By now, the numbers are well known and appear daily in news reports and commentaries: About 3.7 million Californians would lose their Medi-Cal health care coverage if Congress moves forward with the promise to repeal the Affordable Care Act. Another 1.2 million would lose the federal subsidies that have made coverage affordable to them via the California health benefit exchange.

We – the county human services agencies charged with fighting poverty and helping people achieve self-sufficiency – know the people behind those numbers and the tremendous difference health care has made in their lives. Having affordable health care has allowed them to spend their incomes on rent, food and other basic needs. Since the ACA was implemented just over three years ago, families and individuals have poured into our offices, relieved that perhaps for the first time they have access to health insurance. Many have cried, convinced for years that obtaining health coverage was only a dream and having lived in fear that even the smallest medical need could sink them further into economic despair.

Now, these families and individuals are fearful once again. Fearful that the health coverage they depend upon will be taken away and economic stress and chaos will return to their lives.

As if that human toll isn’t gut-wrenching enough, the UC Berkeley Labor Center recently released projections on the economic losses to California if the ACA is repealed: $20.3 billion in lost GDP, $1.5 billion in lost state and federal tax revenue, 209,000 jobs lost. Many of those jobs would be in the health care industry but with a ripple effect to other industries that support health-care jobs, including the food and janitorial services.

In the health and human services field, we know that ripple effect all too well, for people and programs. An unexpected job loss can lead to a family losing their home and suddenly in need of our services. When one program is cut at the federal or state levels, all programs feel the results.

We must remember that the effect of a repeal goes way beyond health care in California. A significant part of our ACA story is how the law has positively affected the overall social safety net that supports low-income families and working people.

By taking advantage of available federal dollars to invest in health care for millions of Californians, California policymakers and leaders also have been able to make other incremental budget investments to support children, families and individuals living in poverty. We have increased grants to poor families; we are improving our support of foster children and families who open their homes to them; we are combatting child sex trafficking and serving victims in specialized ways.

We and our many advocacy partners are mindful of this as President Trump takes office and on the heels of Governor Brown releasing his budget last week.

Last month, I spoke at a gathering of state leaders and advocates who discussed the 2017-18 state budget with much trepidation as the threat of an ACA repeal loomed. Since that discussion, we’ve seen the U.S. Senate and House take the first steps to upend the ACA.

While a lot is happening quickly and the next steps are complicated, this much is clear for California:

1. Any scenario that Congress pursues to repeal the ACA will lead to terrible consequences for our state budget, health and human services programs, and ultimately the millions of low-income people struggling to survive across the state. California aggressively implemented the ACA and its Medicaid expansion, which means low-income parents and other adults who previously were ineligible now have health care coverage. In many counties, half the population or more is enrolled in Medi-Cal. Further, the aforementioned economic impacts cannot be ignored or written off.
2. Fiscal relationships and program responsibilities are complex between the state and counties. Over the last several years, a massive amount of work went into not only implementing the ACA but also supporting the many other health and human services programs counties administer on behalf of the state, and tremendous fiscal shifts occurred as a result. We can’t easily unwind those obligations if Congress makes the dire move to repeal the ACA.
3. Now is the time to educate lawmakers about what the ACA, Medi-Cal and our many other safety net programs are doing for people every day. These programs are cost-effective, create better outcomes for children, decrease the chances of those youth becoming adults who live in poverty, boost the economy in multiple ways, and are a wise investment of taxpayer dollars.

Our county human services staff hear daily how Medi-Cal and the ACA has changed people’s lives. As Congress continues taking steps to repeal the Affordable Care Act, we will continue to demand they preserve the Medi-Cal expansion and that any replace­ment must adequately ensure the same level of quality benefits so no one loses health coverage.

Congress must hear from you too. Share your stories – with us and your federal representative. Now is the time to let federal elected officials know that the Medi-Cal program is important to you, your family, your business, and your community.

Step 1: Share your story with us.

Step 2: Tell YOUR congress member directly why health care is important to you and why they should not take away health care protections and coverage.

Step 3: Make your voice heard on social media using #Fight4OurHealth and #ProtectOurCare, and encourage family and friends to do the same.

The next four years may be some of the most challenging and unchartered times many of us have faced as citizens, public servants and advocates. No matter what happens, we will continue to work toward advancing human services for the welfare of all Californians.

– Frank Mecca

Frank is the Executive Director of CWDA.