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Conventional estimates of the number of uninsured Californians are derived from the Current Population Survey (CPS). Unfortunately, CPS estimates of the number of people receiving Medi-Cal and welfare (AFDC/CalWORKs) are well below the numbers implied by official Medi-Cal records, suggesting that the conventional estimates of the number of uninsured Californians (and their characteristics) are seriously flawed. To improve understanding of these issues, the California HealthCare Foundation (through its then separate the Medi-Cal Policy Institute-MCPI) and the U.S. Department of Health and Human Services, Administration for Children and Families (DHHS-ACF) funded RAND to match CPS data to individual-level administrative data for the Medi-Cal program. With the cooperation of the California Department of Health Services (CDHS), the U.S. Bureau of the Census, and the California Census Research Data Center (CCRDC), that match was performed. This document describes the findings of the analysis of those matched data.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Medi-Cal, the CPS, The MEDS, and Under-Reporting

  • Chapter Three

    The Matched Data

  • Chapter Four

    Extrapolating to the Full Data

  • Chapter Five

    New Estimates of the Uninsured

  • Chapter Six

    New Estimates of Medi-Cal and Welfare Enrollment Rates

  • Chapter Seven

    Conclusion

  • Appendix A

    Detailed Notes on File Construction and Matching

  • Appendix B

    Regression Specification for Response Errors

This research was jointly funded by the California Health Care Foundation and the U.S. Department of Health and Human Services, Administration for Children and Families and was performed under the auspices of RAND Labor and Population.

This report is part of the RAND Corporation working paper series. RAND working papers are intended to share researchers' latest findings and to solicit informal peer review. They have been approved for circulation by RAND but may not have been formally edited or peer reviewed.

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