The California Simulation of Insurance Markets (CalSIM) model is a tool used to estimate the impact of various federal and state policies on employer decisions to offer health insurance coverage. The model projects that if California takes no action, the number of uninsured Californians is projected to increase to 4.4 million in 2023 due to the elimination of the individual mandate penalty and other factors. The model also projects that if California takes no action, the individual market is projected to be smaller and have a less healthy risk mix, resulting in higher premiums that would further reduce affordability. To address these challenges, California policymakers are considering near-term policies that do not require federal approval but aim to improve affordability and expand coverage. Some of the options being considered include a single payer or unified public financing approach.
