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Two Years After ACA Implementation: Coverage Gains Continued and Fewer Affordability Concerns Cited

Amy Adams, Senior Program Officer, Improving Access

The uninsured rate in California reached historic lows two years after the implementation of the Affordable Care Act (ACA), according to new data from the 2015 California Health Interview Survey, now available on ACA 411. Consumers also reported fewer affordability problems.

(Click on the images to explore the data.) 

Specific findings include:

  • The uninsured rate dropped by six percentage points, from 15.5% in 2013 to 9.5% in 2015, a historic low in California. The enrollment surge in Medi-Cal was a driving force behind this drop. The percentage of Californians covered by the program grew from 20.1% in 2013 to 30.9% in 2015.

  • All demographic groups experienced coverage gains. Uninsured rates declined significantly across most racial/ethnic and income groups. Among income groups, the biggest coverage gains were experienced by those earning less than 138% of the federal poverty level (FPL), the income threshold to qualify for Medi-Cal. This group experienced a nearly 10 percentage point drop in their uninsured rate, from 22.6% in 2013 to 12.8% in 2015. The uninsured rates among whites, African Americans, and Asians were all roughly cut in half. While the uninsured rate among Latinos also dropped, from 21.4% in 2013 to 15% in 2015, this rate is more than twice that of Asians and African Americans, and three times that of whites.

    Rate of Uninsured Californians, by Race/Ethnicity, 2013-2015

    Rate of Uninsured Californians, by Income Level, 2013-2015

  • Californians were less likely to say that cost was the main reason for being uninsured — this figure dropped dramatically between 2013 and 2015, from 52.6% to 28.8%. A decline was seen across all income levels. This finding suggests that expanded access to Medi-Cal and subsidized coverage through Covered California have had an important impact on many Californians' ability to afford health insurance.

    Californians Citing "Can't Afford / Too Expensive" as Reason for Lack of Insurance, 2013-2015

  • Cost was also less likely to be the reason people went without needed health care. While cost remains a barrier to health care access, some important progress was made in 2015: Among those who reported foregoing necessary care, the share who reported that they did so because of cost declined from 55.4% to 49.1% between 2013 and 2015.

    Californians Citing "Cost" as Reason for Forgone Care, 2013-2015

These new data show that the early gains in coverage and affordability reported a year ago have continued to grow over time. Future blog posts will explore the impacts of the ACA on other important issues, such as access to care and private insurance.

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