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.
This page provides the number and percentage of children and teens enrolled in Medi-Cal by county, congressional district, assembly district, and senate district, as of July 2024. These estimates reflect the district boundaries after the 2024 election
This page provides estimates of the number of individuals and percentage of population enrolled in Medi-Cal by county, congressional district, assembly district, and senate district, as of June 2024.
The Inflation Reduction Act of 2022 (IRA) included additional federal subsidies to make health insurance more affordable in the individual market, but these expire at the end of 2025. If Congress does not extend the expanded subsidies and levels revert to those in the original Affordable Care Act, all 2.37 million Californians in the individual market—including those not receiving subsidies—would face higher health insurance premiums and be forced to choose between more expensive coverage, less generous coverage, or forgoing coverage all together and going uninsured.
These comments were submitted to the California Office of Health Care Affordability (OHCA) in advance of the Board’s meeting in Monterey County on August 28, 2024. The comments describe the data and research showing that Monterey County has among the highest hospital prices in the state and country.
Blog post exploring the factors surrounding a proposal to expand Covered California to undocumented Californians by creating a “mirror marketplace.” This would give undocumented Californians, who are prevented by federal law from participating in Covered California, the ability to shop, compare, and enroll in health plans.
Comments submitted to the California Office of Health Care Affordability (OHCA) in response to the proposal of a 3.0% statewide health care spending growth target for 2025 to 2029.
In this brief we estimate the new costs to the state resulting from SB 525 as well as the savings it would generate through reductions in safety net program enrollment of affected workers and their family members.
In April, the Biden Administration announced a proposed rule that would allow an estimated 40,000 uninsured DACA recipients in California access to subsidized health coverage through Covered California. This fills an important gap in health coverage options, but it renders access to Covered California contingent on DACA status—which itself is at risk of being overturned by the courts.
California continues to make remarkable progress in expanding access to health coverage, including by expanding Medi-Cal eligibility for low-income undocumented residents. Yet, we project there will be 520,000 uninsured undocumented residents who earn too much for Medi-Cal and do not have employer coverage. This group remains categorically excluded from enrolling in Covered California and cannot receive federal subsidies to make coverage more affordable.
Labor Center research was used in a years-long campaign by health and immigrant advocates to bring health coverage to undocumented Californians.
Proposed federal regulations would fix the family glitch by extending subsidies to spouses and children offered unaffordable family coverage through an employer. The employee would still be excluded from subsidies if their cost for single coverage through their employer was affordable. We use the California Simulations of Insurance Markets (CalSIM) model to project for 2023 how many people would fall into the family glitch in California, how many would be newly eligible for a positive dollar subsidy, and how many would enroll in Covered California with subsidies under the family glitch fix.
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.
Comment submitted to the Internal Revenue Service on proposed regulation that would address the ACA “Family Glitch.”
The Medi-Cal redetermination process has been paused during the COVID public health emergency. As a result, many more individuals have newly enrolled in Medi-Cal than disenrolled, increasing Medi-Cal enrollment by almost 2 million since the beginning of the pandemic. This blog post summarizes (1) the available estimates of the potential reduction in Medi-Cal enrollment once the PHE is unwound and redeterminations have been completed, and (2) the likely eligibility for and enrollment in private coverage among those losing Medi-Cal.
California has the opportunity to expand Medi-Cal to all low-income Californians, regardless of immigration status or age. This policy would result in a massive increase in coverage, bringing close to 700,000 undocumented Californians into coverage and reducing the uninsured rate for residents under 65 to just 7.1%, the biggest single improvement since implementation of the ACA.
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.
This blog post focuses on one policy idea currently being considered by state policymakers to address rising health care costs – creating an Office of Health Care Affordability.
The American Rescue Plan substantially increases premium subsidies for coverage purchased through health insurance exchanges like Covered California. We project that these subsidies will help over 1.6 million Californians, including 151,000 individual market enrollees who will qualify for subsidies for the first time and 135,000 uninsured people who will become insured.
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%).
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.
