The report states that California has seen historic increases in health insurance coverage due to the implementation of the Affordable Care Act (ACA). Over one million Californians have obtained subsidized insurance through Covered California, and the state's Medicaid program now covers approximately one out of three Californians. However, the report warns that without state action to protect and build upon these coverage gains, the uninsurance rate could grow to 11.7 percent in 2020 and 12.9 percent in 2023. The report also notes that the federal law zeroing out the ACA individual mandate penalty beginning in 2019 will result in lower individual market and Medi-Cal enrollment, but significant uncertainty exists about how much enrollment will decline in California.
