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California’s Future: Health Care

Shannon McConville | January 2018


California has seen dramatic declines in the number of uninsured residents since 2014, when major coverage expansions under the Affordable Care Act (ACA) were implemented. About 93 percent of Californians now have health insurance coverage, up from 82.5 percent in 2013; this translates to about 5 million fewer uninsured state residents. Medi-Cal, the state’s Medicaid program, is responsible for much of the coverage gain, while Covered California, the state’s insurance marketplace, continues to see robust enrollment.

The state’s expansion of health coverage faces an uncertain future. The president and congressional Republicans have pledged to dismantle the ACA and to fundamentally alter the Medicaid program. A rollback of federal funding would substantially reduce California’s ability to continue its current level of coverage. With federal policy still uncertain, the state has been exploring options for maintaining current coverage levels and expanding health insurance to all Californians. Recently, the legislature proposed a state single-payer health system as an option for achieving universal coverage. The plan lacks important details—including how it would be financed. There is support for such a plan, but opinions may shift once details on funding are introduced, particularly since there is a large partisan divide.

This publication is part of a briefing kit that highlights our state’s most pressing long-term policy challenges in 11 key areas:

We gratefully acknowledge the support of the PPIC Corporate Circle and the PPIC Donor Circle.

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