California ’s Coverage Expansion: Fiscal And Political Risks

Young people growing up in California lived under the dark shadow of the risk of a cataclysmic earthquake (also known as “The Big One”) that would destroy their homes and lives. Two significant earthquakes—the 1971 Sylmar quake in the Los Angeles’ suburban San Fernando Valley (6.6 on the Richter Scale) and the 1989 Loma Prieta quake (6.9 on the Richter Scale) in the southern mountains of the San Francisco Bay Area—killed dozens, reminding residents of nature’s frightening hidden power. But these quakes left the rest of California intact. So far, the Big One has not arrived. On May 4, 2017, with the passage of the Republicans’ American Health Care Act (AHCA) in the US House of Representatives, a sharp tremor was felt by California’s vast health system. The AHCA threatens withdrawal of at least $150 billion from the state’s health system over the next ten years, with the sharpest reductions felt from 2020 thru 2022. However, even if the House bill fails to become law, if history is any guide, California’s notoriously cyclical economy may not ultimately sustain the weight of the state’s expanded Medi-Cal program, posing future economic risks to its care system. Sheer Scale Of California’s Coverage Expansion California’s aggressive expansion of Medi-Cal and the state’s insurance exchange, Covered California, brought the state’s uninsured rate down by a full 10 percentage points, from more than 17 percent in 2013 to around 7 percent today. In ...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Costs and Spending Following the ACA Insurance and Coverage Payment Policy ACA repeal and replace American Health Care Act California Covered California Medi-Cal Source Type: blogs