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Future Uncertain for CA Healthcare Reform Under GOP

By Doug Desjardins  
   November 22, 2016

If the new administration were to water down segments of federal healthcare reform by revising Medicaid expansion and reducing or eliminating federal subsidies, it would have a major impact on California and its estimated 5.5 million newly insured residents.

Medi-Cal alone could lose $16 billion in federal funds, advocates say.

California healthcare policy experts say it is too early to tell what impact the policies of President-elect Donald Trump will have on the Affordable Care Act (ACA), but they agree the ACA is unlikely to remain intact.

Although Trump vowed to "repeal and replace" the ACA during his campaign, a wholesale repeal of the ACA is unlikely. Any legislation to do so would probably have to override a Democratic filibuster and would require 60 votes in a Senate that includes only 51 Republicans.

Therefore, policy experts expect the new administration to take a piecemeal approach to dismantling the Act by reducing federal funding for it.


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If the new administration were to water down segments of federal healthcare reform by revising Medicaid expansion and reducing or eliminating federal subsidies, it would have a major impact on California and its estimated 5.5 million newly insured residents.

"California is currently receiving $20 billion in federal funds each year for Medicaid expansion and federal subsidies," said Micah Weinberg, president of the Bay Area Council Economic Institute.

"That includes about $15 billion to $16 billion for Medicaid expansion and $4 billion to $5 billion in subsidies."

Proposals made by Trump and House Speaker Paul Ryan would dismantle many elements of healthcare reform, according to a policy brief from advocacy group Health Access California. "Dramatic rollbacks in healthcare and coverage are at the top of the agenda of both President-elect Trump and Speaker Paul Ryan, who has reiterated long-standing plans to cut Medicaid and Medicare," the brief stated.

Many of those changes, as well as repeal of many elements of the ACA, could be passed through budget reconciliation, which only requires 51 votes in the Senate, a majority of the House, and the President's signature, the brief noted.

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