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Risks and Resiliencies of the Affordable Care Act

A research article published in the Journal of Health Politics, Policy and Law by Mark A. Peterson, professor of public policy, political science and law, compares the “political vulnerability and resiliency” of the Affordable Care Act (ACA) with the repeal of the Medicare Catastrophic Coverage Act (MCAA) nearly three decades before. “The political-institutional contexts and the processes of coalition change could hardly have been more different for MCCA and ACA,” notes Peterson in his article, “Reversing Course on Obamacare: Why Not Another Medicare Catastrophic?” in the Duke University Press publication. “However, they had some shared vulnerabilities stemming from program design,” he argues. “The ACA survived the political weakness inherent in its policy attributes due to its particular balance and timing of benefits and costs and by being shielded long enough by election results and the constitutional separation of powers to have its benefits take root.” — Stan Paul

More Than 45,000 Californians Living With HIV Would Be Impacted by Medicaid Cuts in Senate Health Plan According to a fact sheet from the California HIV/AIDS Policy Research Centers, the cuts would be felt by patients covered by Medi-Cal

Tens of thousands of Californians living with HIV would be impacted by Medicaid cuts under the Better Care Reconciliation Act (BCRA), according to a fact sheet released by the California HIV/AIDS Policy Research Centers in collaboration with the UCLA Luskin School of Public Affairs.

The fact sheet highlights new data from the California Department of Public Health, Office of AIDS, which indicates that 45,033 people living with HIV received health coverage through Medi-Cal in 2014. These data also indicate that approximately 11,500 people living with HIV enrolled in Medi-Cal because of the Affordable Care Act (ACA). Medi-Cal, California’s Medicaid program, covers the cost of medications that help low-income people living with HIV achieve viral suppression, which both improves their health and prevents new infections.

Last week, the U.S. Senate released the BCRA, which would make dramatic cuts to Medicaid. A similar bill passed by the U.S. House of Representatives, the American Health Care Act (AHCA), would have cut Medicaid nationwide by $834 billion over 10 years.

The BCRA would radically restructure the Medicaid program by converting it to a per capita cap or block grant and effectively end the ACA’s Medicaid expansion. Together, these changes would result in a massive fiscal shift from the federal government to the states and add billions in additional costs to the state of California.

“People living with HIV have complex health-care needs that require high-quality, consistent and affordable health care,” said Ian Holloway, director of the Southern California HIV/AIDS Policy Research Center and an assistant professor in the Department of Social Welfare at the UCLA Luskin School of Public Affairs.

The CHPRC fact sheet emphasizes that limits on Medicaid financing and coverage would have a detrimental impact on California’s efforts to provide care and treatment for people living with HIV and to reduce new HIV infections.

“It is important for policymakers to understand the threats the BCRA poses to people living with HIV and other vulnerable communities in California,” Holloway said.