3.4M Previously Uninsured in Calif. Gained Coverage After ACA

Nearly 60% of Californians who were uninsured before Covered California's first open enrollment period have since gained coverage, according to a new survey by the Kaiser Family Foundation, the Los Angeles Times' "L.A. Now" reports.

Covered California is the state's health insurance exchange under the Affordable Care Act (Karlamangla, "L.A. Now," Los Angeles Times, 7/29).

Details of Survey

For the survey, researchers interviewed more than 2,000 randomly selected, uninsured California residents between the ages of 19 and 64 in 2013 before open enrollment began.

Researchers then re-interviewed 1,219 of those individuals after the open enrollment period ended (KFF survey, 7/30).

Findings

The survey found that about 3.4 million previously uninsured Californians were enrolled in health coverage after the first open enrollment period.

Of all survey respondents:

• 25% gained insurance through Medi-Cal, California's Medicaid program (Abelson, New York Times, 7/30);
• 14% enrolled in private coverage, including 9% who purchased plans through the exchange;
• 12% gained employer-sponsored coverage; and
• 5% purchased an unsubsidized health plan outside of the exchange.

The survey also found that Latino enrollment in California was higher than expected, with 61% of eligible Latinos gaining insurance. In addition, there was a 58% increase in coverage among those formerly uninsured between the ages of 19 and 34 (O'Neill, "KPCC News," KPCC, 7/29).

However, 42% of California residents who were uninsured before the open enrollment period remained without coverage afterward, including:

• 24% who qualified for subsidies through the exchange; and
• 39% who qualified for Medi-Cal.

About 30% of those in the state who remained uninsured are undocumented immigrants, according to the survey.

Of those who remained uninsured, 80% had not had coverage within two or more years, including 37% who said they have never had health insurance.

Seventy percent of uninsured residents said they felt they needed health coverage ("L.A. Now," Los Angeles Times, 7/29).

Barriers to Coverage

Survey respondents reported several barriers to enrolling in coverage, including:

• Concerns about bringing undue attention to the immigration status of family members;
• Difficulty comparing the costs and features of plans through Covered California's website;
• Difficulty determining how to sign up for Medi-Cal and subsidies; and
• High costs (New York Times, 7/30).

Importance of Enrollment Assistance

Researchers found that outreach campaigns and personal enrollment assistance were key in reducing the number of uninsured individuals in California.

About 70% of uninsured California residents who were contacted about enrolling in coverage signed up for a health plan, compared with about 50% who were not contacted that signed up.

In addition, about 60% of individuals who enrolled in Medi-Cal or Covered California during the open enrollment period said someone helped them with the process (Gorman, Kaiser Health News, 7/30);

Challenges to Enrolling Remaining Uninsured

KFF President and CEO Drew Altman said reaching the remaining uninsured population California presents new challenges, adding that "expanding coverage gets harder from here."

Mollyann Brodie, senior vice president at KFF, said there is a disconnect between what individuals expect health plans will cost and what available plans actually cost.

She said outreach during the next open enrollment period must be "even more targeted and more intense to convince this group of Californians that they can actually get health insurance" ("L.A. Now," Los Angeles Times, 7/29).