Nearly 5 million uninsured Californians could gain access to health coverage in 2014 when the nation's healthcare law expands eligibility for subsidized insurance programs for the poor, according to a new report.
At that time, more than two-thirds of the state's 7 million uninsured residents will be eligible for California's Medi-Cal insurance program, which serves the state's poorest people, or for federal subsidies aimed at those who earn more but have no coverage through their jobs.
Many of the newly insured would be low-income adults who have long been unable to don't qualify for Medi-Cal, which applies only to families. The rules will change in 2014 to include adults without children.
"It is good news that there is help on the way for millions of people," said researcher Shana Alex Lavarreda, of the UCLA Center for Health Policy Research, which produced the study being released Tuesday.
But the state faces significant challenges as it works to enroll millions of new people for insurance.
The UCLA analysts noted that nearly 1 million uninsured children and adults who were eligible for low-income insurance programs last year were not enrolled because of the complexity of both the application process and eligibility requirements.
The report also did not take into account budget cuts under discussion by state leaders grappling with multibillion-dollar deficits. Gov. Jerry Brown is seeking to cut the Medi-Cal reimbursement rates for medical providers by 10% this year while capping the numbers of doctor visits for Medi-Cal recipients and requiring patients to pay more out of their pockets.
Medi-Cal, funded by the state and federal governments, is one of California's largest annual expenditures.
The federal government is expected to pump additional money into the insurance program in 2014 by covering the entire cost of childless adults for the first three years after they enroll. But stable public funding remains a source of widespread concern among healthcare advocates.
"Will we have the political leadership to take full advantage of the opportunities and the money that is available to the health system and our economy?" asked Anthony Wright, executive director of the consumer group Health Access California. "Even when we are getting more people coverage, that coverage is providing less access to the care people need."
The UCLA researchers drew their data from the 2009 California Health Interview Survey, which estimated the number of Californians who were uninsured for all or part of that year.
They found that 3.1 million uninsured Californians would be eligible for Medi-Cal in 2014. Most of these people are low-income adults without children who would be eligible for the first time. Some would be able to obtain coverage through the counties where they live.
The researchers also found that 1.7 million uninsured Californians who earn too much money to qualify for Medi-Cal would be eligible for federal subsidies to offset the cost of health policies they could buy in the state's new health benefit exchange. A family of four earning up to $88,000 a year would be eligible for a subsidy.
Although a little more than 1 million undocumented Californians would not qualify for any of the public programs, 1.2 million uninsured people with incomes too high to receive assistance would be able to buy insurance in the new exchange, the researchers found.
"It will be a good thing in 2014 when all of this is ramped up," Lavarreda said. "It's going to expand coverage to millions of people."