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The CHCF Blog

The Coverage Connection

Marian Mulkey, Mulkey Consulting
Marian Mulkey
Marian Mulkey

For people under age 65, among those with income of less than 138% of Federal Poverty Guidelines (about $24,000 annually for a family of four), 23% are uninsured at any given time.

Among the highest earning families (more than 400% of FPG, or about $94,000 annually), only 6% are uninsured at any point in time.


People Uninsured at a Point in Time by % of FPG, 2013

Medical insurance provides financial protection from health care expenses, but it is also a pathway into the health care system. Lower-income people — largely because they are less likely to have coverage — are also less likely to have a regular source of medical care. Lacking a stable connection to care, they often miss out on essential preventive services.

People with a Usual Source of Care by % of FPG, 2013

Under the Affordable Care Act (ACA), California expanded its Medi-Cal program for people up to 138% of FPG, adopted market reforms, and established a state marketplace, Covered California. These changes should make it easier for lower-income people to find and afford coverage in 2014 and beyond. The expectation of lawmakers and policy experts is that increased enrollment in coverage will translate into expanded access to care.

Come the end of 2014, changes in these two measures — people uninsured at any time and people with a usual source of care — will reveal a lot about how Californians are doing as a result of the ACA.

About Marian

When Marian Mulkey ended her 17-year tenure at CHCF, she was its chief learning officer, responsible for advancing organizational learning and evaluation at all levels of the foundation and reporting to the president/CEO.

Previously, Marian led CHCF's work to analyze the Affordable Care Act and inform stakeholders on ways to implement the law that will improve and expand coverage, and before that she led work to monitor California's health insurance markets. Prior to joining CHCF, she worked as an independent health policy consultant and at Kaiser Foundation Health Plan.

Marian received a bachelor's degree in biology and economics from Reed College in Portland, Oregon, and master's degrees in public policy and public health from the University of California, Berkeley.