The Uninsured at the Starting Line in California: California findings from the 2013 Kaiser Survey of Low-Income Americans and the ACA

Rachel Licata, Rachel Arguello, and Rachel Garfield
Published: Feb 19, 2014

Table A1: Demographics of Adults in California, by Insurance Coverage
	Uninsured	Insured
	Uninsured	Employer	Nongroup	Medi-Cal
Income
≤138% FPL	52%	10%*	—	78%*
139-400% FPL	39%	31%*	37%	19%*
>400% FPL	8%	59%*	—	—
Family Work Status
Working Family	71%	90%*	72%*	36%*
Non-Working Family	29%	10%*	—	64%*
Age
19-25	17%	11%*	—	—
26-34	28%	18%*	—	18%*
35-44	22%	26%	—	23%
45-64	33%	44%*	66%*	48%*
Health Status
Ongoing Health Condition	23%	32%*	43%*	55%*
No Ongoing Health Condition	75%	68%	57%*	45%*
Fair or Poor Health Status
Excellent/Very Good/Good	67%	90%*	82%*	51%*
Fair or Poor	33%	10%*	—	49%*
Race
White, Non-Hispanic	26%	50%*	56%*	33%
Hispanic	52%	26%*	—	43%*
Black, Non-Hispanic	—	5%	—	—
Asian/Pacific Islander	—	13%	—	—
American Indian Alaska Native	—	—	—	—
Other/DK, Non-Hispanic	—	6%	—	—
Citizenship
Citizen	64%	89%*	92%*	80%*
Non-Citizen	36%	10%*	—	20%*
NOTES: Don’t Know and Refused responses not shown. Excludes people covered by other sources, such as Medicare, VA/CHAMPUS, or other state programs. NA: Not applicable “–“: Estimates with relative standard errors greater than 30% or unweighted cell sizes below 30 are not provided. * Estimate statistically significantly different from uninsured estimate at the 95% confidence level. SOURCE: 2013 Kaiser Survey of Low-Income Americans and the ACA.

Table A2: History of Uninsurance and Attempts to Gain Coverage Among Currently Uninsured Adults in California, by Income
	All	By Income
	All	≤138% FPL	139-400% FPL
Length of Time Uninsured
< 3 months	7%	—	—
3 Months to Less than a Year	10%	8%	11%
1 Year to 5 years	33%	34%	31%
5 Years or More	28%	26%	31%
Have Never Had Coverage	22%	25%	21%

Attempts to Gain Coverage
Applied for Medi-Cal in past 5 years	24%	28%	18%^
Applied for Medi-Cal but did not enroll	15%	17%	12%
Applied for Medi-Cal but told ineligible	12%	14%	10%

Tried to purchase nongroup coverage in past 5 years	17%	12%	22%^
Tried to purchase nongroup coverage but did not purchase policy	12%	8%	17%^
Tried to purchase nongroup coverage but too expensive	10%	7%	13%
NOTES: Don’t Know and Refused responses not shown.Excludes people covered by other sources, such as Medicare, VA/CHAMPUS, or other state programs. “–“: Estimates with relative standard errors greater than 30% or unweighted cell sizes below 30 are not provided.NA: Not applicable. Estimates not shown for >400% as estimates do not meet criteria for statistical reliability. ^ Estimate statistically significantly different from <138% FPL estimate at the 95% confidence level. SOURCE: 2013 Kaiser Survey of Low-Income Americans and the ACA.

Table A3: Ease of Applying for Medi-Cal, Among Adults who Have Applied, by Income
	All	By Income
	All	≤138% FPL	139-400% FPL
Share reporting step was somewhat or very easy:
Finding out how to apply	78%	77%	84%
Filling in requested information	68%	65%	72%
Assembling the required paperwork	61%	60%	56%
Submitting the application	77%	78%	75%
Share reporting all steps were somewhat or very easy	48%	47%	46%
NOTE: Includes adults who either are currently covered by Medi-Cal or report that they have applied for the program within the past 5 years. Estimates not shown for >400% as estimates do not meet criteria for statistical reliability. SOURCE: 2013 Kaiser Survey of Low-Income Americans and the ACA.

Table A4: Reasons For and Problems With Choosing Health Plan, Among Adults in California Who Had and Made a Choice, by Income
	All	By Income
	All	≤138% FPL	139-400% FPL	>400% FPL
Share who chose plan primarily because:
Your costs under the plan were low	27%	20%	23%	31%
The selection of health care providers was broad or included your doctor	27%	28%	24%	27%
The plan covered a wide range of benefits or a specific benefit that you need	29%	22%	33%	29%
Friends or family recommended the plan	5%	—	—	—
Other members of your family were already enrolled in this plan	4%	—	—	—
Some other reason	8%	12%	8%	—
Share of Insured Adults Reporting:
Difficulty comparing services covered under each plan	25%	28%	29%	22%
Difficulty comparing what costs would be under each plan	17%	18%	20%	15%
Difficulty comparing the doctors, hospitals, and other health care providers you could see under each plan	29%	19%	26%	33%
At least one aspect of plan choice to be difficult	38%	37%	37%	38%
NOTES: Among 58% insured adults who had a choice of plans and reported that they made the choice themselves. Excludes those who responded Don’t Know or Refused. “–“: Estimates with relative standard errors greater than 30% or unweighted cell sizes below 30 are not provided. SOURCE: 2013 Kaiser Survey of Low-Income Americans and the ACA.

Table A5: Problems with Health Coverage Among Insured Adults in California, by Coverage
	Insured
	Employer	Nongroup	Medi-Cal
Share who:
Rate Health Coverage as “Not so good” or “Poor”	9%	23%*	23%*
Share who report that:
Needed Service Not Covered by Plan	14%	35%*	34%*
Plan Would Not Pay for Service You Thought Was Covered	20%	36%*	36%*
Costs You Had to Pay for a Service Were Higher Than Expected	35%	61%*	25%*
NOTES: Excludes people covered by other sources, such as Medicare, VA/CHAMPUS, or other state programs. “–“: Estimates with relative standard errors greater than 30% or unweighted cell sizes below 30 are not provided.*Estimate statistically significantly different from employer estimate at the 95% confidence level. SOURCE: 2013 Kaiser Survey of Low-Income Americans and the ACA.

Table A6: Californians’ Knowledge of Coverage Pathways Available Under the ACA, by Income and Coverage
	Uninsured^{^}	Insured
	Uninsured^{^}	Employer Coverage	Nongroup	Medi-Cal
Know “only a little” or “nothing at all” about Medi-Cal
All	74%	71%	82%	52%*
By Income
≤138% FPL	76%	76%	—	47%*
139-400% FPL	74%	73%	81%	65%
>400% FPL	—	69%	80%	—

Know “only a little” or “nothing at all” about Covered California
All	85%	67%	70%	84%
By Income
≤138% FPL	89%	82%	—	85%
139-400% FPL	84%	80%	71%	80%
>400% FPL	—	57%	67%	—
NOTES: Excludes people covered by other sources, such as Medicare, VA/CHAMPUS, or other state programs. ^{^}Uninsured excludes undocumented immigrants. “–“: Estimates with relative standard errors greater than 30% or unweighted cell sizes below 30 are not provided. *Estimate statistically significantly different from uninsured estimate at the 95% confidence level. SOURCE: 2013 Kaiser Survey of Low-Income Americans and the ACA.

Methods