New Report: California’s Historic Health Coverage Gains at Risk Without State Action

Today, the UC Berkeley Labor Center and UCLA Center for Health Policy Research released a report titled “California’s Health Coverage Gains to Erode Without Further State Action” detailing the negative state-level impacts of the elimination of the Affordable Care Act’s (ACA) individual mandate.

Researchers find that because of the removal of the requirement to have health insurance, the uninsurance rate of people under age 65 could grow to 11.7% in 2020 (about 4 million people) and then to 12.9% in 2023 (or 4.4 million people), undoing the historic gains that California has made under the ACA. The largest groups of the remaining uninsured are undocumented Californians who are barred from accessing most health coverage options and Californians who struggle to afford their care.

California’s aggressive implementation and improvement of the ACA has led to the largest drop of the uninsured of all 50 states, but this progress is in peril without additional state action. California’s historic health coverage gains are at risk from federal efforts to undermine our health care system and undo key components and protections of the Affordable Care Act. Our state should take active steps to not just protect our progress but proceed down the path to universal coverage.

Many California legislators have already supported our proposals earlier this year that would provide greater affordability in Covered California and the individual insurance market, and remove barriers to Medi-Cal based on age, disability, or immigration status. Health Access supports reinstating the individual requirement to have coverage at the state level, as part of a broader package to also ensure coverage is more affordable. California policymakers should act on already-proposed legislation expanding Medi-Cal to all income-eligible Californians, regardless of immigration status. We were impressed this year with the bipartisan legislative support for increased affordability assistance in Covered California, much needed in our high cost-of living state.

While these proposals had lots of momentum in the legislature this year, this report puts in clear relief why these steps must be taken now. The report highlights the need for urgency to this agenda not just to get to universal coverage, but to prevent an increase in the uninsured rate after a historic drop. Without health coverage, more people will live sicker, die younger, and live one emergency away from financial ruin. It would be unconscionable to allow more Californians to lose coverage when there are tangible, achievable actions to prevent this backslide.

Protecting California’s health care will require bold leadership by our elected officials in the face of the constant attacks to our health system by Congress and the Trump Administration. Following an election season defined by health care, there is a clearly stated desire by the California electorate to not just keep us where we are, but to improve the system and make it work better for more people. We hope this report sets off alarm bells in the halls of the Capitol and spurs us all into action to protect our progress and expand health coverage further.