After years of decline after the enactment of the Affordable Care Act (ACA), new 2018 Census data released today shows the first national increase in the uninsured rate since 2013, with the rate going up from 7.9% to 8.5%, or by 1.9 million Americans to 27.5 million. By contrast, California’s uninsured rate has held steady at 7.2%, lower than the average national rate, with 2.8 million uninsured, according to the Census.
While the Trump Administration and Congress continues to seek to sabotage our health care, California has aggressively implemented and improved upon the ACA, which accounts for the largest drop in the uninsured rate of all 50 states from 2013 – 2018, down by more than half (17.2% to 7.2%).
After the ACA covered millions and brought our uninsured rate down, it is disappointing that Trump Administration attacks on our care have made the national uninsured rate rise, meaning more people uncovered, living sicker, dying younger, and an emergency away from financial ruin. But California has countered these attacks to protect our progress in reducing the uninsured rate, and has taken steps to lower it even further.
Some examples include:
- When the Trump Administration expanded access to short-term “junk” insurance which can undermine protections for people with pre-existing health conditions, California became the first state to ban these plans from being sold.
- While the Trump Administration promotes state waivers to institute work requirements in Medicaid, which reduces participation in the program, California prohibited any waivers that make it harder to enroll in coverage.
- As the federal marketplace slashed funding by nearly 90% for enrollment outreach and marketing, our state’s exchange, Covered California, expanded it’s own budget by 10%.
- And this year, after Congress zeroed out the penalty for not having coverage, California enacted a state-level individual mandate to to help stabilize our health care system, while also making huge investments in affordability assistance to help more Californians afford coverage.
California was also one of the first states to set up an exchange and implement a Medicaid expansion under the ACA, and has now become the first state to remove unfair barriers in the system expanding access to all income-eligible Californians up to age 26 regardless of immigration status. These steps show what a state can do on it’s own, without the need for federal approval, and is the focus of the over 70 organizations as part of the #Care4AllCA campaign to get our state to universal coverage in the next few years.
But we must remain vigilant as the health coverage for millions remains at risk. As we speak, the current Texas vs. US case is seeking to undo subsidized coverage for 5 million Californians and consumer protections for millions more and would cost California’s health system $25 billion a year.
At the same time, we still have more to do at the state-level if we want to cut our uninsured rate by half again. Californians continue to need state action to help them access and afford coverage. Everyone benefits when everyone is covered. These Census numbers give new momentum to continue our work towards universal coverage despite the current federal obstacles.
United States Census: Health Insurance Coverage in the United States: 2018
Health Access Fact Sheet: California Efforts to Shield Consumers from Trump Sabotage