Date of Graduation
Summer 8-9-2026
Document Access
Project/Capstone - Global access
Degree Name
Master of Public Health (MPH)
College/School
School of Nursing and Health Professions
Department/Program
Public Health
First Advisor
Kyle Knight
Abstract
Without structural policy intervention, approximately 4.6 million Californians remain at risk of being uninsured by 2030, worsening racial and ethnic health disparities and hospital uncompensated care burdens. This policy analysis advocates for a hybrid universal coverage model combining sliding-scale subsidies (California Senate Bill 78) with full-scope Medi-Cal expansion for all income-eligible residents regardless of legal status (California Assembly Bill 133). The framework relies on existing funding mechanisms, including the Managed Care Organization tax and the Health Care Affordability Reserve Fund. Comparative analysis indicates that market-only subsidies leave severe equity gaps, whereas immediate single-payer transitions pose substantial fiscal and administrative risks. A hybrid approach balances political feasibility, financial sustainability, and continuity of care. Projections show the policy prevents coverage loss for 2.2 million residents while safeguarding the state’s General Fund. Near-term tax adjustments are offset by reductions in uncompensated emergency care, higher workforce productivity, and stabilized hospital infrastructure across California’s 58 counties.
Recommended Citation
Castaneda Martinez, Guadalupe, "Bridging Fiscal Sustainability and Health Equity: A Policy Analysis of California’s Healthcare Coverage Safeguards" (2026). Master's Projects and Capstones. 2045.
https://repository.usfca.edu/capstone/2045
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