Biggest Health Insurance Companies In California - The Affordable Care Act (ACA) went into effect on January 1, 2014, bringing health insurance reforms and new health insurance options to California and elsewhere across the country. Before 2014, under a waiver, California implemented an early expansion of Medi-Cal, the state's Medicaid program, and enacted innovative strategies to reshape the health care delivery system within its safety net. In 2014 and 2015, millions gained coverage through Covered California, the state's health insurance marketplace, and through additional Medi-Cal expansions. Based on these reforms, the state continues to expand eligibility and redesign delivery systems to provide citizens with efficient and quality care. This fact sheet provides an overview of population health, health coverage, and the health care delivery system in California in the era of health reform.
California is home to more than 38 million people, making it the most populous state in the US. At nearly 156,000 square miles, California is the third largest state
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The largest country in terms of geography. 1 While approximately one-third of the state's total area is covered by forests, 2 the vast majority of the state's population (95%) lives in urban areas, and half of them are concentrated in southern California alone 5 . Out of 58 districts of the country. Los Angeles and San Diego counties alone account for a third of the country's population.3
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The population of California is very diverse (Table 1). Unlike most states in the US, California's population is majority minority, with 39% of residents identifying as white, another 39% as Hispanic, 14% as Asian, 5% as Asian, and 3% as other race/ ethnicity (Figure 1).4 More than a quarter (27%) of the population was born abroad5, and 12% are non-citizens, which makes up about 22% of non-citizens in the country. 6 More than four in ten (44%) residents speak a language other than English at home, a rate more than double the national average (21%), 7 And almost one in five (19%) speak English less than "very good".8 In contrast, the country's age distribution is similar to national averages, with non-elderly adults representing the majority of the population (62%), followed by children (25%) and the elderly (12%).
Poverty rates in California reflect national averages and vary by race/ethnicity and age (Table 1). In 2013, more than 5.7 million Californians, or 15% of the state's population, lived in poverty, a decrease from 2011 when the poverty rate reached 17%.9 Blacks (29%) and Latinos (20%) in California they are significantly more likely to be poorer than whites (11%) and Asians (9%).10 The poverty rate and overall rates by race/ethnicity are in line with the national average. However, the cost of living in California is among the four highest in the nation, so low-income people in California will have a harder time getting by than elsewhere; A family of four in California would need to earn $137,643 in an urban median income area to have purchasing power equal to 400% of the federal poverty level ($97,000).11 As in most other states, children in California are more likely than adults to live in a poor household from In 2013, more than one in five (21%) children in the country lived in poverty, compared to 14% of non-elderly adults and 11% of older adults (Figure 2).12
Sources: Kaiser Family Foundation estimates are based on the Census Bureau's March 2014 Current Population Survey (CPS: Annual Social and Economic Supplement).
California's economy continues to recover from the recession, but unemployment remains high. California, like most states, experienced a decline in GDP during the Great Recession, but the economy has seen significant improvements since then. In 2014, California's real GDP per capita was $54,462 compared to the national average of $49,469.13. While national real GDP grew by 2.2% from 2013 to 2014, California's GDP grew by 2.8%, placing it among the nine states with the highest GDP growth. Lessons in the USA 14 The largest industry sector in the country is finance, insurance, real estate, rental and leasing, which accounted for 21% of total GDP in 2014. Education, health and social assistance contributed 7% of total GDP. GDP, a small share lower than the national average (8%).15 The unemployment rate has also improved significantly since the recession, falling from a high of 12.2% in October 2010 to 6.3% in June 2015.16 However, the unemployment rate in California and it remains well above the national rate of 5.3% with nearly 1.2 million people in California remaining unemployed as of June 2015.17
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Budget measures, tax increases and a strengthening economy have helped improve California's fiscal outlook since 2012. Along with the state's measures to control costs and increase revenue, the state's economy has also improved. The economic recovery led to a sharp increase in personal income tax collections and a rise in stock prices in 2013, leading to higher-than-expected revenues.18 After nearly a decade of constant budget deficits, which peaked at $45.5 billion in 2010, 19 California experienced a budget surplus in 2015 and a projected surplus for 2015. 2016.20
Medi-Cal acts as both a source of state budget expenditures and a source of federal revenue. California spent just over a quarter (25.1%) of its total funding on Medi-Cal in 2013, compared to a national average of 24.5%. However, because Medicaid is jointly funded by the states and the federal government, California receives at least $1 in federal funding for every $1 it spends of its own funds on the program. Because of this funding structure as well as state constitutional requirements regarding K-12 funding in California, Medi-Cal represents only 15.5% of total general fund expenditures, second only to K-12 education. Meanwhile, Medi-Cal accounts for the largest share of federal funds flowing to the state (40.5%) Provider taxes and local funds, among other funding sources, contributed to Medi-Cal funding in 2013.
California ranks above the national average on many measures of population health, but faces significant environmental health challenges. According to general health indicators, California ranks 17th
21 Compared to other states, California has among the five lowest rates of smoking, obesity and physical inactivity, and violent crime has fallen by 54% since 1990. 22 However, high levels of air pollution as well as an extended period of severe and unprecedented drought23 present challenges for public health. continues into the country.
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Disparities in health care access and outcomes exist in California (Table 2). As in other states across the country, measures of health status and access differ by race/ethnicity in California (Table 2). Whites (14%) are more likely to smoke than Hispanics (10%) and nearly as likely as blacks (15%), but a smaller share of whites report being in poor or poor health, poor mental health, diabetes, or overweight or obese .more compared to blacks and Hispanics. Additionally, Hispanics (57%) and Asians (74%) in California are less likely than whites (81%) to report a usual source of care. Disparities in health factors and outcomes also exist across California's 58 counties, with poor rural counties, particularly those in the North and Central Valleys, doing worse than urban counties on measures such as life expectancy, health behaviors, clinical care, and environmental factors.24
Data may not add up to 100% due to rounding and data limitations. Figures for whites and blacks do not include Hispanics.
State and local efforts to address health disparities in California are underway. The California Office of Public Health (OHE) was incorporated into the California Department of Health in 2012 to provide leadership in reducing health and mental health disparities among vulnerable communities, including racial minorities, the LGBTQ community, people with disabilities, and undocumented immigrants. Among its major initiatives, OHE launched the California Health Disparities Reduction Project (CRDP), an initiative to reduce mental health disparities in the state. The office also has a team on climate change and public health that has issued two reports on how to reduce the impact of climate change with a focus on vulnerable communities.25 In addition, through the leadership of OHE, the state promotes health in all policies. (HiAP), a collaborative approach to improving the health of all people by integrating health, equity and sustainability issues into decision-making across sectors and policy areas.26
Before the implementation of the ACA, California had the highest number of uninsured of any state in the country. In 2013, just before the ACA's major coverage expansion went into effect, 5.8 million nonelderly Californians (15%) were uninsured, and California alone accounted for 14% of all nonelderly uninsured people nationwide.27 In In 2013, half of nonelderly Californians were covered by an employer plan, while more than a quarter (26%) were enrolled in Medi-Cal or other public coverage (Figure 4).28 Private coverage rates in the state were low due to a combination of high unemployment ( which limited the employer's access to coverage) and high premium costs for non-group coverage29 (which made such coverage unaffordable for many). Before the ACA, public coverage through Medi-Cal was limited to only certain groups of low-income adults, leaving many without an affordable coverage option.
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As in other states across the US, the majority of uninsured non-elderly persons in California had at least one full-time worker in the household (71%), and more than half (52%)
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