Health Care Reform in the Balance

California and the Future of the Affordable Care Act

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California got off on the right foot in implementing the Affordable Care Act (ACA). This means it has more leeway to make adjustments to the program than do many smaller states, which will need greater assistance from federal policy changes and higher government spending to stabilize their individual marketplaces. However, if Congress continues to dismantle or underfund the program in coming years, California will have to decide whether to recreate features of the ACA, such as the individual mandate, at the state level, modify the ACA, or move toward other ways to finance healthcare access for the state’s residents. This report traces how California successfully built an ACA marketplace and what its options are in this period of retrenchment.

About the Authors

Micah Weinberg, PhD
Micah Weinberg is currently President of the Economic Institute at the Bay Area Council. In this role, he manages a team of professional researchers who produce world class economic and policy analysis and insight. Economic opportunity, affordable housing, reliable transportation, and lifelong learning are the pillars of personal and community health. Dr. Weinberg’s own research and advocacy focuses on improving these “social determinants” of health as well as on expanding access to high quality, affordable healthcare. Before coming to the Council, Micah was Senior Research Fellow at the New America Foundation. Dr. Weinberg’s writing has appeared in diverse outlets from Politico to Policy Studies Journal, and he has appeared on Fox News and NPR. He holds a doctoral degree in Political Science from the University of North Carolina at Chapel Hill and graduated with honors from Princeton University with a degree in Politics.

Leif Wellington Haase
Leif Wellington Haase, president of LWH Consulting, is a leading author and researcher on the U.S. health system, focusing on health care reform, insurance coverage,
and health care costs. He is the author of numerous books and articles, including A New Deal for Health: How to Cover Everyone and Get Medical Costs Under Control. He has served as executive director for the California Task Force on Affordable Care and was director of the New America Foundation’s California Program, which sponsored research on issues of critical importance to California, including health care, education, energy, and tax and budget policy. Before joining New America, Haase served as senior program officer at The Century Foundation and led its health policy program. He holds degrees from Yale University and Princeton University.