Health Insurance Coverage in California in 2013 and 2014, After Implementation of the Affordable Care Act

This paper presents data on health insurance coverage in California in 2013 and 2014, based on the March 2014 and 2015 Supplements to the Current Population Survey (CPS). It reflects research done by the Employee Benefit Research Institute (EBRI) on health insurance coverage trends in California, recently published in the California Health Care Foundation’s California Health Care Almanac, and supported by the California Health Care Foundation, based in Oakland, CA. Because 2014 is the first year for which many of the key, coverage-expansion provisions of the Affordable Care Act of 2010 (ACA) were effective, the 2013-2014 data provide some initial findings on the ACA’s first-year impact. From 2013 to 2014, health insurance coverage expanded among individuals under age 65 in California, and the uninsured rate fell. In 2013, 5.5 million California individuals were uninsured, and this figure fell to 3.8 million individuals in 2014. In percentage terms, California’s uninsured rate fell from 16 percent in 2013 to 11 percent in 2014 (a 31 percent reduction). The 2013-2014 reductions in the uninsured rate were primarily due to expanded individual health insurance and Medicaid coverage, as there was very little increase in employment-based coverage. Younger adults and lower-income California residents had the highest uninsured rates in 2013, and experienced the greatest rate reductions, the lowest percentage-point reduction of any age group in 2014. With respect to firm size, workers in small firms had the highest uninsured rate in 2013, but workers in firms with more than 50 employees (particularly those in the 50-99 employee group) experienced the greatest reductions in uninsured rates. Among race/ethnic groups, Latinos had the highest uninsured rate for 2013 (22.8 percent) and saw that rate fall to 15.8 percent in 2014, a significant 31 percent year-over-year decline, but still the highest 2014 uninsured rate of the identified race/ethnic groups. Asians experienced the largest year-over-year uninsured rate reduction, moving from an uninsured rate of 12.1 percent to 7.7 percent (a 36 percent reduction)