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

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.

Miranda Dietz, Laurel Lucia, Srikanth Kadiyala, Petra W. Rasmussen, Ken Jacobs, Dylan H. Roby, Dave Graham-Squire, Jason Zhang, Greg Watson, Xiao Chenand Gerald F. Kominski

3.6 Million Californians Would Benefit if California Takes Bold Action to Expand Coverage and Improve Affordability

Many California policymakers have expressed a desire and commitment to resist federal sabotage of the ACA, control health care costs, and achieve universal health care coverage. As the state explores ways to fundamentally redesign our health care delivery system—including by adopting a single payer or other unified public financing approach—state policymakers are also considering near-term policies that do not require federal approval but address the immediate challenges of improving affordability and expanding coverage.