Survey shows work to do on health coverage

08/03/2014 4:39 PM

08/03/2014 4:40 PM

California and the San Joaquin Valley have largely accomplished what the Affordable Care Act was created to do – get insurance for the uninsured, according to a survey made public Wednesday.

Sixty-six percent of people in the San Joaquin Valley previously without insurance got coverage by the end of open enrollment for the Affordable Care Act this spring. And statewide, 58 percent of those without insurance have obtained coverage.

The challenge for the Valley and statewide now is for the remainder of the uninsured – mostly Hispanic and low-income people – to get enrolled.

In the Valley, most of the newly insured – 41 percent – got coverage from Medi-Cal, the state-federal insurance for people with low incomes, according to the Henry J. Kaiser Family Foundation survey.

“That’s just double the rates in some of the other parts of the state,” said Mollyann Brodie, a foundation senior vice president who helped prepare the report. Statewide, 25 percent received coverage through Medi-Cal.

Apart from Medi-Cal coverage, Valley residents were similar to statewide averages for how they gained coverage: 12 percent in the Valley and statewide got insurance through employers, while 6 percent in the Valley and 9 percent statewide got coverage through Covered California, the state’s health benefit exchange established for the Affordable Care Act. Another 4 percent in the Valley and 5 percent statewide said they got insurance through the individual market.

But those who still lack health insurance likely will need help getting enrolled when open enrollment begins this fall for coverage for 2015.

In Merced County, Hispanics, African Americans, Southeast Asians and members of families with mixed immigration are the common target population. According to certified enrollment counselors in the area, the most difficult to engage are young adults, in the 18 to 34 age group, and people living in rural areas.

Those people “are very detached from the health insurance system,” Brodie said. More than a third, 37 percent, have never had insurance; 45 percent have not had insurance in the past two years or longer.

And nearly a third are undocumented immigrants who are ineligible for programs under the Affordable Care Act, Brodie said.

In Merced County, nearly 9,000 people are ineligible due to undocumented status.

But immigration status is not what’s blocking all the uninsured from getting coverage. When asked why they did not have coverage, about 34 percent of people statewide cited cost, the survey said.

Outreach by enrollment organizations has played a key role in getting people insured, Brodie said. The survey found 69 percent of California’s previously uninsured who were contacted about signing up for health insurance said they got coverage, compared with 52 percent of those who were not contacted.

The study showed the value of outreach organizations to enrollment success, Brodie said, and there may be “a more intense need for them with the harder-to-enroll who are left.”

Health officials in Merced County have described Medi-Cal outreach and enrollment as “extremely successful,” with approximately 10,000 newly eligible adults and several thousand children enrolled.

Avoiding a tax penalty also was motivation for some to get coverage. According to the survey, 21 percent of the newly insured said they wanted to avoid the penalty for not having insurance. But 17 percent cited health issues; 14 percent wanted a safeguard from high medical bills; and 13 percent indicated they wanted insurance for general health needs and preventive care.

The survey is the second in a series based on the Kaiser Family Foundation California Longitudinal Panel Survey Project.

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