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coverage during COVID-19, and the health coverage and economic impacts in California had the Affordable Care Act been repealed.
She provides technical assistance to policymakers and stakeholders, and has served on consulting teams to Covered California, the California Department of Health Care Services, and the Healthy California for All Commission. In 2021, she was appointed by Governor Newsom to serve on the California Long Term Care Insurance Task Force.
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 three unions. Laurel received a Master of Public Policy degree from UC Berkeley and a bachelor’s degree in public policy from Stanford University.
Monterey County has some of the highest hospital costs in the state, and working families are struggling to pay their health care bills. To better understand why health care costs are so high in this Central Coast county, there is an urgent need to collect and analyze data that can help point to causes and solutions to the problem.
The California Office of Health Care Affordability (OHCA) will establish statewide and sectoral health care spending targets with the goal of achieving a more sustainable per capita rate of spending growth on health care provided by a range of health care entities. This policy brief will discuss the various economic indicators that can be used in setting the statewide target.
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.
“I think sessions like this are an important step towards educating voters about the impacts of a single-payer system,” said Laurel Lucia, director of the health care program at the UC Berkeley Labor Center and a member of the Healthy California For All Commission. “With a change as big as single-payer, there’s a lot of education needed.”
“This is one of the drawbacks of having a healthcare system that is tied to employment,” said Laurel Lucia, healthcare program director at the UC Berkeley Labor Center. “We saw during the pandemic, when there were furloughs or layoffs, people lost job-based coverage when they needed it most.”
“These dialysis initiatives have really been about regulating an industry that has a duopoly, high profit rates and well-documented patient safety concerns,” said Laurel Lucia, director of the Health Care program at the UC Berkeley Labor Center.
The state of California is ready with $304 million to help lower- and middle-income consumers pay for health insurance if federal subsidies end. But the fund will cover only a fraction of what would be lost. “We’re fortunate the state has the program, but it’s not enough,” said Laurel Lucia.
Much of the cost for increasing premiums has been swallowed by employers, but it gets passed down to employees anyway. When health costs increase, wages stagnate, said Laurel Lucia, director of health care at the UC Berkeley Labor Center.
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.”
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.
Medicaid, Affordable Care Act plans and special employer subsidies helped many who lost coverage, but “the pandemic has showed the risks of having health insurance tied to employment,” said Laurel Lucia.
