ACA Reduces Racial/Ethnic Disparities in Health Coverage Rates in California

Findings from the 2017 California Health Interview Survey

Tara Becker, UCLA Center for Health Policy Research


Under the Affordable Care Act (ACA) millions of Californians have gained health coverage. With new data from the 2017 California Health Interview Survey (CHIS), this issue brief examines trends in coverage rates among nonelderly (under age 65) Californians from 2013, the year prior to full ACA implementation, through 2017.

Of particular note is how the ACA has narrowed disparities in coverage rates between different racial and ethnic groups. In 2017 there continued to be no statistically significant difference in the nonelderly uninsured rate between white, African American, and Asian/Pacific Islander Californians — a major shift since 2013. However, Latinos continued to experience a higher uninsured rate than other groups.

Other key findings include:

  • The 2017 uninsured rate in California, at 8.5%, remained stable — and nearly 50% lower than it was in 2013, before the ACA was fully implemented.
  • In 2017 enrollment in Medi-Cal declined compared to 2016, but this was offset by an increase in private coverage.
  • Coverage gains under the ACA were maintained in most regions of the state, but variation across regions continued.
  • Coverage gains under the ACA were maintained for low- and moderate-income Californians.

While federal uncertainty over the future of the ACA permeated throughout 2017, the timing of both Covered California open enrollment and the fielding of the CHIS survey mean that 2018 CHIS data may better capture any effects these events had on coverage and enrollment.

Below are data visualizations for a few key findings. See the full issue brief,  ACA Reduces Racial/Ethnic Disparities in Health Coverage (PDF), available for download under Related Materials, for the complete data and analysis.

A note on methodology: In keeping with previous CHIS analyses, all Californians reporting Medi-Cal coverage are considered covered by Medi-Cal. This includes undocumented adults who are not eligible for full-scope Medi-Cal but may have used restricted-scope Medi-Cal. Restricted-scope Medi-Cal is not comprehensive coverage, covering only emergency and pregnancy-related services. When asked by survey researchers about health coverage, some undocumented immigrants who have used restricted-scope Medi-Cal may respond that they have Medi-Cal coverage. If undocumented immigrants reporting Medi-Cal were considered uninsured, the number of Californians who are uninsured would be higher, as would the number of uninsured among some demographic groups, such as Latinos. (Download the full issue brief to read more about the methodology.)