A new brief by the UC Berkeley Labor Center and UCLA Center for Health Policy Research is the first of its kind to model the health coverage impacts of pending legislation in the California State Legislature. The report finds that under the current legislative and budget proposals 1.7 million Californians would be enrolled in coverage instead of being uninsured in 2023. In addition, it would lower health insurance costs by 35% for 2.3 million people enrolled in the individual market. They would either receive state assistance with health care costs or experience lower premiums. The largest group gaining coverage would be low-income undocumented adults who would become eligible for full-scope Medi-Cal coverage. The new report analyzes three policy proposals that, taken together, would benefit 3.6 million Californians:
- Expanding Medi-Cal to all income-eligible adults regardless of immigration status as proposed in AB 4 by Assemblymembers Bonta, Chiu, and Santiago, and SB 29 by Senator Durazo
- Providing greater affordability assistance to low- and middle-income Californians who purchase coverage in Covered California as proposed in SB 65 by Senator Pan and AB 174 by Assemblymember Wood
- Implementing a state-level individual mandate as proposed in SB 175 by Senator Pan and AB 414 by Assemblymember Bonta.
These proposals are also being discussed as state budget items. They are actively supported by the #Care4AllCA campaign of over 70 health, immigrant, labor, senior, children, LGBTQ, and community groups who are advocating for legislators and Governor Newsom to take these steps that could move our state closer to universal coverage, without the need for federal approvals. Governor Newsom has already included parts of each of these proposals in his first state budget.
Due to it’s aggressive implementation and improvement on the Affordable Care Act (ACA), California has seen the largest drop in uninsured of all 50 states, from 20% to nearly 7% uninsured (from 7 million to 3 million uninsured). Researchers of the new brief found that if the state takes no action, the number of uninsured Californians is projected to increase to 4.4 million in 2023. This is due to actions by the Trump Administration and Congress like the elimination of the individual mandate, as well as trends such as premium increases that makes health care increasingly unaffordable (especially in our high cost-of-living state) and wage increases that move people out of Medi-Cal eligibility windows.
While California made historic gains in health care coverage under the ACA, we must take additional steps to help those who struggle to access care due to exclusions or affordability barriers. California can counter the attacks by the Trump Administration to our health system, but also provide additional access and financial assistance for millions in California who find it hard to make ends meet in our high cost-of-living state.
If California does not counter these federal attacks, more people will become uninsured, living sicker, dying young, and being one emergency away from financial ruin. It would be a shame to allow more Californians to lose coverage when there are tangible, achievable actions to prevent this backslide and make our health system stronger for everyone. After a historic health care election, Governor Newsom and the Legislature have the opportunity to craft a state budget that includes a major down payment to increase health care access and affordability and ever closer towards the goal of universal coverage in California.