California Leads Nation in Reducing Uninsured: Highlights from New U.S. Census Report

September 15, 2016

California ranks number one among states in reducing the ranks of the medically uninsured according to a new report released on Tuesday by the U.S. Census Bureau. The report, “Health Insurance Coverage in the United States: 2015” features data from two of the Census Bureau’s annual surveys, the Current Population Survey Annual Social and the Economic Supplement (CPS ASEC) and the American Community Survey (ACS), and includes 2014 and 2013 data for comparison.

Although the report shows improvement across the country, California stands above all of the other states.

  • California had the greatest decrease in the uninsured rate between 2014 and 2015, 3.9 percentage points. The difference between 2013 and 2015 was (unsurprisingly) even greater, dropping by an additional 8.6 percentage points.
  • Nationally, the uninsured rate decreased by 1.3 percentage points between 2014 and 2015 across the country, bringing the number of uninsured from 33 million people down to 29 million.
  • Between 2014 and 2015, the greatest change in coverage was the rise in direct-purchase health insurance (coverage bought by individuals such as California’s health exchange, Covered California), which jumped from 14.6% to 16.3% – an increase of about 1.7 percentage points.
  • The uninsured rate decreased in 47 states (plus the District of Columbia) from 2014 to 2015; the only states that did not have a statistically significant change were North and South Dakota and Wyoming.
  • Although foreign-born noncitizens experienced a greater increase in coverage (4.8 percentage points) than did naturalized citizens (1.5 percentage points), noncitizens still had the lowest coverage rate at 73.6%.
  • In both 2014 and 2015, the uninsured rate was higher in states that did not expand Medicaid than in the states that did expand (see Figure 5 from the report below).

California’s success in getting more people into health coverage reflects its early and robust implementation of the federal Affordable Care Act (ACA).

Within months of passage of the ACA, California adopted state legislation establishing the first state-run ACA exchange, Covered California, and strategically invested federal exchange funds in getting the exchange ready for the first enrollment year in 2014. Covered California funded and worked with state and local organizations to conduct aggressive statewide marketing and outreach. Nearly 1.3 million Californians now have coverage through Covered California.

California also implemented the full expansion of Medi-Cal eligibility allowed under the ACA, taking advantage of higher federal matching funds for states expanding Medicaid. Medi-Cal enrollment has increased from 7.9 million in 2012-13 prior to ACA implementation to over 14 million Californians in 2016-17, and now covers more than one-third of Californians. Nationally, states that expanded Medicaid had the highest reductions in the number of uninsured as illustrated below.

US Census Bureau Uninsured Rate Report
Medicaid expansion states experienced the greatest decreases in uninsured rates.

Be sure to check out the full census report for more details!