High cost is the main reason those eligible for health insurance in California didn’t enroll in 2014. Image: Getty
Two-thirds of Californians who didn’t have health insurance in 2014 were eligible for coverage, but many did not enroll because they said it was too costly, according to a new study by the UCLA Center for Health Policy Research and the UC Berkeley Center for Labor Research and Education.
Researchers found that the other one-third of uninsured Californians were ineligible for coverage under the Affordable Care Act due to their immigration status. Using data from the California Health Interview Survey, or CHIS, the study reports that California residents without health insurance fall into four groups:
• Undocumented residents: 32 percent. Residents who do not qualify for health coverage under the Affordable Care Act, being predominantly low-income and Latino and having limited English-language proficiency.
• Those eligible for Medi-Cal: 28 percent. Adult citizens and lawfully present immigrants with incomes at or below 138 percent of the federal poverty level and children at 266 percent of the poverty level.
• Those eligible to buy coverage on the state health exchange, Covered California, with a federal subsidy to help offset costs: 31 percent. Citizens and lawfully present immigrants with incomes from 139 percent to 400 percent of the poverty level.
• Those eligible to buy health coverage on Covered California but not eligible for federal subsidy: 9 percent. Citizens and lawfully present immigrants with incomes above 400 percent of the poverty level, which disqualified them from federal subsidies.
Among reasons for not having insurance, the largest percentage of citizens and lawfully present immigrants (46 percent) said cost was the main reason.
“We’re a relatively high cost-of-living state,” says Miranda Dietz, a researcher at UC Berkeley and the lead author of the study. “It’s no wonder some Californians, who may be unaware they qualify for health subsidies and other programs, still find the cost of health insurance out of reach. For people who are already stretched paying their rent, filling the car to get to work and feeding the kids, figuring out how to come up with more money for healthcare on top of that is a lot to handle.”
California also has more than 1-million undocumented, uninsured residents who do not benefit from the Affordable Care Act because of their immigration status. “Hundreds of thousands of men, women and children, not to mention the workers who power California’s economy, are one health emergency away from potential financial ruin because they lack insurance,” says Nadereh Pourat, PhD, director of research for the UCLA Center for Health Policy Research. “From an economic perspective, it’s bad business to rely on workers and then not offer them equal-health protection. And from a humanitarian perspective, it’s just wrong.”
“Affordability and Eligibility Barriers Remain for California’s Uninsured,” UCLA Center for Health Policy Research and the UC Berkeley Center for Labor Research and Education, March 31, 2016