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.
Laurel Lucia is director of the Health Care program at the UC Berkeley Labor Center, where she has worked since 2009. Her research focuses on health coverage and cost trends in California, and policies to improve access to and affordability of health care for California workers and their families. Recent publications have examined the impact of rising health care costs for workers in California, policies to improve access to health insurance for California immigrants, shifts in health coverage during COVID-19, and the health coverage and economic impacts in California of the possible repeal of the Affordable Care Act.
She provides technical assistance to policymakers and stakeholders, and her work has been covered in the Los Angeles Times, the Atlantic, and National Public Radio. Previously, Laurel worked on issues affecting long term care workers during her time as a researcher/policy analyst for the Service Employees International Union (SEIU). She has served as an elected officer for two unions. Laurel received a Master of Public Policy degree from UC Berkeley and a bachelor’s degree in public policy from Stanford University.
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.
The Threat to Coverage and Affordability Gains in Covered California if Congress Fails to Renew Subsidy Enhancements
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.
Proposed Office of Health Care Affordability: An important step towards addressing the health care cost problem for California workers
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.
If the state pours more money into part-time faculty health plans, “unions and the districts may negotiate to improve the benefits currently offered,” said Laurel Lucia. Colleges that already offer health plans to part-time faculty “might reduce the premium amount that the worker is required to pay or they might reduce the amount that people have to pay out of pocket to access care.”
Two women’s stories suggest why California’s expansion of Medicaid to undocumented older adults is a big deal
Gov. Newsom’s proposed budget has proposed providing the final missing piece and the largest group remaining: all low-income adults ages 26 to 49, regardless of immigration status. That move would represent the state’s biggest coverage expansion since the Affordable Care Act’s implementation, and comprises about 670,000 people, Lucia said.
“Our health insurance system, which is primarily tied to employment, is not financed in a way that’s progressive,” said Laurel Lucia. “Low-wage workers who get coverage through their jobs pay a much higher percentage of their income than middle- and higher-income workers.”
Lack of access because of immigration status is just one piece of the remaining uninsured. Many other Californians forgo coverage despite being eligible, likely because of the cost. According to the UC Berkeley and UCLA study, 2 million uninsured people qualify for Medi-Cal, employer coverage or Covered California.
“Unfortunately, employers use this threat to discourage workers from going on strike or to push workers to end a strike before an adequate contract agreement has been reached,” says Laurel Lucia.
“We do have a challenge with staffing problems [in healthcare],” said Laurel Lucia, director of the healthcare program at the UC Berkeley Labor Center. “I don’t see how this is the solution. Removing labor protections and benefits for healthcare workers will be bad for both workers and patients.”
Laurel Lucia, director of the Health Care Program at UC Berkeley Labor Center, said she is also somewhat surprised that a health care company would move toward a two-tier wage system at this particular moment when workforce shortages make worker happiness and satisfaction especially important.
You may be able to stay on COBRA if you can afford the premiums, although keep in mind that there’s usually an 18-month limit to this option, said Laurel Lucia, director of the health-care program at the University of California Berkeley’s Center for Labor Research and Education.
The 6-month federal health insurance subsidy for jobless Americans is ending. Here’s what to do next
You may be able to stay on COBRA if you can afford the premiums, although keep in mind that there’s usually an 18-month limit to this option, said Laurel Lucia, director of the Health Care Program at the University of California Berkeley’s Center for Labor Research and Education.