For all the right reasons, the conversation about the Donald Trump-led budget reconciliation centers on massive Medicaid funding reductions and the long-term damage they’ll do to public health. With some 15 million Californians relying on Medi-Cal, the state’s version of Medicaid, to see a doctor, that’s no thought exercise — it’s an emergency. The misery hasn’t arrived yet, but it already feels real.
There is another program, though, that is in more immediate danger of losing its punch. Without an extension of federal subsidies that are scheduled to expire this year, people who shop on the Covered California exchange for their health insurance are going to absorb premium rate hikes in the painful-to-impossible range — 75%, by one estimate.
