Most Californians under age 65 receive health coverage through their or a family member’s employer. Workers earning low wages, however, are far less likely to have job-based coverage, and more likely to be on Medi-Cal or uninsured. This creates a real public cost: California spends tens of billions in state and federal dollars covering low-wage workers through Medi-Cal. In the face of federal Medicaid cuts in H.R. 1, California must revisit the question of who bears responsibility for the health coverage of low-wage workers in a system that primarily relies on job-based coverage for working-age adults and their dependents. This brief examines the low-wage health coverage gap, its costs to the state, and possible policy options—drawing on lessons from other states—available to California lawmakers.

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