "mid-career workers are viewed as too expensive or because there is a deeper bias against older workers" (Walters, "Capitol Alert," Sacramento Bee, 7/31).

She added that forthcoming estimates for demand and use of health care services under the Medi-Cal expansion likely will be adjusted based on the study's findings.

Lavarreda said, "I think the forecasts have been very conservative regarding uptake and ramp-up under the ACA."

Anthony Wright -- executive director of Health Access California -- said, "The trends of those who have been uninsured [have] built this up."

However, he said that the ACA will help many individuals who lost coverage during the recession. "I don't think people realize how much more the rate of uninsured would have risen if we had done nothing" (Payers & Providers, 8/1).

For more coverage of the UCLA study, check out today's "Capitol Desk" post.