Immigrants & Health

The Labor Center’s health care research has a focus on health care access for California immigrant families. Our research has shown that undocumented Californians make up the largest group of uninsured in the state. We have examined proposals to expand Medi-Cal to all low-income Californians regardless of immigration status and analyzed county programs that provide access to care for all. We have analyzed the impacts of the public charge rule on Californians’ health and hunger and the state economy. We have also examined the health care access needs and challenges for Californians with DACA.

Research & Publications
Miranda Dietz,Srikanth KadiyalaandLaurel Lucia

Extending Covered California subsidies to DACA recipients would fill coverage gap for 40,000 Californians

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.

Miranda Dietz,Laurel Lucia,Srikanth Kadiyala,Tynan Challenor,Annie Rak,Yupeng Chen,Menbere Haile,Dylan H. RobyandGerald F. Kominski

California’s Uninsured in 2024: Medi-Cal expands to all low-income adults, but half a million undocumented Californians lack affordable coverage options

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.

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

California’s biggest coverage expansion since the ACA: Extending Medi-Cal to all low-income adults

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.

Miranda Dietz,Laurel Lucia,Srikanth Kadiyala,Tynan Challenor,Annie Rak,Dylan H. RobyandGerald 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%).

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

Laurel Lucia

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

Expanding Medi-Cal to all adults would reduce the number of uninsured in the state by up to one-quarter, potentially newly insuring more than one million Californians. This expansion could improve access to preventive and routine care and improve financial security for those who enroll, in addition to potentially improving worker productivity for those who become newly insured.