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Repealing the ACA Could Put Health Coverage of Nearly 5 Million Californians in Jeopardy

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By Hannah Guzik

If the federal Affordable Care Act is repealed, as some Republican lawmakers and President-elect Donald Trump have proposed, nearly 5 million Californians could lose health coverage, according to a new report.

In the last two years, the health law has enabled about 3.7 million California adults to enroll in the state’s low-income health program, known as Medi-Cal, and 1.2 million residents to receive subsidies to help them pay for insurance through Covered California. Repealing the health law could have a “devastating impact” on these groups, according to the December report from the UC Berkeley Center for Labor Research and Education and the UCLA Center for Health Policy Research.

In recent days, Trump and some Republican legislators have said that they want to repeal the health law and replace it with something else. It’s unclear whether the replacement would still provide funding for health coverage to adults under Medi-Cal or provide subsidies to those who purchase insurance on the state’s exchange.

Under the ACA, the number of uninsured residents in the state has decreased by almost half, from 6.5 million in 2013 to 3.3 million in 2015, according to the report. Since the majority of the health law’s provisions took effect in 2014, California has seen the largest decline in the uninsured rate of any state nationwide.

In addition, the state made progress on reducing health coverage disparities, according to the report. Demographic groups that were the least likely to have insurance before the health law — such as those with the lowest incomes, young adults, part-time workers and Latinos — have since made the biggest strides in securing insurance.

“Repealing the ACA threatens not only to leave millions without health insurance, but also to undo the progress California has made in reducing inequality of health insurance access,” the report states.

About 9.4 percent of the state’s population is enrolled in Medi-Cal thanks to the expansion under the ACA, according to the researchers.

Northern Californian counties and those in the Central and Imperial valleys have the largest percentages of residents who benefited from the Medi-Cal expansion. These counties include Humboldt, Mendocino, Fresno, Merced, Stanislaus and Imperial counties.

Meanwhile, as the most populous county in the state, Los Angeles County has by far the greatest number of Medi-Cal enrollees. There, more than 1.1 million adults have enrolled in Medi-Cal through the expansion.

“To put this in perspective,” the researchers wrote, “if Los Angeles County were its own state, it would have more newly eligible Medicaid enrollees than any state except the rest of California.”

This article appeared on the California Health Report website on Jan. 12, 2017. 

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