The 2023-24 Budget: Assessment of Covered California Budget Solution

Feb 13, 2023 - Notably, the ACA provided for the establishment of state health benefit exchanges, such as Covered California. The ACA also included provisions intended to encourage individuals to enroll in health coverage and improve affordability.
https://lao.ca.gov/Publications/Report/4681

Issues That Could Impact Californians' Health Care Coverage in 2023 and Beyond

Dec 16, 2022 - Impacts of the ACA As noted earlier, the ACA brought about significant changes to the provision of health care coverage in California. Notably, the ACA gave states the option to expand Medicaid eligibility and establish health benefit exchanges.
https://lao.ca.gov/Publications/Report/4654

The 2025-26 California Spending Plan: Health

Oct 16, 2025 - Since this time, the private partner has started initial manufacturing in a facility in Virginia. Accordingly, as a budget solution, the spending plan elimi nates $45  million unspent carryover construction funds in 2024-25.
https://lao.ca.gov/Publications/Report/5075

The 2022-23 Budget: Health Care Access and Affordability

Feb 23, 2022 - ACA Created Individual Mandate That Was Subsequently Set to Zero. As originally enacted, the ACA imposed a requirement, referred to as the individual mandate, that most individuals obtain specified minimum health insurance coverage or pay a penalty.
https://lao.ca.gov/Publications/Report/4560

The 2025-26 Budget: Health Care Access and Information

Feb 20, 2025 - At the time, HCAI indicated that it could defer these funds because construction of the new insulin product will instead occur at an existing site in Virginia. According to HCAI, a forthcoming report to the Legislature will further examine the feasibility of the state engaging more directly in drug manufacturing.
https://lao.ca.gov/Publications/Report/4979

The 2023-24 Budget: Analysis of the Medi-Cal Budget

Feb 10, 2023 - The ACA optional expansion population and families, by contrast, tend to have lower per ‑enrollee costs. In addition, the federal government currently pays 90  percent of Medi ‑Cal costs for individuals enrolled as part of the ACA optional expansion, as opposed to 50  percent for most other beneficiary populations.
https://lao.ca.gov/Publications/Report/4675

Considering Medi-Cal in the Midst of a Changing Fiscal and Policy Landscape

Oct 24, 2025 - This legislation includes about $1  trillion in federal Medicaid reductions over ten years, representing the most significant changes to federal Medicaid policy since the ACA. More Detail on Changes Are Emerging.
https://lao.ca.gov/Publications/Report/5083

The 2025-26 Budget: Understanding Recent Increases in the Medi-Cal Senior Caseload

Mar 6, 2025 - While  this  estimate  is modest, senior caseload was growing slowly before the continuous coverage period, meaning that the incremental effect of continuous coverage, the unwinding, and flexibilities was not as significant for seniors as it was for families and the ACA optional expansion population, which were declining prior to continuous coverage.
https://lao.ca.gov/Publications/Report/5010

COVID-19: American Rescue Plan’s Major Health-Related Funding Provisions

May 6, 2021 - Since 2014, under the Patient Protection and Affordable Care Act (ACA), the federal government has provided subsidies to individuals who purchase coverage through the health benefit exchanges provided they meet income-eligibility rules.
https://lao.ca.gov/Publications/Report/4425

The 2023-24 Budget: Medi-Cal Fiscal Outlook

Nov 16, 2022 - We  also estimate a decrease in what is commonly referred to as the Patient Protection and Affordable Care Act (ACA) optional expansion population (which typically has lower per ‑enrollee General  Fund  costs).
https://lao.ca.gov/Publications/Report/4649