Medi-Cal

The ACA covered millions of people and reduced the racial and ethnic disparities in health coverage in California; to take away these coverage options especially during a global pandemic and recession would exacerbate racial and ethnic inequality in California.

The ACA expanded coverage options available to low-income Californians and unemployed workers; to take away those options during a global pandemic and recession would compound the hardships faced by low-income households.

Overturning the ACA would reduce annual federal funding to California by $28.8 billion in 2022, the year of focus for this analysis. Many Californians’ jobs are also at stake should the ACA be overturned. California would be projected to have 269,000 fewer jobs, $29.3 billion less in state GDP, and $2.2 billion less in state and local tax revenue, compared to if the ACA remains in effect.

Under the Affordable Care Act, eligibility for income-based Medicaid and subsidized health insurance through the Marketplaces is calculated using a household’s Modified Adjusted Gross Income (MAGI). The Affordable Care Act definition of MAGI under the Internal Revenue Code and federal Medicaid regulations is shown below.

In 2019, state lawmakers took steps to protect California’s coverage gains and increase affordability of coverage by instituting a state individual mandate penalty, providing additional subsidies for Covered California’s individual market enrollees, and expanding Medi-Cal to low-income undocumented young adults. California is the first state to include undocumented adults in full Medicaid benefits and the first to provide subsidies to middle-class consumers not eligible under the ACA.

This is the second post in the Labor Center’s blog series “Rising Health Care Costs in California: A Worker Issue.” While our blog series will primarily focus on Californians with…

We urge you to not change the cost of living adjustment method for the OPM to Chained CPI-U, any other the other measures mentioned in the request for comment, or any other index that shows lower growth than the current CPI-U. Additionally, we urge you to include other issues apart from cost of living adjustments when considering any changes to the OPM.

While this proposal may seem simply technical in nature, the harm in California would be very real. Over time, millions of Californians would lose eligibility for benefits or receive reduced benefits, and that reduced assistance would translate to hundreds of millions of fewer federal dollars flowing into the state’s economy.

Many California policymakers have expressed a desire and commitment to resist federal sabotage of the ACA, control health care costs, and achieve universal health care coverage. As the state explores ways to fundamentally redesign our health care delivery system—including by adopting a single payer or other unified public financing approach—state policymakers are also considering near-term policies that do not require federal approval but address the immediate challenges of improving affordability and expanding coverage.

California made historic gains in health insurance coverage under the Affordable Care Act (ACA), but several million Californians remain uninsured and many struggle to afford individual market insurance.