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SACRAMENTO\u00a0\u2014\u00a0The federal safety-net healthcare system for low-income and disabled Americans, Medicaid, won\u2019t be the only medical coverage devastated by the package of spending cuts and tax breaks signed into law by President Trump on the Fourth of July.<\/a> <\/p>\n Covered California, the state\u2019s Affordable Care Act health insurance marketplace, estimates that as many as 660,000 of the roughly 2 million people in the program will either be stripped of coverage or drop out due to increased cost and the onerous new mandates to stay enrolled. Those who do stay could be hit with an average monthly premium increase of up to 66%.<\/p>\n This is Phil Willon, the L.A. Times California politics editor, filling in for columnist George Skelton this week.<\/p>\n To find out more about how the millions of Californians who rely on Covered California for health insurance will be affected by Trump\u2019s megabill, I spoke with Jessica Altman, the organization\u2019s executive director.<\/p>\n We spoke on Thursday, while the Republican-led U.S. House of Representatives was voting to approve the reconciliation legislation. According to estimates by the nonpartisan Congressional Budget Office,<\/a> the package will lead to 11.8 million more people going without health insurance nationwide over the next decade. <\/p>\n Price increase imminent<\/p>\n Covered California<\/a> serves as a marketplace exchange for state residents seeking healthcare insurance under the federal Affordable Care Act, widely known as Obamacare, allowing them to select from name-brand insurance providers and choose from a variety of coverage plans. <\/p>\n \u201cA quarter of the people we cover are sole proprietors. That\u2019s everything from mom-and-pop Etsy shops to a consultant, a highly educated tech worker in San Francisco doing contract work. We really have that full spectrum,\u201d Altman said.<\/p>\n Covered California also serves as a health insurance sanctuary for residents whose income rises enough for them to lose eligiblity for Medi-Cal, as Medicaid is known in California, or those who work for companies that don\u2019t provide benefits. <\/p>\n The current cost for basic coverage ranges from $0 a month for individuals earning around $21,000 \u2014 just above the income eligibility for Medi-Cal \u2014 to 8.5% of the income of people making $75,000 or more, Altman said.<\/p>\n The vast majority of Californians receive federal subsidies to lower their premiums<\/a>, including many middle-income families<\/a> who had become eligible when Congress expanded the financial assistance in 2021.<\/p>\n Those subsidies were not renewed in the Trump megabill. In theory, the Republican-led Congress could remedy that before the end of the year but, given that Trump spent most of his first term in office trying to repeal the Affordable Care Act, the odds of that appear slim.<\/p>\n \u201cWe have many, many people paying less than $10 a month for their health insurance. We\u2019re going to lose that price for sure,\u201d Altman said. \u201cWe also have people, that person making $75,000 a year \u2026 they\u2019re going to lose all of their tax credits and potentially pay hundreds more a month.\u201d<\/p>\n And that price increase will start to hit home in four months, when Covered California\u2019s open enrollment signup period begins for 2026.<\/p>\n Thousands of Californians will drop their coverage because they can no longer afford the expense, Altman predicts.<\/p>\n \u201cThis is a moment where Americans and Californians are so financially strained: Their rent, their food, their gas, their child care, all of their transportation, all of these things,\u201d Altman said. \u201cThey are not in a position today where they feel like any of those costs can rise by 66%.\u201d<\/p>\n Altman said the governor and California Legislature budgeted an additional $190 million for Covered California, which hopefully will help reduce the number of residents who will lose their healthcare coverage. But, she said, it\u2019s nowhere near enough to make up for the federal cuts. <\/p>\n Targeting legal immigrants and \u2018Dreamers\u2019<\/p>\n Approximately 112,000 lawful immigrants in California also will be stripped of premium tax credits and cost-sharing support, essentially pushing health coverage out of financial reach, she said. That includes immigrant groups that have been eligible for assistance for years, including those with work and student visas, refugees, asylees and victims of human trafficking.<\/p>\n \u201cThey are limiting it so only green card holders and a couple of very nuanced categories of certain Cuban immigrants and certain immigrants from Pacific Island nations can get financial assistance,\u201d Altman said.<\/p>\n Immigrants who grew up in the United States after being brought here illegally as children, a group known as \u201cDreamers,\u201d will be stripped of their eligibility, Altman said.<\/p>\n Thousands more Californians likely will drop coverage because of new burdensome verification requirements, including increased tax filings, and bureaucratic hurdles that must be overcome to maintain eligibility.<\/p>\n Big picture<\/p>\n California Gov. Gavin Newsom already has warned<\/a> that the cuts to Medicaid in what Trump calls the \u201cBig Beautiful Bill<\/a>,\u201d a cornerstone of his second-term agenda, will lead to hospital and clinic closures, especially in the state\u2019s underserved rural areas.<\/p>\n Altman said that impact will be exacerbated by the tens of thousands of Californians expected to lose their medical insurance they secured through Covered California. Medical facilities received higher compensation to care for patients who secured health insurance through Covered California than they do for patients on Medi-Cal. And hospitals and clinics will now take an even greater financial hit for caring for Californians with no health insurance, raising healthcare costs for everyone else. <\/p>\n \u201cWe know people will get less healthcare. They will not get their preventive care, they will not get their primary care at the rates that they do when they\u2019re covered,\u201d Altman said. \u201cBut when they really need care, they\u2019re going to go get it. They\u2019re going to get it at the emergency room, and our system is going to pay for it anyway.\u201d<\/p>\n What else you should be reading<\/p>\n The must-read<\/b>: Valadao votes for a Trump megabill expected to disrupt healthcare for many in the Central Valley<\/a>
The TK<\/b>: Gov. Newsom will visit South Carolina, a pivotal presidential primary state<\/a>
The L.A. Times Special<\/b>: Kidnappers or ICE agents? LAPD grapples with surge in calls from concerned citizens<\/a> <\/p>\n