Blog & News
California Achieves Lowest Uninsured Rate Ever in 2022 (Cross-Post)
November 13, 2023:The following blog is cross-posted from The California Health Care Foundation.
Author: Lacey Hartman, Senior Research Fellow, SHADAC
Maintaining Gains Hinges on Transitioning People Who Lose Medi-Cal to Other Coverage in Coming Months
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.
Publication
Did Disparities in Access Worsen During the Pandemic? (CHCF Brief)
The following content is cross-posted from California Health Care Foundation
Author: Lacey Hartman, SHADAC
Previous research has shown that Medi-Cal enrollees fare worse in accessing health care than Californians with employer coverage. A key question is whether and how access to care shifted during the pandemic for the two groups. For example, did existing differences in access worsen or improve? Have new access challenges emerged for those with Medi-Cal, compared to those with employer coverage?
To answer these questions, authors of a new CHCF brief compared data from the 2017–18 and 2020–21 California Health Interview Survey (CHIS). Separate analyses were done for adults and children.
Key findings include:
- Data show that the pandemic did not widen differences in access to care for people with Medi-Cal coverage compared to those with employer coverage. This held true for both adults and children.
- Rather, among adults, there was some narrowing of differences on select measures. However, this is not a positive development, as it appears to have been caused by worsening access to care for adults with employer-sponsored insurance coverage during the pandemic rather than improvements for adults with Medi-Cal.
Authors note that a key issue going forward is how the end of the federal Medicaid continuous coverage requirement will impact access to care among Californians.