New 2014 Census data have made it official, that the uninsured rate in both the United States and in California dropped dramatically with implementation of the Affordable Care Act, confirming independent local surveys and enrollment reports. California’s uninsured rate dropped from 17.2 in 2013 to 12.4% in 2014—and independent surveys suggest that figure is even lower today, more than a year after the Census-based data were collected.
Beyond officially recognizing the success of the ACA, the Census data provide useful state-by-state comparisons: California showed the fifth-largest drop in health insurance, after Kentucky, West Virginia, Nevada, Oregon, and tied with Washington. Prior to full implementation of the ACA, California had one of the highest uninsured rates—seventh in the nation—California is now ranked 20th.
There is no denying the state’s progress in implementing the ACA, that efforts to simplify and streamline eligibility and maximize the ACA’s benefits for all Californians really are paying off. But there’s much more to do. California can and should do more to enroll the remaining uninsured, from further outreach and enrollment, to expanding care and coverage to those excluded from assistance.
California took another important step beyond the ACA this year, agreeing to cover all income-eligible children regardless of immigration status in Medi-Cal starting in 2015. With all this progress, it would be a small but important investment to finish the job by extending coverage to all Californians, as is proposed in the state legislature.
But for now let the Census data reflect that the Affordable Care Act is working in California and nationally. Real progress is possible for states that implement the law in good faith while using it as a jumping off point for further reforms that make sense at the state level.
California has more undocumented immigrants than the populations of four entire states—and the Census does not ask whether people are undocumented or not. What this means for states like California is that efforts to cover the uninsured using the standard ACA coverage options will hit the wall much earlier than they would in other states—unless the state builds on measures like #Health4All kids to cover all adults.