California has made huge strides in recent years to ensure more families and children are healthy and excel in life, particularly by increasing access to health coverage. The state has reduced the number of uninsured children from 2 million in 1999 to just over 100,000 today who are eligible but yet to be enrolled. The number of children in California with health coverage is at 97 percent, an all-time high. This is not the time to turn back the clock. If their parents lose coverage, children are at risk too. 

Yet members of Congress are proposing to do just that. Policy makers in Washington intend to repeal the Affordable Care Act (ACA) without a concrete plan to replace it – an ill-advised scheme that would have unprecedented consequences according to a new report from the Urban Institute.

For starters, the number of children without health insurance would double nationwide. That is twice as many kids who will go to school sick, will lack access to necessary medications, and won’t receive the preventive care that keeps them healthy and avoids costly emergency room visits. Repealing the Affordable Care Act, without a well thought out replacement that maintains or improves coverage, will also bring back high medical costs for families, costing them precious life savings and resources they may not have.

In California, Congress’ failure to negotiate a replacement of the ACA before repeal would put programs like Medi-Cal — which provides coverage to more than half of all California children along with many families, seniors and individuals — on shaky ground. The Urban Institute predicts five million people will lose coverage, and California would lose $160 billion in federal funding over a ten-year period. Additionally, nearly 210,000 people would lose their jobs according to a recent analysis by the Berkeley Labor Center, harming some of our poorest counties the most. 

Through our work at United Ways of California, we have seen what the ACA has meant for real people in our state — it has literally saved lives and helped protect families from financial ruin while boosting the economy by creating jobs and allowing more spending by families who have avoided bankruptcy. Recently, we met Michele, a mother of two and a breast cancer survivor, who would not have received the care she needed without the ACA. In 2010, Michele was self-employed without insurance. Her previous health conditions made health coverage out of reach, but the ACA allowed individuals with preexisting conditions like hers to enroll in coverage. When a 2011 mammogram revealed a third type of cancer in her 20+ year battle, Michele knew she could never have afforded the double mastectomy, chemotherapy and surgeries that her doctors recommended without health coverage. But now her future is in jeopardy again with this proposal.

The proposed repeal of the ACA would just pile more pain on working families in particular. A recent United Ways of California study of household finances in California found that 1 in 3 families — 3.1 million households — struggle to meet the cost of basic needs like housing, food, transportation, child care and taxes. Almost all these families include at least one working adult. Urban Institute researchers note that 82 percent of those who are likely to lose health insurance are in working families. It’s hard enough to make ends meet in California, and losing coverage would add yet another cost and burden. Repeal without replacement also will hurt employers and cause turmoil in local economies and in health care and related industries.

Those who work hard every day to make sure that their children have food on the table shouldn’t have their coverage taken away in exchange for a vague IOU. They can’t rely on a promise that federal legislators will someday — after six years of not coming up with any realistic alternative — reach consensus on a replacement for the ACA. 

Repealing the ACA without a complete, comprehensive replacement strategy is not a plan; it’s a risky gamble that threatens the health of children and families. Our elected officials in Washington, D.C. should not consider repealing the ACA before they have a firm plan that ensures children and families can access safe, affordable health coverage. Our California representatives can be heroes by stating this message loud and clear.


Pete Manzo is President & CEO of United Ways of California, focused on improving the health, financial stability and educational opportunities of Californians.