California health insurance stable in 2021, but many will need to switch coverage once COVID-19 pandemic protection ends – California Health Care Foundation

During 2021, the second year of the COVID-19 pandemic, the health insurance situation in California remained relatively stable. This article focuses only on age-based Medicare coverage thresholds for California residents under the age of 65, and the coverage rates highlighted below do not include, unless otherwise specified ( That is, “non-elderly”) children are included. Based on the 2021 California Health Interview Survey (CHIS), the percentage of Californians under age 65 with no health insurance (7.4% in 2021) was not significantly different from the previous year. Also, there were no statistically significant changes between demographic groups, including income, age, geography, race and ethnicity.

Also, the percentage of Californians covering each market, which is 5.9% in 2021, remained statistically unchanged from 2020. Meanwhile, the percentage of Californians with Medi-Cal coverage (California’s Medicaid program) is likely to be 26.4% in 2021, higher than 24.8% in 2021. In 2020, the difference is not statistically significant. Findings show that Medi-Cal enrollment among people under 65 will increase by 7.3% in 2021 (893,552 enrollees), up from 12,244,085 in December 2020 to 13,137,637 in December 2021 This contrasts with records from the California Department of Health Services, which reported that

There are multiple potential explanations as to why survey data on Medi-Cal enrollment may differ from Medi-Cal records. According to research, Surveys tend to underestimate people enrolled in state Medicaid programs, in part because people are confused about the program name and whether they are still enrolled in Medicaid. and may have worsened during the pandemic. Because health insurance is essential to maintaining access to care, a temporary policy called “continuous coverage” allows enrollees to be unenrolled from Medicaid during public health emergencies. There was no Because of this policy, some Californians may have retained her Medi-Cal coverage, which they assumed had expired.

At the same time, the percentage of Californians with employer-sponsored insurance (ESI) has dropped significantly from 60.1% in 2020 to 57.8% in 2021. group. For example, her ESI rate among non-elderly adults (ages 18–64) dropped significantly, while middle-income individuals (139%–400% of the federal poverty level) and Latinos were more likely to have Medi-Cal enrollment. rate was statistically significantly increased.

The percentage of Californians without health insurance at any point in time remained unchanged in 2021, but the percentage of Californians without long-term (one year or more) insurance has increased from 4.8% in 2020. By 2021, it will rise to 5.7%, a statistically significant increase.

Conclusion and discussion

Overall, the stability of state health insurance rates can be seen as positive, especially during the upheaval of the COVID-19 pandemic. Despite massive job losses in 2020, California’s uninsured rate has fallen to historic lows in the first year of the pandemic. This is almost certainly due to federal and state efforts to maintain or improve access to health insurance. It’s worth noting that California was able to maintain this low premium rate in a second year of pandemic volatility.

However, there have been other measurements that indicate that California’s coverage situation has changed slightly since 2020. For example, the state’s ESI coverage rate dropped significantly in 2021. However, it’s important to recognize that the percentage of Californians with her ESI in 2020 was the highest since the Affordable Care Act was fully implemented in 2014. So it is possible that the trend of increasing ESI in her in recent years has only moderated.

Another indicator of potential concern was California’s long-term uninsured rate increase from 2020 to 2021. In this case, however, trend data indicate that the long-term uninsured rate of 4.8% in 2020 may simply have been an outlier. Pandemic — A rate of 5.7% in 2021 has fallen in line with a narrow range of rates between 5.3% and 5.8% in other years since 2016.

Overall, the 2021 CHIS data show a surprisingly stable picture of health coverage. The COVID-19 pandemic, which began in 2020 and continued into 2021 and beyond, could have resulted in significant losses in health insurance coverage, primarily due to falling ESIs due to rapid unemployment. However, uninsured rates have not soared and ESI coverage has not shown a dramatic decline compared to pre-pandemic trends.

Much of the government support that helped keep people covered during the crisis has ended or is expected to end soon, even if the pandemic lasts until 2022. Expanding Medi-Cal coverage for this subpopulation is largely due to ongoing coverage provisions related to public health emergencies expected to end in 2023. CHCF writes elsewhere. As such, it is important to keep those who maintain Medi-Cal eligibility enrolled and take steps to link those who become ineligible to alternative sources of coverage. This, along with other challenges such as inflation, can make it difficult to sustain increased coverage in California. And to fully understand the impact, it’s essential to continue monitoring the data beyond 2022.

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