Undocumented Immigrants

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%).

Many California policymakers have expressed a desire and commitment to resist federal sabotage of the ACA, control health care costs, and achieve universal health care coverage. As the state explores ways to fundamentally redesign our health care delivery system—including by adopting a single payer or other unified public financing approach—state policymakers are also considering near-term policies that do not require federal approval but address the immediate challenges of improving affordability and expanding coverage.

California made historic gains in health insurance coverage under the Affordable Care Act (ACA), but several million Californians remain uninsured and many struggle to afford individual market insurance.

Expanding Medi-Cal to all adults would reduce the number of uninsured in the state by up to one-quarter, potentially newly insuring more than one million Californians. This expansion could improve access to preventive and routine care and improve financial security for those who enroll, in addition to potentially improving worker productivity for those who become newly insured.

A new study by researchers at UC Berkeley and UCLA projects how changes to federal law that remove the Affordable Care Act (ACA) individual mandate penalty in 2019 could significantly impact California’s record-breaking health coverage gains.

We project that between 150,000 and 450,000 more Californians will be uninsured in 2020, growing to between 490,000 and 790,000 more uninsured in 2023, compared to the projected number if the ACA penalty had been maintained.

This report profiles three county programs that offer health care services to undocumented residents and aims to serve as a resource for designing and implementing similar programs elsewhere across the nation.

This data book provides estimates of the remaining uninsured in California in 2017 by Covered California rating region and for large counties using a preliminary version of the California Simulation of Insurance Markets (CalSIM) model v 2.0.

In California, the Supreme Court’s decision would not only clear the way for improved work opportunities and wages, reductions in child poverty, and greater peace of mind for families, but it also would expand access to comprehensive health insurance for many.

This brief examines the characteristics of the uninsured and the reasons for remaining uninsured among the undocumented who are ineligible for coverage under the ACA due to their immigration status, and the citizens and lawfully present immigrants who are eligible for coverage but did not enroll.