13.5 million Californians are covered by Medi-Cal. Here's how Trump's plan could cost the state

A long with his vow to repeal Obamacare, President-elect Donald Trump has promised to restructure Medicaid, the nation’s low-income health program — a move that could be acutely felt in California, where 1 in 3 residents receive health coverage through the state version, experts say.

Medi-Cal enrollment surged by 5 million over the last three years to a total of 13.5 million under President Obama’s Affordable Care Act.

Some of those Californians could lose portions of their benefits or possibly be dropped from coverage altogether if Trump carries out his plan, which would likely cost the state billions. Even residents who relied on the program long before the current expansion could be affected.

Under the Affordable Care Act, the federal government offered states money to let more people into their Medicaid programs, which are jointly funded by state and federal governments. California is one of 31 states that took the deal, prompting the Medi-Cal enrollment surge over the last three years.

Now anyone in California can sign up if their annual income is low enough: $16,395 or less for a single person or $22,108 or less for a couple. Medi-Cal is free for participants.

Experts say that an immediate repeal of the Affordable Care Act is unlikely and that Congress will probably slowly dismantle the law while devising replacement plans. California would lose $15.3 billion in federal funding if the Medicaid expansion is fully undone, according to the state’s Legislative Analyst’s Office.

The Medicaid program in general, which now covers 73 million Americans, has been criticized for being unsustainable and inefficient, with an annual price tag of more than $500 billion and growing. Medi-Cal alone is a $90-billion program, with roughly 65% of that cost shouldered by the federal government.

Under the current funding model for Medicaid, the federal government reimburses states for their programs’ expenses regardless of how big they are. President Johnson created the program in 1965 with this flexible funding model so it could serve as a safety net that could accommodate periods of greater need, such as during economic downturns.

Trump and his pick for secretary of Health and Human Services, Rep. Tom Price (R-Ga.), have said they want to limit spending by giving states a fixed amount of money each year. States will then have an incentive to eliminate fraud, waste and abuse, according to Trump’s website. - Read More, latimes

13.5 million Californians are covered by Medi-Cal. Here's how Trump's plan could cost the state

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