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Health Equity Forum: News from the Executive Director – March 2015

The Affordable Care Act: Five Years Later

Today we pause to celebrate five years since President Barack Obama signed the historic Patient Protection and Affordable Care Act (ACA). We pause to acknowledge the millions whose lives have been drastically improved through access to affordable health coverage, to give thanks to the hundreds of advocates and government allies that have worked tirelessly to get the ACA up and running, and to honor our President and our elected representatives who stood up and dared to approve the nation’s first major health reform legislation in a generation. 

Five years ago, as CPEHN began working with our partners on the implementation of the ACA, we knew that California’s communities of color, who were disproportionately uninsured, would have the most to gain from the success of the new law. We have seen a dramatic decrease in the number of uninsured in our state and across the nation – many of the 4.6 million that have received coverage through Medicaid (Medi-Cal in California) and Covered California  are from communities of color, immigrant communities, and are Limited English Proficient.

Just look at some of the successes we’ve seen in these first three years under the ACA.  Close to 2.5 million young adults between the ages of 19 and 26 have been allowed to stay on their parent’s health insurance in California and communities of color were one in five adults that enrolled in California’s Pre-Existing Condition Insurance Program (PCIP), which offered coverage to those who could not obtain insurance before enactment of the ACA. Over 500,000 Californians, a majority from communities of color, enrolled in county Low-Income Health Programs which provided low-income, single adults with preventive care and other basic health services. And over $30 million in federal funding went to California’s school-based health centers, which offer much needed care to our youth, particularly in underserved areas. 

But most significantly California has led the nation in expanding access to health care for millions of Californians. We were the first in the nation to establish a health benefit exchange and were one of the first states to expand Medicaid to millions of single adults including legal permanent residents here less than five years and Deferred Action for Childhood Arrivals (DACA). In the first year of enrollment, 3.4 million people enrolled in health coverage, and in the second year, which just closed last month, another 1.2 million joined them. 

Nothing this big could happen without some bumps in the road. Enrollment among Latinos and African Americans through Covered California has been lower than anticipated. Major backlogs in the Medi-Cal program prevented some individuals from receiving much needed coverage. But after CPEHN and our partners raised concerns, Covered California and the Department of Health Care Services took action. An investment by Covered California in targeted marketing and outreach seems to have paid off as Latinos represented 37% of the 1.2 million new enrollees (up from 31% last year). African-American enrollment was up 4% this year up from 3% last year. We hope that with more enhanced outreach and education in communities of color and low-income areas, we will see these trends continue.

Five years after the signing of the Affordable Care Act, we celebrate this landmark law by breathing life into its provisions and continuing to provide greater access to health care to those most in need. But we must also remember that our work isn’t done. Millions remain uninsured, most from communities of color, and many continue to be ineligible due to their immigration status. While we pause to celebrate our successes, they are the reason to continue the push towards health care for all and ensure equity is the foundation for health care improvements. CPEHN is excited to work with our partners on these next big challenges so that the legacy of the Affordable Care Act will be felt for generations to come.