Romney Win Could Significantly Change Health Reform in Calif.

If GOP presidential candidate Mitt Romney is elected and delivers on his promise to dismantle the Affordable Care Act, California residents enrolled in health care programs launched in anticipation of the ACA might be without coverage in 2014, Kaiser Health News reports.

Background

Each state runs a federally subsidized high-risk pool for individuals with pre-existing conditions. The pools expire in January 2014 because an ACA provision is set to take effect that allows those individuals to purchase health plans from private insurers through state-run health insurance exchanges (Varney, Kaiser Health News, 11/5).

California already has established a state health insurance exchange, called Covered California.

State officials estimate that about two million residents, many of whom are uninsured, will obtain insurance through the exchange beginning in 2014 (California Healthline, 6/29).

Implications of Romney Dismantling ACA

If Romney becomes president and dismantles the ACA, state residents with pre-existing conditions might not be able to obtain coverage through the exchange after the high-risk pools close, according to observers.

In addition, if Romney undoes the reform law, state residents participating in the Low Income Health Program -- developed by the state as a precursor to a Medi-Cal expansion under the ACA -- might not have access to the expanded program after LIHP is shut down in 2014. Medi-Cal is California's Medicaid program.

Comments

Anthony Wright -- executive director of Health Access California -- said, "It's the ballgame at stake," adding, "We go from the major reforms to a salvage operation" if Romney dismantles the ACA.

Peter Harbage -- a policy analyst and health issues advisor -- said, "The fundamental design of health reform in California was a layering of stuff," adding, "Phase one, phase two and phase three, and if one of the later phases doesn't materialize, then people could be left without insurance."

However, Michael Cousineau -- an associate professor of family medicine at the Keck School of Medicine at the University of Southern California and health care financing adviser -- said that Romney's support of states choosing their own health reforms could suggest that his administration still would allow California to expand its insurance programs.