Online Program

Vulnerable populations in health care reform: Examples from California

Tuesday, November 5, 2013 : 12:30 p.m. - 12:50 p.m.

Gerald Kominski, PhD, UCLA Center for Health Policy Research, University of California, Los Angeles, Los Angeles, CA
Ken Jacobs, UC Berkeley Center for Labor Research and Education, Berkeley, CA, CA
Shana A. Lavarreda, PhD, MPP, Center for Health Policy Research, UCLA, Los Angeles, CA
Daphna Gans, PhD, UCLA Center for Health Policy Research, University of California, Los Angeles, Los Angeles, CA
The Affordable Care Act will expand health insurance coverage in California, which has the highest number of uninsured of any state in the nation. Beginning in 2014, millions of low- and middle-income Californians will gain access to coverage under the expansion of Medi-Cal and through premium and cost-sharing subsidies offered through the California Health Benefit Exchange. However, as many as four million Californians could remain uninsured or face access barriers.

This panel examines populations that will be left out and highlights policy recommendations to increase enrollment numbers. The panel's moderator will provide a brief overview of reform implementation efforts, innovations and analysis. The first study presents data from the California Simulation of Insurance Markets (CalSIM), which is designed to predict uptake and disparities in health insurance coverage. Based on CalSIM, almost three-quarters of the remaining uninsured in California will be U.S. citizens or legal immigrants. Two-thirds of Californians remaining uninsured will be Latino even though Latinos make up only 45 percent of the non-elderly population. The second study focuses on child health, specifically the fate of an estimated 150,000 ineligible, non-citizen children. The third study uses CalSIM to examine access issues, specifically on the nearly 250,000 Californians with limited English proficiency who could remain uninsured due to language barriers. Policy recommendations from the studies include increasing multi-lingual outreach to raise awareness about the Medi-Cal expansion and the Exchange and ways to make subsidized coverage more affordable.

Learning Areas:

Provision of health care to the public
Public health or related public policy
Public health or related research

Learning Objectives:
Analyze populations that will be left out of the Affordable Care Act implementation Discuss policy recommendations to increase enrollment numbers

Keyword(s): Health Reform, Access to Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am director of the UCLA Center for Health Policy Research and a professor of health policy and management in the UCLA Fielding School of Public Health. I also currently serve as an associate director of the California Medicaid Research Institute. My research interests focus on evaluating costs and cost-effectiveness of health care programs and technologies, with a special emphasis on public insurance programs and microsimulation models for forecasting eligibility and enrollment under health reform.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.