The share of Californians under age 65 (“nonelderly”) without health insurance reached a historic low in 2022. Based on the most recent California Health Interview Survey (CHIS), the percentage of nonelderly Californians without health insurance dropped to 6.2% in 2022, a statistically significant decline from 2021 (7.4%). The rate of nonelderly people without coverage for a year or more also reached a historic low in 2022. Commonly called the “long-term uninsured,” their rate dropped from 5.7% in 2021 to 4.5% in 2022, another statistically significant decline.
Disparities in Coverage by Race and Ethnicity Narrow, but Inequities Persist
California’s Latino/x population experienced the largest improvement in coverage between 2021 and 2022; the share who reported being uninsured at the time of the survey dropped from 11.4% in 2021 to 9.1% in 2022, a change that was statistically significant. The Latino/x rate in 2022 also represents a historic low for this group.
The uninsured rate for White Californians also declined by a statistically significant but smaller amount, from 3.6% to 2.8%. There were no other statistically significant changes between 2021 and 2022 by race/ethnicity.
Although there have been important gains in narrowing disparities in coverage by race and ethnicity in the state, Latino/x Californians continue to be uninsured at rates triple that of their White counterparts. Black and Asian Californians are uninsured at twice the rate of White Californians. Due to small sample sizes for American Indians and Native Hawaiian / Pacific Islanders in the survey, it was not possible to produce reliable uninsured rates for those groups.
Discussion
The fact that fewer nonelderly Californians were without coverage in 2022 than ever before is clearly good news. However, in 2023, the federal continuous coverage requirement for Medicaid came to an end. It’s estimated that as many as 2–3 million Californians may leave Medi-Cal as a result. How many Californians ultimately lose their Medi-Cal coverage and whether those leaving the program get connected to other coverage will have a huge impact on the state’s uninsured rate going forward.
These issues — as well as other challenges, such as inflation — may make holding onto California’s coverage gains difficult in the coming years. It will be vital to continue monitoring data from 2023 and future years to fully understand the impact of the pandemic — and the end of associated coverage protections, as well as other policy changes — on California’s health coverage landscape.
Authors & Contributors
Lacey Hartman
Lacey Hartman is a senior research fellow at the State Health Access Data Assistance Center (SHADAC), where she leads a range of projects aimed at helping states use data to inform policy. Lacey previously worked as the research and policy director at Portico Healthnet and as a senior research economist in the Health Economics Program at the Minnesota Department of Health. She holds a bachelor’s in women’s studies and political science from Macalester College in St. Paul and a master’s degree in public policy from the University of Minnesota.
