Health Coverage

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California Workers' Rights: A Manual of Job Rights, Protections and Remedies

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Alexis Manzanillaand Laurel Lucia

Expanding Covered California for All by Ending Immigration Status-Based Exclusions

Blog post exploring the factors surrounding a proposal to expand Covered California to undocumented Californians by creating a “mirror marketplace.” This would give undocumented Californians, who are prevented by federal law from participating in Covered California, the ability to shop, compare, and enroll in health plans.

Laurel Lucia, Enrique Lopezlira, Ken Jacobsand Savannah Hunter

Proposed health care minimum wage increase: State costs would be offset by reduced reliance on the public safety net by health workers and their families

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.

Miranda Dietz, Srikanth Kadiyalaand Laurel Lucia

Extending Covered California subsidies to DACA recipients would fill coverage gap for 40,000 Californians

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.

Miranda Dietz, Laurel Lucia, Srikanth Kadiyala, Tynan Challenor, Annie Rak, Yupeng Chen, Menbere Haile, Dylan H. Robyand Gerald F. Kominski

California’s Uninsured in 2024: Medi-Cal expands to all low-income adults, but half a million undocumented Californians lack affordable coverage options

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.

Miranda Dietz, Tynan Challenorand Srikanth Kadiyala

Fact Sheet: Fixing the Family Glitch in California — Projections from the California Simulation of Insurance Markets

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.

Miranda Dietzand Laurel Lucia

What’s at Stake for California Health Care Affordability in the Inflation Reduction Act?

The Inflation Reduction Act (IRA) currently being considered by Congress would improve health care affordability for many Californians by addressing high and rising drug prices and by extending the improved premium affordability assistance to Covered California enrollees that began in 2021. The extension of federal premium assistance would also unlock additional state-financed affordability help to reduce how much Covered California enrollees pay out-of-pocket when they access care.

Laurel Lucia, Tynan Challenorand Miranda Dietz

How will Californians’ health coverage sources change when the public health emergency ends?

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.

Miranda Dietz, Laurel Lucia, Srikanth Kadiyala, Tynan Challenor, Annie Rak, Dylan H. Robyand Gerald F. Kominski

California’s biggest coverage expansion since the ACA: Extending Medi-Cal to all low-income adults

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.

Srikanth Kadiyala, Tynan Challenor, Annie Rak, Laurel Lucia, Dylan H. Roby, Gerald F. Kominskiand Miranda Dietz

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.

Miranda Dietz, Srikanth Kadiyala, Tynan Challenor, Annie Rak, Dylan H. Roby, Laurel Luciaand Gerald F. Kominski

American Rescue Plan Improvements to Covered California Affordability: Who Gains?

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.

Miranda Dietz, Laurel Lucia, Srikanth Kadiyala, Tynan Challenor, Annie Rak, Dylan H. Robyand Gerald F. Kominski

Undocumented Californians Projected to Remain the Largest Group of Uninsured in the State in 2022

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%).

Laurel Lucia

Modified Adjusted Gross Income under the Affordable Care Act – UPDATED WITH INFORMATION FOR COVID-19 POLICIES

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.

Laurel Lucia

California could lose 269,000 jobs if the ACA is overturned

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.