More than 3 million Californians stand to benefit from improved access to health insurance and lower premiums if California revises some health care policies, according to a study from the UC Berkeley Center for Labor Research and Education.
The study found that expanding existing programs and countering federal policies that make health insurance more expensive would help 1.7 million Californians sign up for health insurance and allow 2.3 million to pay less for their coverage. Approximately 400,000 Californians were counted in both groups, bringing the total number of people who benefit to 3.6 million.
Several of the proposals analyzed are hallmarks of Governor Gavin Newsom’s plans for California’s health insurance markets, while others are already making their way through the state legislature. The Desert Sun reported that 22 bills this year aim to make health care more affordable and accessible, as the Trump Administration rolls back some of parts of the Obama-era Affordable Care Act.
The Affordable Care Act originally gave states the authority to expand Medicaid — a federal/state health insurance program for low-income Americans — to nonelderly adults with incomes below 138% of the poverty level, or about $17,000. (Previously, Medicaid coverage was only available to low-income adults with dependent children or low-income elderly people in nursing homes). After California expanded Medi-Cal, the state’s Medicaid program, in 2013, the rate of uninsured Californians dropped by almost half — from 16.4% in 2013 to 8.7% in 2016, according to the Employee Benefit Research Institute.
But 2.9 million Californians remained uninsured, and the number is projected to rise to 4.4 million by 2023 if the state takes no further action to expand coverage. Population growth, higher premium costs and the Trump Administration’s elimination of the individual mandate penalty — which required uninsured people to get coverage or pay a fine — starting this year will drive up the total number of people without health insurance, the center estimated.
People without legal status in the United States are not eligible for coverage under the Affordable Care Act and face particular hurdles getting health insurance. California is one of a few states that provide Medi-Cal for undocumented minors, who lose the insurance once they turn 19.
The center estimated that if Medi-Cal were expanded to all low-income adults, regardless of immigration status, coupled with other changes to the health care system, the number of insured people would instead fall to 2.7 million by 2023. The center considered the combined impact of expansion, help with premiums and out-of-pocket costs and implementation of a statewide individual mandate to replace the federal one.
Newsom has proposed expanding Medi-Cal to undocumented adults up to age 26, as well as reinstating the individual mandate in California. Covering undocumented children and teens costs the state more than $360 million a year, and expanding coverage up to age 26 would add another $260 million, according to the Sacramento Bee.
Some state legislators are more ambitious. A bill introduced by State Sen. Maria Elena Durazo (D-Los Angeles) proposes expanding coverage to low-income people of all ages, with an estimated cost of almost $3 billion a year, according to Capital Public Radio. Advocates like California Insurance Commissioner Ricardo Lara say the expansion of coverage — and expected eventual drop in health insurance premiums — is worth the cost, according to the Sacramento Bee.
“It’s something that’s very personal to me,” Lara, who grew up without health insurance in East Los Angeles, told the Bee. “I knew this was an important issue because I lived it.”
Photo: The Los Angeles County Hospital is a large source of medical care for the city’s undocumented population. By Pablo De La Hoya.