​​Annie Rak is a programmer/analyst at the UCLA Center for Health Policy Research. As the lead programmer on the California Simulation of Insurance Markets (CalSIM), Rak helps implement new model features, refines the methodology of existing model features, and helps calibrate the model to deliver estimates on health insurance outcomes in California. 

Rak has a bachelor's degree in applied math from Harvard College.

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CalSIM
Policy Brief
Policy Brief

California’s Uninsured in 2024: Medi-Cal Expands to All Low-Income Adults, But Half a Million Undocumented Californians Lack Affordable Coverage Options (UCLA Center for Health Policy Research and the UC Berkeley Labor Center)

Summary: California’s historic expansion of Medi-Cal eligibility to all low-income Californians regardless of immigration status is scheduled to go into effect in January of 2024, when low-income undocumented adults ages 26-49 will become eligible for full-scope Medi-Cal coverage. 

Findings: Authors project that after the new enrollment has taken place, California’s uninsured population will decrease to a record low of 2.57 million under age 65. This represents substantial progress in access to health insurance. Close to 1 million undocumented Californians will have gained access to Medi-Cal through the expansions to children, young adults, older adults, and now adults ages 26-49. However, they also project there will be 520,000 uninsured undocumented residents who earn too much for Medi-Cal and do not have employer coverage. This group remains categorically excluded from enrolling in Covered California and cannot receive federal subsidies to make coverage more affordable. 

This policy brief is a joint effort by the UCLA Center for Health Policy Research and the UC Berkeley Labor Center.

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The Threat to Coverage and Affordability Gains in Covered California if Congress Fails to Renew Subsidy Enhancements
Policy Brief
Policy Brief

The Threat to Coverage and Affordability Gains in Covered California if Congress Fails to Renew Subsidy Enhancements

​Summary: Since the enactment of the Affordable Care Act (ACA) in 2010, California has reduced the number of uninsured from 6.5 million in 2011 to a projected 2.99 million in 2023. This dramatic increase in the number of Californians with health insurance coverage was the result of policy choices at both the state and federal levels to not simply implement the ACA but to build on it, including through early implementation, expansion of Medi-Cal, and improvements in subsidies.

In response to the COVID-19 pandemic, Congress enacted the American Rescue Plan of 2021 to provide additional temporary financial help for buying health insurance through the Affordable Care Act Marketplaces; this help substantially improved affordability and increased enrollment in Covered California.

Findings: If these enhanced subsidies are not extended for 2023 and beyond and subsidies revert to ACA level, the authors project 220,000 fewer Californians will have individual market insurance in 2023 than if enhanced subsidies are extended, and premiums will be less affordable for more than two million individual market enrollees. California’s recent progress on coverage and affordability could be reversed unless Congress renews the subsidies or state policymakers fill in the gaps.
 

Read the Publication:

Health Coverage for Californians
Policy Brief
Policy Brief

California’s Biggest Coverage Expansion Since the ACA: Extending Medi-Cal to All Low-Income Adults

​Summary: Since the Affordable Care Act (ACA) was enacted in 2010, California has successfully implemented the law and built upon its provisions by extending affordable coverage to even more California residents. The proposal to expand Medi-Cal to all low-income residents ages 26 to 49 regardless of immigration status would cover close to 700,000 Californians and result in the largest decrease in the uninsured rate since the major insurance reforms in the ACA were implemented in 2014. This policy would also reduce disparities in the uninsured rate for undocumented residents and Latinos in the state, with the result that almost three-quarters of the undocumented population would be insured. But this policy alone does not fully close the gap of the remaining uninsured: 2.3 million Californians under age 65 (7.1%) would be uninsured by 2024, including nearly one out of four undocumented residents. This assumes enhanced federal subsidies through Covered California, made possible by the American Rescue Plan (ARP) Act, are also extended.
 

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American Rescue Plan Improvements to Covered California Affordability: Who Gains?
Research Report
Research Report

American Rescue Plan Improvements to Covered California Affordability: Who Gains?

Summary: The American Rescue Plan (ARP), a $1.9 trillion relief and recovery package passed last month, includes the first major federal improvements to the Affordable Care Act since it was passed over 10 years ago. The ARP substantially increases premium subsidies for coverage purchased through health insurance exchanges like Covered California.

