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Survey Shows Drop in California's Uninsured, but with New Cost Concerns

By John Reichard, CQ HealthBeat Editor

July 30, 2014 -- What happens when a big state with a big uninsured population goes all out to adopt the health care overhaul law? In the case of California, a huge increase in coverage that brings the newly enrolled a greater sense of security but also difficulties paying their premiums.

Of Californians uninsured prior to the Oct. 1 start of open enrollment under the overhaul, 58 percent now report having health insurance, according to a recent survey from the Kaiser Family Foundation. That "translates to about 3.4 million previously uninsured adult Californians who have gained coverage," the foundation said.

The largest chunk of the newly enrolled signed up for California's expanded Medicaid program. Employer coverage was the next biggest source of insurance for the newly enrolled, followed by California's insurance exchange and by non-group plans sold outside of the exchange.

Specifically, 25 percent of previously uninsured Californians said they now are part of California's Medicaid program, which is called Medi-Cal. Twelve percent said they obtained coverage through an employer, followed by 9 percent through the exchange, called Covered California, and five percent who enrolled in non-group plans outside of Covered California.

Fifty-two percent of previously uninsured Hispanics reported signing up. Fifty-eight percent of previously uninsured young adults between the ages of 19 and 34 enrolled. Fifty-four percent of previously uninsured people with incomes at 138 percent of the federal poverty level or less got coverage. And 53 percent of the uninsured who reported fair or poor health said they'd gotten coverage since last summer.

Outreach efforts paid off, with 69 percent of the previously uninsured who said they'd signed up reporting they were contacted about getting coverage.

Seventy-three percent of the newly insured said their plan is a good value and 64 percent said they felt well protected by their plan. Thirty-seven percent said their new coverage made them feel more financially secure compared to 16 percent who said they felt less secure.

But in a finding that stirs uncertainty about whether they will keep up their coverage, 46 percent of the newly uninsured who got coverage in plans other than Medi-Cal said that paying for coverage is difficult.

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