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CA Fact Sheet 062510

CA Fact Sheet 062510

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Healt h Care Fact s: California
Page 1 of 3
National Coalit ion on Healt h Care
June 2010
DEM OGRAPHY
The Pat ient Prot ect ion and
Affordable Care Act (ACA) was
enact ed on March 23, 2010.
Successful implementation requires
cooperat ion bet ween key

st akeholders, federal and st at e agencies, and reform advocacy organizat ions. Because t he fift y st at es vary great ly, each st at e’s implement at ionprocess will be unique.

California has t he largest
populat ion in t he Unit ed St at es,
est imat ed t o be 36,961,664 in
2009.1 The healt h care needs of
California’s diverse populat ion pose
challenges t o t hose implement ing
health reform in the state.
Percent of Population in California per Race / Ethnic Group2
* Ot hers include American Indian, Alaska Nat ive, Asian, Nat ive Hawaiian and ot her
Pacif ic Islanders.
CALI FORNI A AND THE UNI NSURED: HOW WI LL THE AFFORDABLE CARE ACT HELP?
While 81% of all Californians have healt h insurance, over 6.5 million individuals remain uninsured,3
including about 11% of California’s children4 and almost a quart er of t he st at e’s working populat ion.5

ACA is designed t o address t hese concerns by providing affordable access t o healt h insurance coverage t o t hose individuals who would ot herwise be unable t o obt ain coverage, and t o ext end current benefit s and services provided by Medi-Cal (California’s Medicaid program, which is a federal and st at e funded public insurance program t hat provides healt h insurance coverage for low-income and disabled

individuals and families).
NEW BEN EFI TS UNDER ACA: THE EFFECTS I N CALI FORNI A
Insurance
Coverage
ACA est ablishes new requirement s for privat e healt h insurers in order t o make healt h
care plans more accessible to the public. These requirements include the following:
Ef f ect i ve I mmedi at el y: Pl ans must cover cer t ai n pr event i ve heal t h ser vi ces, such as
vaccines and screenings, wit hout a co-pay.
42.3
6.7
38.614.1
Whit e (Non-Hispanic)
Bl ack
Hispanic
Other*
Health Reform Facts: California
Healt h Care Fact s: California
Page 2 of 3
National Coalit ion on Healt h Care
June 2010
Ef f ect i ve Sept ember 2010:
Insurers will not be allowed t o drop any insured person because he/ she get s
sick or develops a chronic healt h condit ion. In addit ion, ACA allows individuals
t o renew healt h insurance coverage regardless of t heir healt h st at us.
Individuals up t o t he age of 26 can choose t o be covered under t heir parent s’
insurance plan.
Ef f ect i ve Januar y 2014:
Under t he “ guarant eed issue” provision, an insurer must accept every
employer and individual in the state that applies for coverage.
Insurers cannot exclude people from coverage if t hey have a pre-exist ing
condit ion (e.g., ast hma, diabet es, or any ot her long-t erm condit ion) or past
illness.
All insurers will be required t o offer a coverage package t hat offers essent ial
benefit s.
Small
Business
Assi st ance
Effect ive Immediat ely: ACA makes t ax credit s available t o qualifying small businesses t o
help them afford coverage for their employees. These tax credits could total up to 50% of
a business’ healt h insurance premiums. In 2008, California had over 583,444 small
businesses,6 which represent ed over 77% of t he st at e’s employers.7
Health
Insurance
Exchanges

Effect ive January 2014: ACA requires t hat st at es creat e an insurance market “ exchange” – a market place where people will be able t o compare and shop for healt h insurance. This will make access t o healt h plans easier and more efficient . U.S. cit izens, legal immigrant s,

and small businesses will be able t o purchase insurance t hrough t hese exchanges.
Tax Credits
for
Individuals
Effect ive January 2014: ACA provides a t ax credit t o qualified individuals so t hey may
purchase health insurance through the exchanges. Qualification for the tax credit will be
based on t he individual’s household income and his/ her number of dependent s. A
person who earns bet ween 133% and 400% of t he federal povert y level8 may be eligible
for individual tax credits.
High-Risk
Insurance
Pools

Effect ive July 2010: High-risk pools are designed t o provide healt h insurance coverage t o people who were previously uninsurable due t o a pre-exist ing condit ion. It is est imat ed t hat t his program may provide services t o 30,000 Californians per year when fully

implement ed.9
Expansion
of
M edi-Cal
(M edicaid)
Effect ive January 2014: ACA cont ains provisions which would creat e new eligibilit y
requirements for Medi-Cal (California’s Medicaid program). For example, adults under
t he age of 65 earning less t han 133% of t he federal povert y level, may be eligible t o apply

regardless of whet her t hey have children. The Legislat ive Analyst ’s Office in California est imat es t hat approximat ely 2 million addit ional Californians may now be eligible for Medi-Cal.10

I M PLEM ENTATI ON CHALLENGES I N CALI FORNI A
Successful implement at ion of ACA will require a joint effort among local, st at e, and federal agencies, as
well as many non-governmental organizations. The State of California will face several challenges:

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