State’s Uninsured Reduced Up To 40%

With the U.S. Supreme Court scheduled to hear oral arguments next month in a case that could directly impact how easily individual Americans are able to obtain health insurance, a new study by researchers at UCLA demonstrate how unstable the insurance situation had been in California until last year.

According to the data by the UCLA Center for Health Policy Research, in 2013 more than one in eight Californians under the age of 65 had gone without health insurance for more than a year. Altogether, 6.6 million Californians had lacked insurance for all or part of the prior year, and 4.1 million had no coverage at all for at least an entire year.

However, the fortunes of those who were uninsured changed dramatically as the Affordable Care Act began enrolling Californians in large numbers last year in both Medi-Cal and commercial insurance. According to the UCLA data, 1.5 million Californians were newly enrolled in Medi-Cal by April 2014, another 1.2 million purchased commercial coverage through Covered California, the state's health insurance exchange. Of those who bought coverage through Covered California, 650,000 were previously uninsured. 

Although the UCLA study did not factor in the 2014 enrollments, the data suggest that the number of uninsured in California dropped by as much as 40% last year.

"Despite the ongoing fight over healthcare reform, what these numbers show is how dire the situation was prior to its implementation," said Shana Alex Charles, director of the UCLA Center's health insurance studies program. "These were the 'bad old days' that we don't want to go back to." Charles added that the Affordable Care Act was a huge factor in decreasing the numbers of uninsured in California.

For example, nearly 90% of those who purchased insurance through Covered California have qualified for tax subsidies based on their annual income, officials said. Those subsidies in some cases knocked their premiums down to as little as $50 a month or less, putting insurance that had been considered wildly unaffordable prior to the ACA well into reach. 

Nationwide, the number of uninsured dropped from just under 50 million in 2012 to about 30 million at the end of last year, a 40% reduction, according to data from the Kaiser Family Foundation.

The effects of the ACA has helped to revese some of the damage wreaked on California by the Great Recession, which began in December 2007 but began heavily damaging the U.S. economy starting in the second half of 2008 and throughout much of 2009.

According to the UCLA, data, the total number of uninsured Californians rose from 6.4 million in 2007 to 7.1 million in 2009. That total began to taper off as many more residents who lost jobs qualified for coverage under Medi-Cal or Healthy Families income guidelines. 

However, job-based health insurance coverage took a significant dip, from 52.1% of the state's population in 2009 to 49.5% in 2012, the first time ever fewer than half of those who had health insurance did not get the coverage from their jobs. That number rose only slightly in 2013, to 50.5%.

Meanwhile, a case pending before the U.S. Supreme Court that focuses on language in the Affordable Care Act could strike down subsidized health insurance for the millions of Americans who purchased coverage through the federal exchange because their states do not operate their own exchanges. According to the Kaiser Family Foundation, 87% of those who have purchased coverage through the federal health insurance exchange receive a subsidy for their coverage, slightly lower than in California, with each one averaging $268, covering 72% of the premium's cost. 

Studies by the Robert Wood Johnson Foundation and the Rand Corp. on the scenario of the high court striking down the subsidies in the 34 states that do not operate their own exchanges suggest that the number of uninsured would grow by 8.2 million by 2016. Premiums in the state and federal health insurance exchanges would also increase as much as

Charles observed that in less polarized political times, Congress would quickly tweak the ACA if the Supreme Court struck down the subsidies. But in today's polarized political climate, it is likely that millions of Americans would be unable to afford unsubsidized premiums and quickly lose their coverage. 

According to data released by Covered California earlier this month, signups for the most recent open enrollment period that concluded Feb. 15 are expected to top 500,000.