About 3.4 million previously uninsured Californians — 58 percent — report getting health insurance since last summer, according to new data from the Kaiser Family Foundation, but the remaining uninsured may be nearly impossible to reach.
"Expanding coverage gets harder from here," Kaiser Family Foundation CEO and President Drew Altman said. "Most of those who remain uninsured have gone years without coverage, and many are immigrants who don't qualify or are worried about drawing attention to family members' immigration status."
"Among the 42 percent who remain uninsured, many have characteristics that traditionally make them hard to reach with health coverage," the report read. "Among this group, 37 percent say they have never had health insurance, and another 45 percent say they have been uninsured for two or more years. Most have low-to-moderate incomes."
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About six in 10 of the remaining uninsured are Hispanic, nearly half of whom isn't eligible for coverage through Covered California or Medi-Cal, the state's Medicaid program, due to their immigration status.
In addition, most remaining uninsured Hispanics (54 percent), and 37 percent of those Hispanics eligible for PPACA coverage options, say they worry that enrolling in coverage would bring attention to their family's immigration status. That's despite the fact that federal immigration officials have said they will not use application information as the basis for enforcing immigration laws in a Department of Homeland Security policy issued in October of 2013.
The report is Kaiser Family Foundation's second look into California's uninsured. Last year they surveyed about 2,000 uninsured Californians as they tried to buy health coverage using the exchanges. They followed up with the group to see how they circumstances have changed and how the law affected them.
The Kaiser report also indicated that the cost of insurance and difficulty comparing plans in the exchanges were among the biggest barriers in getting enrolled.
Specifically, nearly half (46 percent) of those newly insured in plans other than Medi-Cal say that paying for coverage is difficult. And roughly 3 in 10 of those who enrolled in Medi-Cal and about four in ten of those who enrolled through Covered California said confirming enrollment was "very" or "somewhat" difficult. Significant shares also reported it was difficult to determine if their income qualified them for assistance, the report said.
Still, all told, 58 percent of previously uninsured Californians bought health plans since last summer.
The largest share of previously uninsured Californians gained coverage through the Medi-Cal (25 percent), followed by those gaining coverage through an employer (12 percent) or Covered California (9 percent). Another 5 percent say they obtained other individual market coverage.
When asked the reason why they got covered, 21 percent of the newly insured said they were motivated by PPACA and wanted to avoid the penalty for not having health insurance. Others say they got it because of issues with their health (17 percent), as a safeguard against emergencies and high medical bills (14 percent), or for more general health needs and preventive care (13 percent).
"By tracking how California's uninsured residents fared, our survey sheds light on the best opportunities and ongoing challenges for those making plans for the next round of open enrollment," said Kaiser senior vice president Mollyann Brodie.
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