A research center predicts that repeal of the Affordable Care Act would eliminate more than 200,000 jobs in California and impact the state and local economic picture.
In a study released last week, the UC Berkeley Labor Center said that counties such as Stanislaus with large populations in the Medi-Cal program would be hardest hit. Stanislaus would lose a projected 3,000 jobs, while 4,000 job losses are predicted for San Joaquin County.
The center concluded that 135,000 of the 209,000 jobs eliminated statewide would be in the health care sector, with hospitals, physician offices, labs, outpatient centers and dental offices shedding staff members as consumers lose insurance coverage or Medi-Cal eligibility.
If Republicans in Congress repeal key provisions of Obamacare, California will lose around $20.5 billion in federal dollars that paid for expanding Medi-Cal eligibility and provided subsidies that made Covered California insurance plans affordable for individuals and families.
At the same time, insurers in California and wealthy households would see tax reductions totaling $6.3 billion, the report said.
The research assumed that Congress next year will pass a bill similar to Republican-backed legislation in 2015 that was vetoed by President Barack Obama. Such legislation would eliminate the federal Medicaid expansion, which made millions of single adults eligible for Medi-Cal in California, and do away with cost-sharing subsidies that made health insurance affordable.
Almost 5 million California residents could lose coverage without those provisions, the labor center said.
Hospitals in Stanislaus County said administrators were not available this week to comment on whether a repeal would translate into job losses. Much would depend on what would replace the Affordable Care Act under a Donald Trump administration and the Republican-led Congress.
Community health centers that are safety nets for the San Joaquin Valley’s poor are concerned about talk of repealing the ACA. Even before it became a heated issue in the presidential election, a five-year trust fund providing funding for health centers under the ACA was set to expire in 2017, said Mary-Michal Rawling, government affairs director for the Golden Valley Health Centers in Stanislaus and Merced counties.
If the trust fund is allowed to expire, the Golden Valley centers will lose $8 million in funding, Rawling said. She would not speculate on job cuts because there are too many unknowns at this point.
Partly to serve an increase in patients under the ACA, Golden Valley opened new clinics in Ceres and Empire and expanded dental sites.
“Cutting jobs is a realistic part of the equation when you are looking at 10 percent of the budget being cut,” Rawling said. “We are extremely concerned about it. We are in the business of providing health care to people who need it the most, so we are concerned patients won’t have access to the health care they need and their health will decline.”
In Merced County, more than half of the county population relies on Medi-Cal for access to health services, and there are 240,000 on Stanislaus County’s Medi-Cal rolls, or 44.5 percent of residents.
Since 2013, Stanislaus County government has added 82 staff positions backed by funding through the Affordable Care Act. A large majority of the 65 county employees added in 2013-14 have worked in a regional call center to assist with Medi-Cal enrollments for Stanislaus, Napa and Marin counties. Those positions were funded by federal money and a state match.
County Chief Executive Officer Stan Risen declined to talk about staff cuts if the federal funds are eliminated. “The president-elect has indicated there are portions of the ACA he would like to retain,” Risen said. “It is hard to know what the final (legislative) package is going to look like. For now, when people call into the center, they are told we are not anticipating changes in eligibility in 2017.”
Representatives of the California Nurses Association said they respect the work of the UC Berkeley Labor Center. The union has not endorsed the ACA, but favors a single-payer health system that would exclude the insurance industry.
The union noted that Kaiser Permanente enrolled thousands of new members through the ACA, but it was not clear how much Kaiser and other health care providers staffed up to serve the newly insured.
“We are on record opposing (House Speaker) Paul Ryan’s proposals for cutting the ACA and anything that lessens the care for the patients our nurses take care of,” said Don Nielsen, government relations director for the nurses union. “They have talked about repealing it, but they have not talked a lot about what they will replace it with. No one in the country is in the mood of going backward when it comes to health care.”
According to the UC Berkeley center, about 367,000 health care jobs were added in California after enactment of the health reform law in 2010. More than 180,000 of those jobs materialized between early 2013, just before people began enrolling in ACA health plans, and September of this year.
The study also predicted the economic impact would affect other industries, such as health care suppliers, restaurants and food service, janitorial services and accounting firms. The projections include 8,000 job losses for restaurants and drinking establishments, 6,000 in real estate, 6,000 in insurance and related businesses, and 5,000 in employment services.
According to the report, the health care industry has been a major source of employment growth in California during recovery from the Great Recession.
The UC Berkeley Labor Center study can be viewed at http://laborcenter.berkeley.edu/ under “Publications”.
Ken Carlson: 209-578-2321