California hit a health coverage milestone — now 2.2 million could lose insurance

After years of Affordable Care Act and Medi-Cal expansion, California got close to universal health coverage, with about 95% of residents insured.

Researchers now warn that the state is moving in the opposite direction, and that millions could lose coverage within a few years, reported Bakersfield.com.

What's happening?

State and federal policy changes could leave 2.2 million Californians without insurance over the next four years, according to estimates from the UC Berkeley Labor Center and UCLA Center for Health Policy Research.

By 2030, those groups project the state's uninsured rate could approach 15%.

Some of the biggest losses are expected in Southern California, where immigrant and low-income communities make up a larger share of the population.

Researchers say undocumented residents and poorer Californians would be hit hardest overall, while uninsured rates among Black and Asian Californians could more than double.

"I knew it was going to be bad, but seeing that doubling was shocking to me," said Miranda Dietz, director of the labor center's healthcare program.

Next summer, California plans to impose monthly premiums and drop dental benefits for immigrants without legal status. It has already halted Medi-Cal enrollment for undocumented adults.

Why does it matter?

Health coverage is often the difference between getting preventive care early and facing a medical emergency later. For families living paycheck to paycheck, losing insurance can mean delaying doctor visits, skipping medication, or taking on debt.

Means said Medi-Cal still has shortcomings, but he sees it as far stronger than it was in 2008, when his wife, Kandi Hill, died of stage four cervical cancer after struggling to get proper care. For him, the issue is deeply personal.

"I truly believe if all this happened now, she'd have been fine," he said.

California had become a national example of how expanding coverage can reduce disparities and bring more people into regular care. Reversing that momentum could widen racial and economic gaps, particularly in communities already dealing with immigration fears, housing strain, and rising costs.

Many of the expected coverage losses may have little to do with whether people still qualify. New work-reporting rules and shorter eligibility windows could cause people to fall off insurance because of paperwork problems alone.

What's being done?

California once broadened Medi-Cal so that low-income undocumented adults and children could enroll, and the expansion eventually covered more than 1.6 million people. State officials say they are now trying to contain rapidly rising healthcare costs without cutting off more access than necessary.

Rather than scaling back Medi-Cal, some Democratic lawmakers want California to raise new revenue to support the program. Their push comes as benefits are being trimmed and advocates warn those cuts will ultimately harm families and communities.

As federal work requirements begin, health policy experts say even small administrative mistakes could strip eligible people of their coverage.

"All it takes is one piece of lost mail and all of a sudden you lose coverage … and things can snowball," said Dylan Roby, a health policy researcher and professor at UC Irvine.

"None of us want anything for free. I work two jobs. My kids go to school," Means said. "We're just asking for some dignity."

Orlando put it even more plainly: "We pay taxes every year. We deserve to have health insurance."

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