Expert: Millions More Uninsured Will Get Coverage in Next Three Years

Now that the final numbers from Covered California's first open enrollment period are in, experts are already looking ahead to the next steps.

Nearly 1.4 million Californians have signed up for health care coverage through the exchange. Another 1.9 million are now covered by the expanded Medi-Cal program. That's almost 3.5 million state residents.

And yet 5.8 million Californians remain uninsured.

Gerald Kominski, professor of Health Policy and Management and director of the UCLA Center for Health Policy Research, said these numbers are on target with early projections.

Kominski says about one million of the remaining uninsured are undocumented and not eligible for coverage under the Affordable Care Act. But he expects the majority of the others will gain insurance over the next few years.

"We really think that enrollment in ACA is a 3-year process rather than get everyone enrolled the first year," Kominski said.

He projects that by 2017 the number of remaining uninsured, excluding those who are undocumented, will be 1.2 million people.

"I think that would be a tremendous success," Kominski said.

So why the lag time?

"We projected there would be full expected enrollment after three years of the program," Kominski said. "Part of that is because of the tax penalties that get phased in over the next three years. No one has paid a penalty yet for being uninsured. That will happen next April when income taxes are due."

Once the penalties hit home, Kominski said he expects those additional enrollments will start rolling in.

The other big issue that health policy experts are keeping their eyes on going forward is so-called churn.

Ken Jacobs, chair of the UC Berkeley Labor Center, said that it's important that the huge outreach effort continues — both because of Californians that remain uninsured and those that may lose their insurance in coming years for any number of reasons.

Changing jobs, getting married or divorced, having or adopting a baby — any of these are qualifying events that will allow people to sign up for coverage outside of the open enrollment periods.

Jacobs said at least half a million Californians will become newly eligible for the exchange during the course of the year by losing their existing coverage.

The information storm around the initial enrollment period may be over. But experts say while millions of Californians signed up during this first phase, there are still millions more who will be shopping for Covered California plans over the next few years.