By Celina Keshishian

This holiday season, there’s a new conversation Americans are having as millions across the country gain access to new and affordable health coverage. While this is a historic and momentous step forward, it’s easy to forget that millions of Californians will be left out of receiving the gift of health this holiday season.

With an estimated 7 million uninsured, California has the largest number of individuals with no health insurance in the country. New health coverage options available under the federal Patient Protection and Affordable Care Act are enabling millions to enroll in health insurance that they previously couldn’t afford. Thanks to Medi-Cal expansion in the Golden State, 1.4 million Californians will be newly eligible for the program.

And yet, after all is said and done, it is estimated that 3.1 to 4 million Californians will remain uninsured according to the UC Berkeley Center for Labor Research and Education and UCLA Center for Health Policy Research.

Approximately 1 million are predicted to be undocumented populations who have been explicitly excluded from participating under federal law. This means that three-quarters of the uninsured will be U.S. citizens or lawfully present immigrants who may be eligible for Medi-Cal or purchasing coverage through Covered California. Obstacles including lack of access to a computer or materials in their native language will hinder some populations from learning and enrolling into new health plans. For some, changes in circumstances like gaining or losing employment will result in coverage gaps. And for an estimated 40 percent, the promise of health care reform to provide affordable access to coverage will not be so affordable after all.

Providing care to the remaining uninsured will remain a major challenge for communities across California, including Solano County. Often, the option of last resort – hospital emergency rooms – is extremely costly, forcing those without a reliable source of care to put off necessary preventative health services. Ensuring access to a reliable source of care for the remaining uninsured and preventing costly emergency room visits is both prudent and economically sound policy.

The critical role community health centers play in serving our most vulnerable populations cannot be underestimated. Community health centers across California and in Solano County are a critical source of care for uninsured and underinsured populations and will continue to be even as we enter a new era in health care. Establishing and maintaining coordinated systems of care that incorporates community health centers, hospitals and county health systems will help ensure a responsive health care system that properly meets the needs of its populations.

Communities across the state are working together to promote sustainable safety-net health care services for these populations. As we move into the new year, let’s celebrate our community health centers for their noble service and unwavering dedication to serving their communities. And let’s all agree on a common resolution to finding an affordable and accessible solution to providing health care for California’s remaining uninsured.

Celina Keshishian is a Project Coordinator at the Community Clinic Consortium, which is a partner of Solano Coalition for Better Health.