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California’s Health Care Environment and Health Reform Efforts: June 2013 Update

California is the nation’s most populous state, home to over 37 million residents. California also has the largest number of uninsured at 7.3 million people or 20% of the state’s population. This represents 15% of the total uninsured across the country. Therefore, California’s actions to expand coverage through the Medicaid expansion and health insurance marketplaces under the Affordable Care Act (ACA) have implications, not only for health coverage and access within the state, but also for national goals of reducing the number of uninsured. As California develops its infrastructure to expand coverage through the ACA, it may prove to be a model for other states. However, a number of factors combine to make California a unique health care environment.

With an eye toward 2014, this brief provides an overview of health care and health policy in California, through a discussion of the state’s demographics, budgetary environment, Section 1115 “Bridge to Reform” Medicaid Waiver, health reform implementation efforts, as well as future coverage and health care challenges and considerations.