Health Care Costs

The Labor Center’s research on health care costs analyzes the affordability of coverage and care for Californians enrolled in job-based coverage or Covered California, underlying health care cost trends, and the impact of potential solutions to control health care costs and improve affordability for California’s working families. This research includes a recent blog series Rising Health Care Costs in California: A Worker Issue.

Research & Publications
Miranda Dietzand Laurel Lucia

Measuring Consumer Affordability is Integral to Achieving the Goals of the California Office of Health Care Affordability

Consumer health care affordability has deteriorated over the past two decades in California due to rising premiums along with increasingly common and increasingly large deductibles for job-based coverage. This report documents these trends and their implications for Californian’s health and financial well-being, and recommends how California’s new Office of Health Care Affordability can monitor consumer affordability metrics in order to ensure that consumers benefit from the office’s efforts to control growth in per capita health care spending.

Laurel Lucia, Miranda Dietzand Tynan Challenor

What can we afford? Considerations for aligning Office of Health Care Affordability spending target with Californians’ ability to afford increases

The California Office of Health Care Affordability (OHCA) will establish statewide and sectoral health care spending targets with the goal of achieving a more sustainable per capita rate of spending growth on health care provided by a range of health care entities. This policy brief will discuss the various economic indicators that can be used in setting the statewide target.

Laurel Lucia

Many California family child care providers will now be better able to afford health care

This blog post outlines the assistance offered by the recently-established Child Care Providers United California Workers Health Care Fund, summarizes recent findings from a David Binder Research/ California Health Care Foundation survey that underscore the need for this new health care investment for family child care providers, and discusses how the program will improve affordability for providers and benefit California as a whole.

Miranda Dietzand Laurel Lucia

What’s at Stake for California Health Care Affordability in the Inflation Reduction Act?

The Inflation Reduction Act (IRA) currently being considered by Congress would improve health care affordability for many Californians by addressing high and rising drug prices and by extending the improved premium affordability assistance to Covered California enrollees that began in 2021. The extension of federal premium assistance would also unlock additional state-financed affordability help to reduce how much Covered California enrollees pay out-of-pocket when they access care.

Srikanth Kadiyala, Tynan Challenor, Annie Rak, Laurel Lucia, Dylan H. Roby, Gerald F. Kominskiand Miranda Dietz

The Threat to Coverage and Affordability Gains in Covered California if Congress Fails to Renew Subsidy Enhancements

In response to the COVID-19 pandemic, Congress enacted the American Rescue Plan of 2021 to provide additional temporary financial help for buying health insurance through the ACA Marketplaces. If these enhanced subsidies are not extended for 2023 and beyond, we project 220,000 fewer Californians would have individual market insurance in 2023 than if enhanced subsidies are extended, and premiums would be less affordable for more than two million individual market enrollees.

Miranda Dietz, Laurel Lucia, Srikanth Kadiyala, Tynan Challenor, Annie Rak, Dylan H. Robyand Gerald F. Kominski

Undocumented Californians Projected to Remain the Largest Group of Uninsured in the State in 2022

Even after the American Rescue Plan (ARP) substantially increases premium subsidies for health insurance coverage purchased through Covered California, large inequities remain in who has access to affordable coverage. Nearly 3.2 million Californians will remain uninsured in 2022, or about 9.5% of the population age 0-64, according to our projections. The highest uninsured rates will be among undocumented Californians (65%) and those eligible only for insurance through Covered California (28%).

Laurel Lucia, Xiao Chen, Dave Graham-Squire, Hanqing Yao, Petra W. Rasmussen, Greg Watson, Dylan H. Roby, Ken Jacobs, Srikanth Kadiyala, Gerald F. Kominskiand Miranda Dietz

California’s Steps to Expand Health Coverage and Improve Affordability: Who Gains and Who Will Be Uninsured?

In 2019, state lawmakers took steps to protect California’s coverage gains and increase affordability of coverage by instituting a state individual mandate penalty, providing additional subsidies for Covered California’s individual market enrollees, and expanding Medi-Cal to low-income undocumented young adults. California is the first state to include undocumented adults in full Medicaid benefits and the first to provide subsidies to middle-class consumers not eligible under the ACA.