Health Care
Health policy
Uninsured
Miranda Dietz (she/her) is interim director of the health care program at the Labor Center. Her health care research focuses on health care affordability and coverage in California. Miranda’s work includes analysis of consumer affordability trends in California, the impact of the Affordable Care Act and Medi-Cal expansion in the state, and estimates of the uninsured. She serves as vice chair of the Data Release Committee for the state’s Health Payments Database. As project director for the California Simulation of Insurance Markets microsimulation model (CalSIM), developed jointly with the UCLA Center for Health Policy Research, she has modeled and analyzed the impacts of various policies on health insurance coverage in California. Miranda has also written on local enforcement of labor standards, low-wage airport workers, and temporary workers in California. She is co-editor with Michael Reich and Ken Jacobs of When Mandates Work: Raising Labor Standards at the Local Level. Miranda received a Master of Public Policy degree from UC Berkeley in 2012, and a bachelor’s degree in government from Harvard University.
California’s historic expansion of coverage to undocumented individuals has not only brought the state closer to universal coverage, but has also reduced racial disparities in health coverage. However, this progress is at risk due to a new state budget proposal that would curtail Medi-Cal benefits for certain immigrants, ahead of additional severe federal cuts to Medicaid being considered.
The onerous documentation needed with Medi-Cal work requirements would increase administrative costs and reduce enrollment and access to care, including for people who are already working or otherwise should be exempt.
This page provides the number and percentage of children and teens enrolled in Medi-Cal by county, congressional district, assembly district, and senate district, as of July 2024. These estimates reflect the district boundaries after the 2024 election
This page provides estimates of the number of individuals and percentage of population enrolled in Medi-Cal by county, congressional district, assembly district, and senate district, as of June 2024.
The Inflation Reduction Act of 2022 (IRA) included additional federal subsidies to make health insurance more affordable in the individual market, but these expire at the end of 2025. If Congress does not extend the expanded subsidies and levels revert to those in the original Affordable Care Act, all 2.37 million Californians in the individual market—including those not receiving subsidies—would face higher health insurance premiums and be forced to choose between more expensive coverage, less generous coverage, or forgoing coverage all together and going uninsured.
If cuts proposed by Republicans in Washington become law, millions of Californians could lose health care provided by Medi-Cal, according to an analysis by the UC Berkeley Labor Center. A cascade of economic damage would follow, touching every part of the state.
“Insurance premiums have been going up faster than wages over the last 20 years,” said Miranda Dietz. Rising hospital prices are largely to blame.
Temporary workers earn 18% less than non-temporary workers and are twice as likely to live in poverty and rely on social safety nets, according to Miranda Dietz, a researcher at the Center for Labor Research and Education at the University of California, Berkeley.
The Biden-era policies contributed to the lowest rate of uninsured U.S. residents in history. If they are allowed to expire next year, experts such as Miranda Dietz said they worry that health insurance costs and the rate of uninsured Americans will increase significantly.
“There are about half a million folks who are undocumented but earn too much for Medi-Cal, so they are uninsured,” Dietz said. “They’re also not part of DACA, because that program no longer accepts new applicants.”
“I think we know that health care is unaffordable, but to see how much that problem has gotten worse in 20 years is really something,” said Miranda Dietz, a policy research specialist at the UC Berkeley Labor Center and co-author of the report. “The costs are taking up more and more of a family’s budget.”
“It’s not just that everything is getting more expensive. It’s that health care in particular is eating up a bigger and bigger chunk of people’s budgets,” said Miranda Dietz.
Nearly 391,000 of those caught in the glitch would qualify for subsidies on Covered California, the state-based insurance exchange, noted health policy researcher Miranda Dietz of the UC Berkeley Labor Center. She worked with colleagues at the UCLA Center for Health Policy Research to examine the impact of the changes in IRS regulations prior to their approval.
According to estimates by UCLA and UC Berkeley, Altman said, almost half a million Californians have employer-sponsored coverage that is less affordable than what they will be able to obtain now on Covered California. An additional 87,000 Californians who could be helped by the new rule are uninsured today, and about 35,000 have policies that aren’t currently subsidized.
“It makes it so it’s very disheartening to take away these extra subsidies that have been really crucial in improving affordability for folks,” Miranda Dietz said.