Findings: Authors project that these subsidies will help over 1.6 million Californians, including 151,000 individual market enrollees who will qualify for subsidies for the first time and 135,000 uninsured people who will become insured. The benefits will be reversed, however, if the subsidies disappear in 2023 and are not made permanent. Despite the ARP’s substantial improvements in the affordability of coverage through Covered California, authors project that the state will still have 3.2 million uninsured Californians under age 65 in 2022, or approximately 9.5% of the population under age 65. (The authors' next blog post will focus on the Californians we project will be uninsured in 2022).

Read the Publication:

CalSIM
Policy Brief
Policy Brief

California’s Uninsured in 2024: Medi-Cal Expands to All Low-Income Adults, But Half a Million Undocumented Californians Lack Affordable Coverage Options (UCLA Center for Health Policy Research and the UC Berkeley Labor Center)

Summary: California’s historic expansion of Medi-Cal eligibility to all low-income Californians regardless of immigration status is scheduled to go into effect in January of 2024, when low-income undocumented adults ages 26-49 will become eligible for full-scope Medi-Cal coverage. 

Findings: Authors project that after the new enrollment has taken place, California’s uninsured population will decrease to a record low of 2.57 million under age 65. This represents substantial progress in access to health insurance. Close to 1 million undocumented Californians will have gained access to Medi-Cal through the expansions to children, young adults, older adults, and now adults ages 26-49. However, they also project there will be 520,000 uninsured undocumented residents who earn too much for Medi-Cal and do not have employer coverage. This group remains categorically excluded from enrolling in Covered California and cannot receive federal subsidies to make coverage more affordable. 

This policy brief is a joint effort by the UCLA Center for Health Policy Research and the UC Berkeley Labor Center.

Read the Publication:

View All Publications

The Threat to Coverage and Affordability Gains in Covered California if Congress Fails to Renew Subsidy Enhancements
Policy Brief
Policy Brief

The Threat to Coverage and Affordability Gains in Covered California if Congress Fails to Renew Subsidy Enhancements

​Summary: Since the enactment of the Affordable Care Act (ACA) in 2010, California has reduced the number of uninsured from 6.5 million in 2011 to a projected 2.99 million in 2023. This dramatic increase in the number of Californians with health insurance coverage was the result of policy choices at both the state and federal levels to not simply implement the ACA but to build on it, including through early implementation, expansion of Medi-Cal, and improvements in subsidies.

In response to the COVID-19 pandemic, Congress enacted the American Rescue Plan of 2021 to provide additional temporary financial help for buying health insurance through the Affordable Care Act Marketplaces; this help substantially improved affordability and increased enrollment in Covered California.

Findings: If these enhanced subsidies are not extended for 2023 and beyond and subsidies revert to ACA level, the authors project 220,000 fewer Californians will have individual market insurance in 2023 than if enhanced subsidies are extended, and premiums will be less affordable for more than two million individual market enrollees. California’s recent progress on coverage and affordability could be reversed unless Congress renews the subsidies or state policymakers fill in the gaps.
 

Read the Publication:

Health Coverage for Californians
Policy Brief
Policy Brief

California’s Biggest Coverage Expansion Since the ACA: Extending Medi-Cal to All Low-Income Adults

​Summary: Since the Affordable Care Act (ACA) was enacted in 2010, California has successfully implemented the law and built upon its provisions by extending affordable coverage to even more California residents. The proposal to expand Medi-Cal to all low-income residents ages 26 to 49 regardless of immigration status would cover close to 700,000 Californians and result in the largest decrease in the uninsured rate since the major insurance reforms in the ACA were implemented in 2014. This policy would also reduce disparities in the uninsured rate for undocumented residents and Latinos in the state, with the result that almost three-quarters of the undocumented population would be insured. But this policy alone does not fully close the gap of the remaining uninsured: 2.3 million Californians under age 65 (7.1%) would be uninsured by 2024, including nearly one out of four undocumented residents. This assumes enhanced federal subsidies through Covered California, made possible by the American Rescue Plan (ARP) Act, are also extended.
 

Read the Publications: