Insurance Commissioner Ricardo Lara has initiated a study to assess the fiscal and economic effects of expanding Medi-Cal and Covered California health coverage to undocumented residents. The California Department of Insurance selected the School of Public Health at San Diego State University (SDSU) to conduct this analysis.
The study will examine financial impacts related to the expansions, including costs, healthcare service utilization, changes in insurance coverage, labor market participation, and broader effects on state and local economies. According to Commissioner Lara, “In an era of constant misinformation, it is imperative to provide data rooted in rigorous, independent analysis rather than politics or partisanship. By partnering with one of our leading public research universities, this independent study will be vital for fiscal decision-making in Sacramento, especially as vulnerable communities often face cuts during budget crises. Rather than avoiding this issue, I want to confront it directly with real answers, not rhetoric, to guide policymakers and the next governor with factual data for informed decision-making.”
SDSU’s School of Public Health was chosen due to its recognized expertise in public health policy and economic modeling. The institution has a history of translating research into actionable recommendations that benefit both California and other regions.
Wilton Choi, assistant professor of health economics at SDSU and principal investigator for the project, stated: “This study offers an important opportunity to understand how California’s expanded access to care has shaped the lives of residents and the state’s health system. Our goal is to provide a clear, evidence-based picture that can help inform future decisions and policy discussions at the legislative level.”
The research team plans to use advanced tools such as tax simulation models and economic impact analyses—resources typically unavailable within state budget offices—to produce a detailed assessment beyond basic cost estimates.
This marks the first comprehensive evaluation focused on Medi-Cal expansion regardless of immigration status since phased implementation began in 2016. The results are expected by 2027 and aim to inform policymakers with neutral data regarding healthcare access decisions in California.
The Department of Insurance continues its role as consumer protection agency for California’s insurance marketplace by regulating industry practices and safeguarding consumers from unfair rates or discrimination.
