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ITUP Legislative Toolkit: Advancing Health Coverage in California

March 26, 2025

This toolkit provides a deep dive into the state of health coverage in California, equipping policymakers with the knowledge and strategies needed to reduce uninsured rates and expand access to care.

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ITUP Legislative Toolkit: Understanding Essential Health Benefits

February 26, 2025

EHBs ensure that all Covered California health plans provide a standardized level of care, protecting individuals and families from gaps in coverage.

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California Health Care Specialty Workforce Shortages Fact Sheet

January 3, 2025

This ITUP fact sheet explores the current state of California’s specialty health care workforce, highlighting critical gaps and opportunities within the system.

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Health Coverage at a Glance In California 2024

August 26, 2024

This ITUP Fact Sheet includes data on the race/ethnicity breakdown of employer-sponsored coverage, Covered California, and Medi-Cal, including enrollment by health plan in California.

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ITUP Blog: Key Highlights in California’s Final FY 2024 – 25 Budget Act

July 12, 2024

This ITUP blog summarizes the final FY 2024-25 Budget Act and is the third in ITUP’s Budget Blog series in addition to Governor’s Fiscal Year 2023-24 Budget Proposal and Governor’s FY 2024-25 Budget: Key Highlights in the May Revision

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2024 Regional Health Coverage Fact Sheets

July 9, 2024

The “Coverage at a Glance” fact sheets include health coverage data with race/ethnicity breakdown of counties and among the uninsured.

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ITUP Convenes Medi-Cal Redetermination Listening Sessions – Final Takeaways

March 28, 2024

Learn more about the Medi-Cal redetermination process and read local insights and additional opportunities to support Medi-Cal redetermination across the state.

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ITUP Blog: 2024 Introduced Legislation

March 14, 2024

This blog summarizes introduced legislation that proposes solutions relating to ITUP’s three priority policy issues: health care coverage and access, delivery system transformation, and the future of health.

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Making Medi-Cal Work for California Farmworkers

December 7, 2023

This issue brief spotlights three actionable ways, identified from work with farmworker advocates and stakeholders, policymakers can use to make the Medi-Cal system work for California farmworkers.

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Health Coverage at a Glance In California

October 23, 2023

This Health Coverage at a Glance in California includes data on the race/ethnicity breakdown of employer-sponsored coverage, Covered California, and Medi-Cal, including enrollment by health plan.

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Expanding Health Coverage for California Farmworkers

July 27, 2023

This issue brief emphasizes three actionable ways policymakers can expand access to coverage for farmworkers.

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ITUP Blog: Governor’s FY 2023-24 Budget: Key Highlights in the May Revision

June 7, 2023

This publication highlights key health and human services proposals in the FY 2023-24 May Revision.

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ITUP Blog: Key Highlights in the Governor’s FY 2022-23 May Revise

June 2, 2022

This ITUP publication highlights key health and human services proposals in the FY 2022-23 May Revision as well as proposals that improve health equity and address the social determinants of health.

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ITUP Blog: Governor’s FY 2022-23 Budget Proposal: Key Highlights

January 20, 2022

This blog highlights key health and human services proposals in the FY 2022-23 proposed budget as well as proposals that improve health equity and address the social determinants of health.

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Snapshot: Remaining Uninsured in California (2021 Update)

December 16, 2021

This ITUP Snapshot updates the profile of the state’s uninsured using 2020 data from the California Health Interview Survey (CHIS), and projections for 2022 from the California Simulation of Insurance Markets (CalSIM).

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2021 Regional Coverage Fact Sheets

April 15, 2021

Each year ITUP releases “Coverage at a Glance” regional health coverage fact sheets highlighting key coverage facts county-by-county in California. Find your local 2021 regional health coverage fact sheet here.

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ITUP Blog: California’s Final 2020-21 Budget

August 6, 2020

This ITUP blog summarizes the final 2020-2021 California State Budget and is the third in our Budget Blog series.

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Health Care Coverage Options During COVID-19

May 19, 2020

This ITUP Fact Sheet provides an overview of what the health coverage landscape looked like before COVID-19 and how the pandemic has impacted coverage access in California.

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Snapshot: Remaining Uninsured in California (Updated)

December 3, 2019

This ITUP Snapshot updates the profile of the state’s uninsured using 2018 data from the California Health Interview Survey (CHIS), and projections for 2022 from the California Simulation of Insurance Markets (CalSIM).

