Health Coverage

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The Labor Center’s health coverage research examines which Californians have which type of insurance, who is left out of our coverage system and why, and the affordability of insurance and care. We have analyzed these outcomes under current and proposed policies including the Affordable Care Act, state policies to expand coverage and improve affordability, and policies that threatened to erode coverage.

Research & Publications

April 2, 2020 -

Laurel Lucia

Modified Adjusted Gross Income under the Affordable Care Act – UPDATED WITH INFORMATION FOR COVID-19 POLICIES

Under the Affordable Care Act, eligibility for income-based Medicaid and subsidized health insurance through the Marketplaces is calculated using a household’s Modified Adjusted Gross Income (MAGI). The Affordable Care Act definition of MAGI under the Internal Revenue Code and federal Medicaid regulations is shown below.

February 20, 2020 -

Laurel Lucia

High Health Care Prices are the Primary Driver of California Workers’ Health Care Cost Problems

This is the eighth post in the Labor Center’s blog series “Rising Health Care Costs in California: A Worker Issue.”

January 29, 2020 -

Laurel Luciaand Ken Jacobs

Increases in health care costs are coming out of workers’ pockets one way or another: The tradeoff between employer premium contributions and wages

This is the seventh post in the Labor Center’s blog series “Rising Health Care Costs in California: A Worker Issue.”

December 18, 2019 -

Kevin Leeand Laurel Lucia

High out-of-pocket costs contribute to poor access to care and financial hardships for California workers

This is the sixth post in the Labor Center’s blog series “Rising Health Care Costs in California: A Worker Issue.” In our last post, we explored the challenges associated with…

December 12, 2019 -

Alex Matthewsand Laurel Lucia

Low-income workers and families struggle with premium contributions

This is the fifth post in the Labor Center’s blog series “Rising Health Care Costs in California: A Worker Issue.” As described in the last blog post, premiums for job-based…

December 3, 2019 -

Alex Matthews, Laurel Luciaand Dave Graham-Squire

Health care costs under job-based plans have grown rapidly, while wages remained flat

This is the fourth post in the Labor Center’s blog series “Rising Health Care Costs in California: A Worker Issue.” Over the last ten years, the cost of job-based health…

November 22, 2019 -

Kevin Lee, Laurel Lucia, Dave Graham-Squireand Miranda Dietz

Job-based coverage is less common among workers who are black or Latino, low-wage, immigrants, and young adults

This is the third post in the Labor Center’s blog series “Rising Health Care Costs in California: A Worker Issue.” Job-based coverage remains the most common form of health coverage…

November 19, 2019 -

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

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.

November 14, 2019 -

Kevin Lee, Laurel Luciaand Dave Graham-Squire

More than half of California adults have job-based coverage

This is the second post in the Labor Center’s blog series “Rising Health Care Costs in California: A Worker Issue.” While our blog series will primarily focus on Californians with…

November 14, 2019 -

Laurel Lucia

New blog post series on the problem of rising health care costs for California families with job-based coverage

This is the first post in the Labor Center’s blog series “Rising Health Care Costs in California: A Worker Issue.” California workers with job-based health coverage are feeling the pain…

July 15, 2019 -

Laurel Lucia

ACA Excise Tax Likely to Further Shift Health Costs to Workers

When enacted in 2010, the Affordable Care Act (ACA) included an excise tax on “high-cost” job-based health insurance—single plans with yearly premiums exceeding $10,200 and family plans with premiums exceeding…

June 21, 2019 -

Laurel Luciaand Ian Eve Perry

Comments on the Consumer Inflation Measures Produced by Federal Statistical Agencies

We urge you to not change the cost of living adjustment method for the OPM to Chained CPI-U, any other the other measures mentioned in the request for comment, or any other index that shows lower growth than the current CPI-U. Additionally, we urge you to include other issues apart from cost of living adjustments when considering any changes to the OPM.

June 11, 2019 -

Ian Eve Perry

Proposed Trump Administration Change to Federal Poverty Definition Would Cut Aid to Millions of Californians

In May, the Trump administration announced it was considering changing the way the federal poverty line is adjusted annually for increases in cost of living, and is seeking public comment…

April 25, 2019 -

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.

April 25, 2019 -

UC Berkeley Labor Center

RELEASE: 3.6 Million Californians to Benefit if State Takes Bold Action to Expand Coverage and Improve Affordability

California made historic gains in health insurance coverage under the Affordable Care Act (ACA), but several million Californians remain uninsured and many struggle to afford individual market insurance.

March 19, 2019 -

Laurel Lucia

More than 500,000 Californians estimated to be eligible for Medi-Cal but uninsured in 2016-2017

More than 90% of Californians eligible for Medi-Cal are now enrolled in the program. This exceeds the take-up rate for individual market coverage, and is similar to the take-up rates…

February 5, 2019 -

Laurel Lucia

Towards Universal Health Coverage: Expanding Medi-Cal to Low-Income Undocumented Adults

Undocumented adults are mostly left out of California’s health insurance system and make up the largest group of uninsured in the state. Low-income undocumented adults have an especially high uninsured…

December 10, 2018 -

Ninez Ponce, Laurel Luciaand Tia Shimada

Proposed Changes to Immigration Rules Would Cost California Jobs, Harm Public Health

Authors of the fact sheet report changes to “public charge” rules proposed by the U.S. Department of Homeland Security could lead to losses of up to $1.67 billion in federal benefits for California and even greater economic losses across the state.

November 27, 2018 -

UC Berkeley Labor Center

RELEASE: California’s Health Coverage Gains to Erode without Further State Action

A new study by researchers at UC Berkeley and UCLA projects how changes to federal law that remove the Affordable Care Act (ACA) individual mandate penalty in 2019 could significantly impact California’s record-breaking health coverage gains.

November 27, 2018 -

Miranda Dietz, Laurel Lucia, Dylan H. Roby, Ken Jacobs, Petra W. Rasmussen, Xiao Chen, Dave Graham-Squire, Greg Watson, Ian Eve Perryand Gerald F. Kominski

California’s Health Coverage Gains to Erode Without Further State Action

We project that between 150,000 and 450,000 more Californians will be uninsured in 2020, growing to between 490,000 and 790,000 more uninsured in 2023, compared to the projected number if the ACA penalty had been maintained.