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State and federal relief prevented deep backslide in health care affordability in California in 2020
State and federal relief prevented deep backslide in health care affordability in California in 2020
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Issue brief (California HealthCare Foundation)
- Author(s):
- Planalp, Colin, author
- Contributor(s):
- California HealthCare Foundation, issuing body.
- Publication:
- [Oakland, CA] : California Health Care Foundation, May 2022
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Insurance Coverage -- statistics & numerical data
Medical Assistance
COVID-19
California - Genre(s):
- Technical Report
- Abstract:
- In 2020, the start of the COVID-19 pandemic meant the imposition of incredible burdens on every corner of US society, particularly the health care system and the people it serves. Among many concerns were well-founded ones that the COVID-19 crisis could make health insurance and health care unaffordable for even more people--already a long-standing problem in California and other states. The economic fallout caused tens of millions of people to lose their jobs, and many stood to lose their health insurance in addition to their income--potentially adding to the number of people left out by the health care system. For those and other reasons, the US government enacted historic relief programs, including multiple instances of direct cash payments to a majority of US families. Other relief was specific to health care, such as special funding for people who lost their insurance to help pay COBRA (Consolidated Omnibus Budget Reconciliation Act) premiums, and funds to cover COVID-19 testing, treatment, and vaccination for people without health insurance. Those federal policies coincided with California health insurance reforms that, while developed before the pandemic, were implemented in 2020. They include a state-level individual mandate for people to obtain health insurance, and state-funded subsidies to make health insurance premiums more affordable for individual-market coverage purchased on the Covered California state-based marketplace. Despite the COVID-19 crisis--and perhaps due in large part to the pandemic relief programs and California’s own reforms--data from the California Health Insurance Survey (CHIS) show that Californians were largely protected from the most dire fallout possibilities. During 2020, the state’s rate of people under age 65 without insurance declined significantly, bringing it to the lowest rate on record. At the same time, the rate of Californians going without needed medical care held steady in 2020 compared to the prior year, and fewer people reported that concerns about cost were resulting in them going without medical care. Surprisingly during a deep recession, there was a significant decline in Californians reporting trouble paying medical bills, and in people saying that medical bills caused them to take on credit card debt or to go without basic necessities, such as food and clothing. Despite these overall positive findings, it is important to acknowledge that each of these topics continued to demonstrate clear inequities when examining the data by income levels and by race and ethnicity. Additionally, the policy interventions that likely influenced these improvements in health insurance and health care affordability are largely temporary. Some pandemic relief programs, such as expanded unemployment benefits, have already ended, while many others are set to end when the federally declared public health emergency expires. Consistent with that, early evidence from the 2022 California Health Policy Survey suggests that some improvements in health care affordability already receded in 2021. The pandemic and associated events made 2020 a unique year in recent human history, so examining those data in isolation may be misleading when trying to understand the affordability of health insurance and health care, and how those measures might change when crisis supports end. For that reason, this brief will also examine how 2020 affordability measures fit into longer-term trends in California.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
- Extent:
- 1 online resource (1 PDF file (9 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918557473506676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918557473506676