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Final Federal Rule on Immigrants and Public Charge Fact Sheet

August 14, 2019

The latest ITUP Fact Sheet review and summarize the final rule, existing federal law related to public charge and health care programs, and assess the potential impacts on immigrant access to health care programs in California.

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Public Charge & Health Care in California

August 14, 2019

On August 12, 2019, the U.S. Department of Homeland Security (USDHS) released the final rule on “public charge.” The latest ITUP Blog and Fact Sheet provide additional background on the final rule.

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Health Care Programs for California Immigrants (Updated)

July 19, 2019

This ITUP fact sheet reviews existing health care programs for immigrants in California. California generally provides better access to health care coverage for immigrants than most other states, including covering all children in Medi-Cal regardless of immigration status.

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2019 County Medically Indigent Care Programs

March 21, 2019

This version of ITUP Tracking provides an update to the ITUP 2017 Review of Medically Indigent Adult (MIA) programs administered by counties for low-income uninsured adults.

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ITUP Issues Comments on Public Charge

December 4, 2018

In comments addressed to the Department of Homeland Security (DHS), Insure the Uninsured Project (ITUP) expressed deep concern with the proposed rule on public charge and urged DHS to withdraw the proposal.

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New Projections Estimate the Uninsured will Rise in California

November 28, 2018

In the years since implementation of the Affordable Care Act California made steady progress in reducing the number of uninsured in the state. According to newly released projections, this pattern is unlikely to continue without state policy intervention.

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New Data Reveals that Racial/Ethnic Disparities in Health Coverage are Narrowing Under the Affordable Care Act

October 31, 2018

According to newly released California Health Interview Survey (CHIS) 2017 data, disparities in health care coverage across race and ethnic subgroups have narrowed with the implementation of the Affordable Care Act (ACA).

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UPDATE: California Strategies: Covering California’s Remaining Uninsured and Improving Affordability

October 8, 2018

This updated issue brief analyzes policy proposals advanced in 2018 to move the state closer to universal coverage by focusing on the challenges many Californians face.

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Proposed Federal Rule on Immigrants and Public Charge Fact Sheet

October 3, 2018

The ITUP fact sheet briefly describes existing federal law on public charge and health care programs, the proposed changes, and the impact on immigrants’ access to health care programs in California.

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Proposed Federal Rule on Immigrants and Public Charge

September 28, 2018

In late September 2018, the U.S. Department of Homeland Security released a proposed rule to change the factors affecting a “public charge” determination for immigrants to the U.S. The proposed rule represents a dramatic shift in immigration policy and could prevent many low-income immigrants from reuniting with their families in the U.S.

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California’s Uninsured Rate is 7.2 Percent, According to New Census Data

September 13, 2018

A new report from the U.S. Census Bureau shows California continued to make progress in reducing the number of uninsured in 2017. Census Bureau figures show that between 2016 and 2017, the number dropped by 47,000, leaving 2.8 million uninsured, or 7.2 percent of the population.

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California’s Health Care Safety Net

June 26, 2018

ITUP is pleased to release a new report, California’s Health Care Safety Net, the first in a new ITUP series, Health Policy Essentials, highlighting the basics on California health care programs and policy issues. This first issue brief focuses on the programs, providers and populations that make-up the state’s health care safety net for low-income and underserved communities.

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California Strategies: Covering California’s Remaining Uninsured and Improving Affordability

June 7, 2018

This issue brief analyzes policy proposals advanced this year to move the state closer to universal coverage by focusing on the challenges many Californians face.

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Remaining Uninsured in California (Revised and Updated, April 2018)

April 27, 2018

California fully embraced the federal Affordable Care Act (ACA) with dramatic results. California’s uninsured rate is
currently at just 7 percent overall and 8.1 percent among those under 65 years old. In the years prior to the ACA,
California’s uninsured rate hovered between 16 and 19 percent.

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Exploring Public Options in California

March 20, 2018

This ITUP report looks at public plan choice, the “public option,” through a California lens. ITUP identifies the unique circumstances in California relevant for the discussion about public options and outlines how a California public option might be structured.

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Notes from the Field: Immigrant Communities in California Under the Cloud of Immigration Enforcement

February 14, 2018

In 2017, ITUP hosted annual workgroups throughout California, 10 regional workgroups and two collaboratives in Los Angeles. This report includes background on the legal complexities at the intersection of immigration policy and health access, and highlights key themes from the workgroup discussions.

