ACA Repeal Will Wipe Out Coverage Gains by Small Business Workers and Self-Employed

 ACA Repeal Will Wipe Out Coverage Gains by Small Business Workers and Self-Employed

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Republicans’ efforts to repeal and replace portions of the Affordable Care Act (ACA) threatens the health coverage of California’s self-employed, as well as workers in such small businesses as restaurants, small retailers and family farms.

A study out May 18 by the UC Berkeley Center for Labor Research and Education (CLRE) showed that more than one million small business employees and over half a million self-employed Californians benefited from the health insurance options provided by the ACA.

Lack of coverage among these two groups dropped sharply from one in five lacking insurance in 2013 to less than one in three in 2015. Among the self-employed, the rate dropped from 33.8 percent in 2013 to 17.9 percent in 2015. Among small business employees the uninsured rate plummeted from 31 percent to 18.8 percent in 2015.

The study, “California’s Self-Employed and Small Business Employees Experienced Large Health Coverage Gains under ACA,” analyzed California Health Interview Survey (CHIS) data. It found a significant decrease in the number of uninsured among workers with less access to employer-sponsored insurance.

“Republican leaders in Congress are proposing to roll back federal funding for the expansion of Medicaid (Medi-Cal in California) under the ACA,” said Laurel Lucia, co-author of the brief. “It will make it very difficult for states like California to continue the program.”

“The Republican proposal could mean the loss of health insurance for the self-employed and small business employees. Without Medi-Cal expansion and less subsidies for private insurance many of them won’t be able to afford to remain covered.”

Among the key findings of the study are:
• One in five small business employees and self-employed Californians relied on ACA coverage in 2015 (the most recent year for which information is available under CHIS).
• Small business employees had a higher rate of enrollment in Medi-Cal expansion than other workers: 15.2 percent of employees at businesses with 50 or fewer workers, or 778,000 workers, compared to 9.5 percent of employees at larger businesses.
• About 246,000 small business employees, or 4.8 percent, enrolled in the online marketplace, Covered California, and were eligible for subsidies – more than double the rate for workers at large businesses.
• Around 214,000 self-employed Californians, or 8.1 percent, were enrolled in Covered California and were estimated to be eligible for robust subsidies based on income. That is a much larger proportion than that of all other workers -- 2.9 percent.
• An additional 353,000 self-employed Californians enrolled in the Medi-Cal expansion.
The ACA has been a lifeline for California’s small business employees and the self-employed,” observed Ken Jacobs, the school’s CLRE chair.

And he went on to say that dismantling the ACA “would be a big step back.”