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.
Dylan H. Roby
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%).
A Little Investment Goes a Long Way: Modest Cost to Expand Preventive and Routine Health Services to All Low-Income Californians
The California legislature is considering a proposal (Senate Bill 1005, the Health for All Act) that would expand Medi-Cal coverage to include primary and preventive care, prescription drugs, mental health care, dental care, and other routine health services for all low-income California residents regardless of immigration status. This brief finds that the proposed Medi-Cal expansion would involve new state spending, but the cost is modest in comparison to the impact on health and coverage, and the policy also produces savings.
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.
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.