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California Could Lose Billions If The Affordable Care Act Is Overturned

The Supreme Court of the United States, pictured Aug. 3, 2017. (Liam James Doyle/NPR)
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The Supreme Court on Tuesday will take up a make-or-break challenge to the Affordable Care Act, better known as Obamacare. Texas and other conservative states have pursued the court case. California is leading a group of states defending the law.

Sacramento was an early and enthusiastic adopter of the ACA when it passed in 2010. If the law is overturned, the state will lose several billion dollars a year in federal health insurance subsidies.

UCLA health professor Steve Wallace said the state’s Medi-Cal expansion would also take a big hit.

“If [the ACA] is invalidated, the federal support for California’s [Medi-Cal] expansion would disappear,” he said.

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Governor Gavin Newsom estimates that would cost California $20 billion a year. A shrunken Medi-Cal program would hurt the poorest Californians.

“The state could pay for expansion but it would have to pay for 100% versus like 10%,” Wallace said.

If the ACA is fully struck down without a replacement, pre-existing conditions protections go away, and so do the state insurance marketplaces.

The Kaiser Family Foundation estimates one-quarter of non-elderly adults in California have a preexisting condition that would make them declinable for health insurance.

The Supreme Court is expected to issue its decision next year.

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