Report: ACA Challenges in Calif. Could Be Lessons for Other States
A new Kaiser Family Foundation survey highlights the challenges that California faced when beginning Affordable Care Act implementation and how the state could offer lessons for others implementing the law, Kaiser Health News reports.
The report surveyed 2,500 California adults in October 2013, before the beginning of open enrollment.
Details of Findings
The report found that many uninsured residents were disconnected from the health care system. Specifically, it found that:
- 50% of uninsured California residents had not had access to health insurance for five years or longer;
- 22% of uninsured residents never had access to health coverage; and
- 25% of uninsured residents said they had a regular physician.
According to KHN, some respondents had attempted to purchase coverage in the past but were unable to do so because of high cost or eligibility restrictions.
The survey also found that uninsured California residents largely were unaware of the ACA's benefits, including their potential eligibility for federal subsidies.
About 38% of uninsured California residents said they had difficulty determining the differences in costs, services and provider networks offered on specific health plans.
Meanwhile, about the same percentage of low- and middle-income residents had difficulty paying their premiums, the survey found (Hernandez, Kaiser Health News, 2/20).
In addition, the survey found that lack of Internet access and bank accounts could hinder enrollment efforts for uninsured individuals in California. For example:
- 27% of low-income adults lacked Internet access; and
- 13% of adults with moderate incomes lacked Internet access (KFF report, 2/19).
Forty percent of consumers eligible for Medi-Cal also did not have access to a bank account, according to KHN.
Mitch Katz, director of the Los Angeles County Department of Health Services, said the findings show that health officials should take into account other issues consumers are facing, such as housing costs and mental health problems. "Insurance, which is incredibly valuable, is not health care," Katz said, adding, "Insurance may or may not enable you to gain health care."
Kaiser Family Foundation President and CEO Drew Altman said the survey indicates that reaching the uninsured population will require more targeted outreach. He said, "This really is not just Travelocity or Kayak or Amazon.com, it's a vastly more complicated, hands-on, community-based outreach challenge" (Kaiser Health News, 2/20).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.