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Latinx and Asian Immigrants Across California Regions have Different Experiences with Law and Immigration Enforcement

November 8, 2021

Latinx and Asian immigrants, California's two largest immigrant groups, face barriers to health care and experience worse health outcomes compared to U.S.-born Californians. This is in part due in part to restrictive immigration policies that permit local law enforcement (e.g., police, sheriffs) to collaborate with immigration enforcement authorities in the surveillance, policing, and deportation of noncitizens.Authors used data from the Research on Immigrant Health and State Policy Study (RIGHTS) to examine Latinx and Asian immigrants' experiences with local law and federal immigration enforcement policies and practices in three California regions, Bay Area (n=305), Los Angeles and Southern California (n=989), and the San Joaquin Valley (n=141). The survey is a follow-up to the 2018 and 2019 California Health Interview Survey (CHIS). Respondents were asked if they had ever experienced any of six different encounters with surveillance, policing, or deportation by law enforcement, including local police, sheriffs, or immigration enforcement authorities.

Latinx and Asian Immigrants Have Negative Perceptions of the Immigrant Experience in California

November 8, 2021

Evidence indicates that there are disparities in immigrants' access to health care and health status compared to U.S.-born residents, in part due to immigration policies that determine access to public benefits or shape lives. This fact sheet examines data from the Research on Immigrant Health and State Policy Study (RIGHTS) on the perceptions of Latinx and Asian immigrants in California. RIGHTS is a follow-up survey of the 2018 and 2019 California Health Interview Surveys (CHIS). Respondents reported their perceptions of immigrants' experiences at the workplace, accessing health care, encountering law or immigration enforcement, and using public benefits.

Addressing Barriers to Breast Cancer Care in California: The 2016 - 2017 Landscape for Policy Change

February 1, 2018

In 2018, over 29,000 women will be diagnosed with breast cancer in California and an estimated 4,500 will die of the disease. While the Affordable Care Act (ACA) has successfully expanded access to health insurance and breast cancer care, numerous population subgroups remain uninsured, and many others may lack adequate coverage for treatment and management of their breast cancer. Although insurance improves breast cancer outcomes compared to those with no insurance, challenges may remain even for the insured. Among those insured, there appear to be significant barriers to cancer care as health insurance premiums are increasing, networks are narrowing, and as the cost of breast cancer drugs is increasing.This report provides a comprehensive assessment of the significant barriers and challenges to accessing breast cancer care in California through the  completion of three key tasks: (1) a synthesis of the peer reviewed literature, news media, reports and policy briefs, (2) completion of a series of key informant/stakeholder interviews, and (3) an analysis of social media. The authors find five categories of barriers: (1) Health System Barriers, (2) Insurance Barriers, (3) High Costs, (4) Individual and Cultural Characteristics, and (5) Language.Although many barriers are shared across insurance types, where possible, this report provides insight on barriers unique to the insurance status of women, specifically for the uninsured, those covered by Medi-Cal, and those covered by commercial insurance. Findings from this report can be used to guide efforts of policymakers to improve timely access to breast cancer care among all women in California.

Public Funds Account for  Over 70 Percent of Health Care  Spending in California

August 31, 2016

This policy brief examines public versus private health care expenditures in California.  The authors find that personal health care expenditures are estimated to total more than $367 billion in 2016 and that approximately 71 percent of these expenditures will be paid for with public funds (i.e., taxpayer dollars). This estimated contribution of public funds to health care expenditures is much higher than estimates that include only major health insurance programs such as Medicare and Medicaid. Several additional public funding sources also contribute to health care expenditures in the state, including government spending for public employee health benefits, tax subsidies for employer-sponsored insurance and the Affordable Care Act (ACA) insurance exchange, and county health care expenditures. As health care reform continues to take effect, it will be important to monitor the public versus private contributions to state health care expenditures to ensure that funds are being distributed both efficiently and equitably.

Preliminary Regional Remaining Uninsured 2017 Data Book, California Simulation of Insurance Markets (CalSIM) version 2.0

August 11, 2016

This data book provides estimates of the remaining uninsured in California in 2017 by Covered California rating region and for large counties using a preliminary version of the California Simulation of Insurance Markets (CalSIM) model v 2.0.

