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.

The California state government has close to a quarter of a million employees, almost half of whom are women and almost two-thirds of whom are workers of color. But across occupations and throughout the state, many state workers earn well below what is needed to attain a decent standard of living in California.

Proposed federal regulations would fix the family glitch by extending subsidies to spouses and children offered unaffordable family coverage through an employer. The employee would still be excluded from subsidies if their cost for single coverage through their employer was affordable. We use the California Simulations of Insurance Markets (CalSIM) model to project for 2023 how many people would fall into the family glitch in California, how many would be newly eligible for a positive dollar subsidy, and how many would enroll in Covered California with subsidies under the family glitch fix.

Comment submitted to the Internal Revenue Service on proposed regulation that would address the ACA “Family Glitch.”

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.