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New data from the California Health Interview Survey (CHIS) show that 94.6% of Californians under 65 years old had health insurance in 2025, a statistically significant increase from 93.8% in 2024. The gain represents a return to the 2023 insured rate, which was California’s highest on record.
It was a good year for coverage. It may also be the high-water mark.
The 2025 numbers reflect more than a decade of coverage expansion. All Californians with low incomes were eligible for full-scope Medi-Cal, regardless of immigration status. The Medi-Cal unwinding was over, and enhanced federal premium subsidies were still available through Covered California.
Then the policy ground shifted. In July 2025, Congress passed deep cuts to Medicaid through H.R. 1 and did not renew the enhanced subsidies. Facing a budget gap, the state decided to freeze new enrollment in full-scope Medi-Cal for undocumented adults. None of these changes took effect in 2025.
That makes 2025 an inflection point between expansion and contraction, and a useful marker for what comes next.
Private Coverage Drove the Gain
Most of the increase came from Californians buying insurance on their own. That share rose from 5.3% to 6.0% (see table below). This includes Covered California plans, and enhanced premium subsidies likely helped.
Medi-Cal enrollment held steady overall but shifted within groups. For example, it rose in rural areas.
Enrollment in employer coverage held steady at 58%.
Health Insurance Coverage Rates Among Californians, Ages 0–64
| Coverage Type | 2024 | 2025 |
|---|---|---|
| Employer-Sponsored Insurance | 58.0% | 58.1% |
| Private Purchase (includes Covered California) | 5.3% | 6.0%* |
| Medi-Cal | 28.2% | 27.9% |
| Medicare | 1.2% | 1.3% |
| Other Public | 1.1% | 1.3% |
| Total Percentage Insured | 93.8% | 94.6%* |
Note: The Medicare category includes anyone with Medicare coverage, including people who also have Medi-Cal.
Source: California Health Interview Survey
Continuity Improved for Black Californians
The figures in the table reflect coverage at a single point in time. The share of Californians insured for the entire past year also rose in 2025, to 91.4% from 90.3% in 2024. Black Californians saw the sharpest gain, with year-round coverage jumping from 89.5% to 95.2%. Latino/x Californians rose from 86% to 87.6%.
Among adults ages 18 to 64, the share reporting a preventive care visit climbed from 66% to 69.5%. For adults with incomes below 138% of the federal poverty level, the increase was striking, from 62.4% to 69%.
Using CHIS Data
AskCHIS is a free online health query system that allows users to quickly search for health statistics by county, region, and state.
Drawing on the responses of more than 20,000 state residents interviewed each year by the California Health Interview Survey, AskCHIS provides reliable data on a wide range of topics across sociodemographic factors. AskCHIS includes data beginning in 2001, so users can look at patterns and trends across more than two decades.
CHIS, the nation’s largest population-based state health survey, is operated with CHCF support by the UCLA Center for Health Policy Research.
The share of adults reporting a usual source of care rose from 83.8% to 86.1%. Again, the lowest-income group gained the most, from 76% to 81.1%. Other groups that saw gains included Medi-Cal enrollees and Latino/x Californians.
Other measures didn’t improve. For example, timely appointments held flat at about 75%. The share of Californians who delayed or went without needed care rose from 16.3% to 17.3%.
Emerging Trends for 2026
These are just a few highlights on coverage and access to care from the latest CHIS release. Data for 2026 won’t be available until this time next year, but other sources already show coverage shifting.
For example, Medi-Cal enrollment fell by roughly 800,000 in the first six months of 2026, according to the latest available data. In the 12-month period ending in June 2026, 1.14 million Californians left the program. Since then, declines have accelerated to an alarming degree.
These losses are occurring broadly across aid, eligibility, and demographic categories. The steepest drop was among undocumented immigrants, whose enrollment in full-scope Medi-Cal fell 19% through June 2026, compared with 5.5% for Medi-Cal overall.
In July 2026, I wrote about troubling Medi-Cal enrollment drops through March 2026, including among undocumented immigrants. State policy changes are surely playing a role, but they don’t explain all the declines. Meanwhile, Covered California enrollment also dropped in 2026. The end of enhanced subsidies likely contributed to that trend.
Did people who lost coverage find another source, or did they go uninsured? Did they change where they get care or stop seeking it? The 2026 CHIS data will help answer these questions.
Just Getting Started
The largest effects of H.R. 1 are still ahead. Next year, many lawfully present immigrants will lose eligibility for Covered California subsidies. More than 1 million Californians are projected to lose Medi-Cal due to H.R. 1 work requirements taking effect in 2027. In the coming months, CHCF will release a framework to track changes in coverage, care, and affordability under H.R. 1. Stay tuned.
The nearly universal coverage California achieved in 2025 shows what is possible. It is also a benchmark to measure against, and one worth working to reclaim.
