What Would Losing Obamacare Mean for Santa Barbara?

The $123 million question confronting Santa Barbara health-care administrators is whether President-elect Donald Trump is serious about repealing the Affordable Care Act (ACA) as he repeatedly pledged to do throughout his campaign. That’s how much extra Medi-Cal money is funneled in from the federal government to pay health-care costs for low-income Santa Barbara County residents annually because of expanded eligibility requirements written into the ACA.

For San Luis Obispo County, the number is $70 million. In both counties combined, the ACA has provided Medi-Cal coverage for an additional 45,000 people. And that doesn’t count the 29,000 people who signed up for private insurance via the Covered California exchange.

How Trump’s campaign rhetoric will translate into actual action remains the subject of intense speculation among health-care executives. Given that most insurance contracts entered into via the ACA won’t expire until 2018, the sky won’t be falling anytime soon. “Nobody really knows what the Trump people will do,” said Bob Freeman, CEO of CenCal Health, which administers Medi-Cal for Santa Barbara and San Luis Obispo counties. “But actions have consequences. If they want to make good on a campaign promise and cut a program that benefits 20 million people, we need to know how they plan to do this. But it will be a lot easier said than done.”