OBJECTIVES: Chile carried out a healthcare system reform in 2005 aimed at reducing health and healthcare inequities. This study assessed whether household income-related inequality in adult self-reported health status (SRHS) was reduced after this reform.  METHODS: Before and after study design using the 2000 and 2009 CASEN surveys (252 748 and 246 924 participants, respectively) we compared the Erreygers concentration index (CI) for SRHS (binary variable: poor=0, fair/good=1) between these two years. Factors associated with good health were explored using weighted logistic regression models. Decomposition analysis of the CIs by “legitimate” (age, sex, marital status, number of household members) and “illegitimate” (income, ethnicity, rural/urban, education, occupation, type of healthcare provision) factors was conducted. RESULTS: Results indicated that there was a significant concentration of fair/good SRHS favoring the rich people in Chile in both years (Erreygers corrected CI for bounded binary variables was 0.165 [Standard Error 0.007] in 2000 and 0.053 [0.002] in 2009). We standardized the 2000 and 2009 CIs to assess horizontal inequity and decomposed them into “legitimate” factors such as age and sex and “illegitimate” factors, mostly socioeconomic conditions. Despite the fact that the CIs are not directly comparable between 2000 and 2009, our findings suggest that the CI might have decreased after the reform, but good SRHS continued to be concentrated among the rich in both years. Decomposition indicated that “illegitimate” factors remained large contributors to income-related inequality in SRHS even after the equity-centered reform of 2005.  CONCLUSIONS: Findings suggest that income-related inequality in SRHS might have decreased in Chile after the healthcare reform. Beyond this observed difference over time, the remaining inequality is still largely due to illegitimate factors that should be tackled through broader policies in the country.