California’s uninsured population could double by 2030, according to a May 4 report from the state’s Legislative Analyst’s Office, which is responsible for nonpartisan fiscal and policy advising.
HR 1’s provisions — including work requirements and more frequent eligibility checks for Medicaid — are beginning to pick up steam. Nonpartisan research organization RAND estimated state Medicaid budgets would contract by $664 billion by 2034, as well.
Here are four notes from the report:
1. Currently, about 5% of Californians, or 2 million people, lack health insurance. While the Legislative Analyst’s Office believes eligibility changes will be the main culprit, people could also exit Covered California, the state’s ACA marketplace. Others could lose coverage due to immigration status. Some may remain in Medi-Cal but only with emergency coverage.
2. As healthier enrollees leave Covered California, individual premiums are expected to rise. Early data suggests the effect justified about one-fifth of gross premium growth (2 percentage points of a 10% increase) in 2026.
3. In 2024, uncompensated care was just over $2 billion. By 2030, that could balloon by billions of dollars due to disenrollments.
4. While hospitals overall could see margin reductions from 0.5 to a few percentage points, clinics could see a greater effect due to their smaller operating revenues and greater reliance on Medi-Cal reimbursement.
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