CHA News Article

Report Projects 4.4 Million Californians Uninsured by 2023

new study by researchers at University of California, Berkeley and University of California, Los Angeles projects up to 4.4 million Californians could be uninsured in 2023 because of the federal law removing the Affordable care Act’s (ACA) individual mandate penalty beginning in 2019. 

Using the California Simulation of Insurance Markets (CalSIM) model developed by the UCLA Center for Health Policy Research and the UC Berkeley Labor Center, the report forecasts that the number of uninsured Californians will grow by between 150,000 and 450,000 in 2020, and by 490,000 to 790,000 more in 2023, compared to the projected number if the ACA penalty had been maintained. The most substantial enrollment changes will occur in the individual market, where projected enrollment is anticipated to decline by 10.1 percent in 2020 and 14.4 percent in 2023. 

Undocumented Californians will continue to make up the largest group of uninsured, and many other Californians who are eligible for coverage — including Medi-Cal, insurance through Covered California and employer coverage — will also lack insurance. Some Californians will not enroll in Medi-Cal despite being eligible because they are not aware of their eligibility, have difficulty enrolling or have other reasons for remaining unenrolled. Some individuals eligible for employer coverage or insurance through Covered California, with or without ACA subsidies, will not enroll due to affordability concerns, rising costs, lack of knowledge of subsidies or other reasons.

The authors suggest policies that could help California protect the progress the state made under the ACA in expanding health coverage, and to reduce the remaining gaps in coverage, including:

  • Expand Medi-Cal to all low-income residents regardless of their immigration status.
  • Provide state subsidies to make individual market premiums and out-of-pocket costs more affordable.
  • Implement a state individual mandate.
  • Continue to support and strengthen outreach and enrollment efforts.