As a result of federal and state policy decisions made in 2025, authors project that 4.6 million Californians under age 65 will be uninsured by 2030 — an increase of 2.2 million — and the uninsured rate will nearly double to 14.7%. This will erode much of the progress California has made since the Affordable Care Act and subsequent state actions to move closer to universal coverage. It will also widen disparities in health care coverage, particularly for low-income, Latino, and undocumented Californians, who already face higher-than-average uninsured rates.

This report, which uses estimates from the California Simulation of Insurance Markets (CalSIM), features Srikanth Kadiyala, a senior economist at the UCLA Center for Health Policy Research, and Dylan H. Roby, an affiliate at the UCLA Center for Health Policy Research.