California has made significant progress in expanding health coverage and improving affordability through the implementation of the Affordable Care Act, resulting in a reduction of the uninsured population from 6.5 million in 2013 to 3.5 million in 2017. However, the elimination of the individual mandate penalty by Congress is projected to increase the uninsured by over half a million Californians. To protect these gains and increase affordability, California has implemented a state individual mandate penalty, provided additional subsidies for Covered California’s individual market enrollees, and expanded Medi-Cal to low-income undocumented young adults. These policies have been modeled using CalSIM, a micro-simulation model of insurance take up in California, and are projected to prevent 770,000 Californians from becoming uninsured and reduce premiums for 1.55 million Californians by 2022, benefiting a net total of 2.2 million Californians.
