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California's Health Care Safety Net: A Sector in Transition

Publication Topics

California Health Interview Survey; Access to Health Care; 2013 California Health Interview Survey (CHIS 2013); 2014 California Health Interview Survey (CHIS 2014); Barriers to/Disparities in Health Care; Safety Net Providers; Health Insurance Coverage and Programs; Health Care Reform; Medicaid/Medi-Cal; Uninsured; Low-Income; Uninsured

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External Publication

Publication Date


Author 1

<a onclick="OpenPopUpPage('{7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=1288&RootFolder=*', RefreshPage); return false;" href="{7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=1288&RootFolder=*">Katrina Connolly</a>

Author 2

<a onclick="OpenPopUpPage('{7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=1289&RootFolder=*', RefreshPage); return false;" href="{7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=1289&RootFolder=*">Matthew Newman </a>

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The report looks at changes in health coverage for the safety-net population in California as a likely result of 2014 implementation of the federal Patient Protection and Affordable Care Act (ACA). The ACA expanded Medi-Cal eligibility to most adults with incomes up to 138% of the federal poverty level and established state health care exchanges that enabled individuals to purchase insurance, often with federal subsidies. The report is primarily based on 2013 and 2014 California Health Interview Survey data.

Key findings:

  • In 2014, 3 in 10 Californians could be considered part of the safety-net population because they were low-income and enrolled in public programs or were uninsured. A safety-net patient is someone who makes less than 300 of FPL ($35,000 for an individual in 2014).
  • Public hospitals are much more reliant on safety-net funding sources, with 70% of their net patient revenue coming from Medi-Cal and county indigent programs, compared to 19% for private nonprofit hospitals.
  • The safety-net population accounted for 83% of community clinic visits.
  • While insurance coverage of the safety-net population increased from 21% to 24% from 2013 to 2014, access to care may continue to be a problem.
  • The safety-net population spent more money out-of-pocket for health care as a percentage of median annual income (3.1%) than the non-safety-net population (1.6%).


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Report: California's Health Care Safety Net: A Sector in Transition

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Press Release

Related Link 1

California Health Interview Survey (CHIS)

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Version: 5.0
Created at 1/26/2016 10:50 AM by i:0#.f|uclachissqlmembershipprovider|celeste
Last modified at 2/24/2016 1:29 PM by i:0#.f|uclachissqlmembershipprovider|celeste