Health care
What Trump wants: The president-elect wants Congress to repeal the Affordable Care Act immediately and offer a replacement plan “very quickly.” Neither he nor congressional Republicans have offered a clear vision for replacement legislation. Previous GOP proposals include halting federal dollars to expand state Medicaid, lifting the mandate to buy insurance, and ending subsidies that help people buy insurance on the health exchanges.
What California has: California is one of the most successful states in expanding health care coverage for its residents under the Affordable Care Act, and stands to lose the most if it is repealed. California has made more progress than other states in lowering the percentage of its population that is uninsured — from 17 percent to 9 percent between 2013 and 2015. The state’s Medicaid program, Medi-Cal, has added 3.8 million people since January 2014, and 1.4 million people are enrolled in health plans through Covered California, the state’s insurance marketplace.
What could happen: People with insurance through Covered California and Medi-Cal should not see their coverage disrupted in 2017. But what happens afterward remains unclear. “I don’t see Covered California being able to function without the federal money,” said Larry Levitt, senior vice president at the Kaiser Family Foundation. “The federal dollars in the ACA make coverage more affordable for people and bring healthy people into the market. So the federal dollars keep the market stable and have enabled people to get insurance through Covered California.” If Republicans end federal funding for Medicaid expansion, Medi-Cal could lose $17 billion, a sixth of the program’s $100 billion budget, health care advocates estimate.