Health Care

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.

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%).

Under the Affordable Care Act, eligibility for income-based Medicaid and subsidized health insurance through the Marketplaces is calculated using a household’s Modified Adjusted Gross Income (MAGI). The Affordable Care Act definition of MAGI under the Internal Revenue Code and federal Medicaid regulations is shown below.

Testimony from Assembly hearing on California’s current health care system.

The ACA covered millions of people and reduced the racial and ethnic disparities in health coverage in California; to take away these coverage options especially during a global pandemic and recession would exacerbate racial and ethnic inequality in California.

The ACA expanded coverage options available to low-income Californians and unemployed workers; to take away those options during a global pandemic and recession would compound the hardships faced by low-income households.

Overturning the ACA would reduce annual federal funding to California by $28.8 billion in 2022, the year of focus for this analysis. Many Californians’ jobs are also at stake should the ACA be overturned. California would be projected to have 269,000 fewer jobs, $29.3 billion less in state GDP, and $2.2 billion less in state and local tax revenue, compared to if the ACA remains in effect.

This fact sheet highlights the key health coverage gains made in California under the state’s robust implementation of the ACA since it was enacted over 10 years ago. These achievements show how much is at stake in California v. Texas, the case the Supreme Court is scheduled to hear on November 10, 2020, under which the ACA could be overturned.

The COVID-19 pandemic has exposed tragic shortcomings in California’s preparedness for infrequent but catastrophic public health threats. This failure has caused serious health consequences—in addition to being financially myopic. One specific type of prevention investment that is widely recognized to be crucial is the stockpiling of personal protective equipment (PPE) for essential workers.

This report examines the costs and benefits of an innovative LA County proposal to recruit frontline workers in the fight against COVID-19 transmission. The proposal requires businesses to permit employees to form public safety councils who meet with management to plan and troubleshoot compliance and report regularly to the DPH.