The American Health Care Act (AHCA) would significantly reduce federal funding for the Medicaid expansion, which is the extension of Medicaid eligibility to low-income adults under the Affordable Care Act (ACA). In California, this would result in a projected $10 billion annual increase in state General Fund spending by 2027 to maintain Medi-Cal expansion eligibility. If the state is unable to make up the lost federal funding, there would be severe coverage drops and healthcare funding losses, with 3.7 million fewer Californians enrolled in Medi-Cal by 2027. The AHCA would also cut federal funding for new enrollees in California by 40 percentage points beginning in 2020, with the state receiving a lower federal match for a growing share of enrollees each year.
