California fully embraced the passage of the Affordable Care Act (ACA) in 2010 and expanded coverage to more than 5.4 million previously uninsured Californians through the Covered California State Exchange and the Medicaid Expansion for very low-income adults. As a result, California’s uninsured rate dropped from 17 percent to seven percent of the total population.

In 2017, the Republican-controlled Congress focused on repealing the Affordable Care Act (ACA). Over the last two years, the Trump Administration adopted several regulatory changes to the ACA that eliminated the cost-sharing program that helped low-income families afford copayments and deductibles, and reduced the mandated benefit levels for some plans, below the ACA essential health benefits package. However, the rest of the ACA remains intact, including the tax credits that help low-income working families purchase coverage, the state and federal exchanges, and funding for the Medicaid expansion.

Throughout our history, California Medical Association (CMA) physicians have advocated for health care coverage for all Californians and improved access to care. These priorities continue to guide our advocacy as Congress and the Trump Administration debate and make changes to the ACA. CMA’s overriding goal is to ensure that Californians maintain access to physicians and meaningful, affordable coverage.

CMA’s Core Principles for Health Care Reform: 

1. Ensure Californians do not lose coverage. 
2. Improve access to physicians. 
3. Protect state and federal Medicaid funding. 
4. Continue tax policies and subsidies that help low-moderate income patients afford coverage. 
5. Advocate for patient choice of physicians and health care coverage. 
6. Maintain the important insurance reforms that protect physicians and their patients, such as coverage for pre-existing conditions, no lifetime/annual limits on benefits, essential health benefits, coverage for children up to age 26 on parent’s policies, and an 85% medical loss ratio. 
7. Stabilize the individual insurance market by continuing the cost sharing reduction subsidies, funding reinsurance for catastrophic cases, and incentivising the healthy to purchase coverage. 
8. Provide access to affordable prescription drugs. 
9. Eliminate regulatory burdens in the Medicaid and Medicare programs. 
10. Medical liability reform that does not undermine California’s MICRA law.

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