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Health Care Reform: 2017 Year-In-Review

January 7, 2018

Because California embraced the opportunities available under the Affordable Care Act (ACA), 2017 began and ended with California reaching historic low rates of uninsured. The timeline below reviews notable health reform events for 2017 and includes links to source documents and related ITUP publications.

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California Department of Health Care Services Confirms Graham-Cassidy Legislation Would Be Devastating for Health Care in California

September 25, 2017

On September 22, 2017, the California Department of Health Care Services (DHCS) released a fiscal analysis of pending Affordable Care Act (ACA) repeal legislation authored by U.S. Senators Graham, Cassidy, Heller and Johnson (Graham-Cassidy).

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Fact Sheet November 2017 – Remaining Uninsured in California

September 13, 2017

California benefited more than most states from the Affordable Care Act (ACA) because California fully embraced the ACA opportunities to expand coverage and streamline enrollment and retention processes. This also means that California has the most at stake in federal efforts to repeal or rollback the ACA coverage expansions. In the years preceding the ACA, […]

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ACA Stands (for Now): Takeaways from the Repeal and Replace Roller Coaster

July 28, 2017

For now, the ACA remains. Credit goes to all the community voices, advocates, and experts who kept the pressure on elected officials and continued to call out the very real threats the proposals represented. Here for consideration are some takeaways from the admittedly chaotic “repeal and replace” process.

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The Common Theme of Pending Senate Health Reform Bills? Dramatic Increases in the Number of Uninsured

July 23, 2017

As of this writing, multiple discussion drafts of potential legislation to repeal or rollback the federal Affordable Care Act (ACA) are pending in the U.S. Senate. All the bills result in dramatic increases in the number of uninsured over the next ten years.

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State Medicaid Agency Finds Staggering Losses for California Under U.S. Senate Bill

June 29, 2017

The magnitude of the state funding gap created by the BCRA threatens every part of the Medi-Cal program – provider payments, eligibility and benefits. The bill threatens California’s progress in reducing the uninsured and improving the health of Californians.

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U.S. Senate Discussion Draft Continues Path to Increasing the Uninsured

June 23, 2017

On June 22, 2017, Senate Republicans released a discussion draft of legislation that would undo key provisions of the ACA. The BCRA would slow the timeline for some changes to ACA, but includes deeper cuts to Medicaid.

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Meeting the Health Needs of the Immigrant Community In Uncertain Times

June 14, 2017

This fact sheet provides information on California’s immigrant community, the barriers they face to access health care, and California policies promoting access and/or coverage for all residents, regardless of immigration status.

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California Budget Conference Committee Considers Coverage Expansion for Young Adults

June 5, 2017

While federal policymakers consider legislation that would eliminate coverage for 23 million Americans, California considers expanding Medi-Cal to all low-income California residents up to age 26   Late last week, the two-house budget conference committee of the California Legislature began deliberations on the 2017-2018 state budget. The conference committee will take up multiple budget items […]

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CBO Confirms Devastating Consequences of the House-passed American Health Care Act

May 25, 2017

On May 24, 2017, the Congressional Budget Office (CBO) released an updated cost estimate for the American Health Care Act passed by the U.S. House of Representatives on May 4, 2017, adjusting their analysis for last minute amendments to H.R. 1628. (See ITUP summary of AHCA here.) The March 23, 2017 CBO analysis of a previous […]

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Summary of President Trump’s Proposed Fiscal Year 2018 Budget Plan

May 24, 2017

On May 23, 2017, the Trump Administration released its proposed federal fiscal year (FFY) 2018 budget plan which relies on draconian cuts to the safety-net to increase spending for the military, border security, tax reform and infrastructure.

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California Moves to Protect ACA Consumer Cost-sharing Reductions (CSRs)

May 23, 2017

On May 18, 2017, California and New York led 13 other states and the District of Columbia in filing a motion to intervene in the federal lawsuit affecting payments that reduce out-of-pocket costs for low income individuals enrolled in Affordable Care Act (ACA) marketplaces. Under ACA, individuals and families with incomes below 250 percent of […]

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U.S. House of Representatives Passes Bill that Will Lead to Millions of Uninsured

May 5, 2017

On May 4, 2017, the United States (U.S.) House of Representatives passed a budget resolution, the American Health Care Act (AHCA) (H.R. 1628), as amended. AHCA passed on a party line vote, 217-213. The AHCA is intended to deliver on the Republican pledge to “repeal and replace” the ACA. Last minute amendments added funding for […]

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