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Which CA Residents Lose Insurance if Medicaid Expansion is Reversed?

News  |  By Doug Desjardins  
   February 15, 2017

Of the 3.7 million people who could lose coverage, most are low-income earners, young adults, part-time workers, or people of color.

This story originally appeared in California Healthfax.

Nearly 10% of California residents have gained insurance coverage under Medicaid expansion, and 3.7 million residents could lose coverage if Medicaid expansion is reversed under a repeal of the Affordable Care Act, according to a recent study.

The impact of an ACA repeal would vary by county, because some counties have benefited more than others under Medicaid expansion, stated researchers in the study, titled ACA Repeal in California: Who Stands to Lose?

A reversal of Medicaid expansion would disproportionately impact low-income earners, young adults, part-time workers, and people of color, according to the study, which was conducted by the University of California Berkeley Center for Labor Research and Education and the UCLA Center for Health Policy Research.

Medi-Cal Enrollment Tops 13.5 million

Of the 3.7 million people who gained coverage under Medicaid expansion,

  • 47% are employed.
  • 12% are either unemployed or actively looking for work.
  • 51% are between the ages of 19 and 39.

In addition, 42% of the enrollees are Hispanic. White people make up the next-largest group (29%) of people who gained coverage, followed by Asian/Pacific Islanders (20%) and African-Americans (9%).

Overall, 9.4% of the state's population enrolled for coverage through Medicaid expansion. The percentage of enrollees in the state's 58 counties ranged from 4.9% to 13.9%. Placer County had the lowest percentage of Medicaid expansion enrollees at 4.9%, followed by Marin County at 5.6%.

Rural Mendocino and Humboldt counties had the highest enrollment rate, at 13.9%, followed by Trinity County with 13.6%, the study found.

Some residents who gained coverage could remain insured through employer-sponsored plans or other programs if Medicaid expansion is repealed, but the majority would likely become uninsured.

CA Governor Vows To Protect State's Health Care

"Coverage would probably become unaffordable for most people," said Laurel Lucia, a healthcare program manager at the UC Berkeley Labor Center and a coauthor of the study.

Covered California by the Numbers
The study also broke down the percentage of state residents who gained coverage through subsidized plans on Covered California.

The study found that 3.1% of state residents—or 1.21 million—have purchased health plans on Covered California with the help of subsidies and the percentage per county ranged from 1.5% to 6.3%.

Lassen County and Kings County had the lowest percentage of residents receiving federal subsidies at 1.5%, and Mono County had the highest rate at 6.3%, followed by Nevada County at 6.2%, according to the study.

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