More than Half a Million Older Californians Fell Repeatedly in the Past Year

November 1, 2014

The capacity of Emergency Medical Service (EMS) providers is being shaped to address falls, and there is even universal design education.  There are tools, media toolkits, and online resources.  Nationally there is a Falls Prevention Awareness Day, and in California, there is fall prevention awareness week. The UCLA Center for Health Policy Research published a detailed health policy brief with policy suggestions to help reduce the risk of falls.

Ready for ACA? How Community Health Centers Are Preparing for Health Care Reform

May 15, 2014

Community health centers (CHCs) are a cornerstone of the health care safety net. They are the primary source of care for many low-income populations, including both those newly insured under the Affordable Care Act (ACA) and those who were left out and will remain uninsured. The ACA provides challenges and opportunities for CHCs, which will require significant changes in infrastructure and care delivery approaches to meet those challenges. This policy brief assesses the progress made by CHCs in Los Angeles County in meeting a number of key indicators of ACA readiness in early 2014. The authors find that 39 percent of CHCs are well prepared, 23 percent have made some progress, and the rest are at the initial phases of preparation and/or lack adequate resources to meet the requirements. CHCs in the latter group will require help to embark on strategic improvements in infrastructure and care delivery

Medi-Cal Expansion under the Affordable Care Act: Significant Increase in Coverage with Minimal Cost to the State

January 1, 2013

Since 2011, California has been taking steps towards expanding Medicaid under the Afordable Care Act (ACA) by implementing Low Income Health Programs (LIHPs) in most California counties. Under the "Bridge to Reform" Medicaid §1115 waiver, just over 500,000 California adults are currently enrolled in coverage in advance of ACA implementation using federal and county funds. he vast majority of these LIHP enrollees can become eligible for Medi-Cal coverage under the ACA beginning January 1, 2014, and the remainder will be eligible for subsidies through Covered California (the California Health Benefit Exchange).In early 2013, California legislators will consider bills to implement a key provision of the ACA that would expand Medi-Cal to low-income adults under age 65, including those without children living at home. Lawfully-present childless adults with income up to 138 percent of the Federal Poverty Level and parents with income between 106 percent and 138 percent of the Federal Poverty Level will be newly eligible. Some unenrolled children and parents who are already income-eligible for the program under existing eligibility rules could also enroll due to the minimum coverage requirement to obtain insurance created by the ACA, improved eligibility, enrollment and redetermination processes, and enhanced awareness of coverage options.In this report, we estimate the growth in Medi-Cal enrollment among both the newly and already eligible using the UC Berkeley-UCLA California Simulation of Insurance Markets (CalSIM) model. We discuss the broader impact of the Medi-Cal Expansion in terms of health outcomes, providers and the economy. We estimate the federal and state spending on increased Medi-Cal enrollment, along with the state tax revenues generated by new federal Medi-Cal spending and potential savings in other areas of the budget.

Achieving Equity by Building a Bridge From Eligible to Enrolled

February 28, 2012

Calls for multilingual outreach and enrollment efforts to enable Californians of color and those with limited English proficiency to benefit from the Health Benefit Exchange. Recommends targeting high-need groups and strengthening data collection.

The State of Health Insurance in California: Findings From the 2009 California Health Interview Survey

February 3, 2012

Analyzes sources of coverage and uninsurance rates by county, effects of declines in income and employer-sponsored insurance, disparities, access to and affordability of care, role of public insurance, and projected impact of federal healthcare reform.

Newly Insured Californians Would Fall by More than 1 Million Under the Affordable Care Act Without the Requirement to Purchase Insurance

January 11, 2012

Compares the estimated number and percentage of currently uninsured Californians who will be insured by 2019 under the Affordable Care Act with the individual mandate and without. Highlights the need for the mandate to ensure affordable coverage.

Proposed Regulations Could Limit Access to Affordable Health Coverage for Workers' Children and Family Members

December 12, 2011

Outlines implications of how the health reform law's premium subsidies apply if employer-sponsored self-only coverage is affordable but family coverage is not. Suggests basing family members' eligibility and affordability on additional cost to employee.