The Affordable Care Act (ACA) has had a significant impact on health coverage in California, with 3.7 million adults enrolling in Medi-Cal expansion and 1.2 million Californians enrolling in subsidized insurance through Covered California. The ACA has also helped to reduce the state's uninsurance rate from 17.2% in 2013 to 8.6% in 2015. However, repealing the ACA could leave millions without health insurance and cost the state economy $20.3 billion in GDP. In Fresno County, 116,746 low-income adults who are enrolled in the ACA Medi-Cal expansion would lose their health insurance, equivalent to 12.0% of the county population. Additionally, 21,840 low- and middle-income residents would lose federal subsidies to help make private insurance purchased through Covered California more affordable. The county's uninsurance rate fell by 45% under the ACA, from 17.9% in 2013 to 9.8% in 2015. Repealing the ACA could also result in the loss of approximately 6,000 jobs in healthcare and other industries and $516 million in GDP from the county economy.
