In 2014, up to two-thirds of California's 7 million uninsured residents will will likely be eligible for new coverage options in the California Health Benefit Exchange either via Medi-Cal expansion or federally subsidized private health insurance, according to a new policy brief from the UCLA Center for Health Policy Research.

The brief presents county-by-county estimates of the number of Californians who had employer-based, public or individual health insurance in 2009, as well as those who were uninsured for all or part of that year. Based on the CHIS 2009 data, 3 million uninsured Californians will gain coverage through health reform's Medi-Cal expansion and 1.7 million will be eligible for federal subsidies through the Exchange. Additionally, 1.2 million will become eligible to purchase non-subsidized coverage through the exchange.

Most Helpful to the Working Poor

Reform may particularly help those struggling in the economic downturn by expanding the definition of those who are eligible for Medi-Cal to include adults without dependent children who earn up to 133 percent of the federal poverty level ($10,956 for one person in 2009). With this newly eligible population added to those who are uninsured but eligible for Medi-Cal under existing regulations, approximately 3 million of the lowest-income nonelderly adults and children will be eligible for coverage through Medi-Cal.

Number of Uninsured Californians Probably Higher Now

California, with its 7 million uninsured, has the largest total number of uninsured residents in the nation, a situation exacerbated by the economic downturn and rising unemployment. That number might have been even higher without a federal subsidy offered around the time the 2009 CHIS data was collected that enabled laid-off Californians to retain their employer-provided health insurance through COBRA. That subsidy has since expired. Larger increases in public program participation, as well as a decline in California's overall population (largely due to undocumented residents leaving the state), also may have kept the total uninsured rate from rising.