The Affordable Care Act (ACA) has expanded Medi-Cal coverage to 3.7 million Californians and provided subsidies to another 1.2 million. However, the ACA could be repealed, which would put these coverage gains at risk. Further cuts to Medi-Cal could also be possible if Congress changes how the federal government funds Medicaid. These cuts could result in a one-third to one-half reduction in federal Medicaid spending over a ten-year period. The majority of Medi-Cal enrollees are in working families, with eight out of ten Medi-Cal enrollees in families with at least one worker. Workers in certain industries, including agriculture and parts of the service industry such as restaurants and retail, disproportionately enroll in ACA coverage. These industries also enroll in the overall Medi-Cal program at rates higher than the California workforce overall. If the ACA is repealed and federal funding cuts to Medicaid occur, workers in these industries and firms whose employees lose health insurance may be negatively impacted.
