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The cost of health care expansion in California would be relatively minimal if the state decides to pursue it, according to a joint study by the UCLA Center for Health Policy Research and the UC Berkeley Center for Labor Research and Education.
The Affordable Care Act, commonly termed “Obamacare,” was signed into law March 23, 2012. It aims to lower the number of uninsured Americans through a number of mechanisms and federal funding implemented over the succeeding four years, and it has made it possible for California to expand Medi-Cal – a program that offers health care to low-income Californians – at a relatively low cost to the state.
Currently, counties pay for medical costs incurred by uninsured residents. Under the Affordable Care Act, the state would be responsible for providing coverage to uninsured residents. The joint study found that federal funding from the Affordable Care Act would cover at least 85 percent of the cost of the expansion, making the state’s share smaller.
The state is expected to pay between $188 and $453 million to the cost of Medi-Cal in 2014, though authors of the joint study expect the expansion will bring between $2.1 and $3.5 billion during the same time period in new federal funding to the state, according to UC Berkeley’s press release related to the joint report.
An additional 1.4 million Californians with household incomes of up to 138 percent of the federal poverty line, which varies depending on family size, would be covered by Medi-Cal through the expansion, according to UC Berkeley’s press release. Students from a low-income family could qualify for Medi-Cal, though they would not be able to get coverage through the UCLA health care system, said Dylan Roby, assistant professor of health policy and management at UCLA and co-author of the study. For a single adult without dependents, the poverty line is drawn at an annual income of $11,170. For a family of four people, the poverty line is drawn at an annual income of $23,050.
Los Angeles and other Southern California counties would benefit most from the expansion because they have more citizens who could benefit from an expanded Medi-Cal, Roby said.
With the expansion, the UCLA’s health care system would be largely unaffected because UCLA’s medical group is not a contracted provider in any of the Medi-Cal health maintenance organizations (HMOs) doing business in L.A. County. HMOs offer managed care for health care on a prepaid basis.
Other UCs, such as UC San Diego and UC Irvine, however, would be more impacted by changes in Medi-Cal, Roby said. In Irvine and San Diego, there are no public safety-net hospitals, so the local UC health care system often moves to fill that role, serving Medi-Cal HMOs, he said.
First-year molecular, cell and developmental biology student Genie Patra, an L.A. native, said she hopes the expansion occurs, though she would not qualify for Medi-Cal either way.
“L.A. could really stand to see more of its less-fortunate get health coverage,” she said. “If there’s not much extra cost for the state, I see no reason not to do it.”
But to go into effect, the expansion will have to pass through the state legislature, said Ross Brown, Medi-Cal specialist at the Legislative Analyst’s Office.
Based on his experience with the program, Brown said it is hard to predict whether an expansion will actually take place.
While the federal government has said it will supply funding for the next few years, there is a possibility it would pull out after a few years if the federal budget doesn’t allow for it, Roby said. In this case, the state may have to foot the bill instead, he said.
“It’s possible that the federal government could decide (to cut the program) and the state is left holding the bag,” Roby said.
Regardless of whether the state chooses to expand its health care programs, Roby said the coverage is already being paid for by counties.
“This care is already being delivered,” he said. “It’s just being delivered by the county, (not the state).”
Email Lemos at zlemos@media.ucla.edu.