California is facing a $20 billion healthcare emergency. That’s how much the state stands to lose in annual federal spending if Republicans repeal the Affordable Care Act.
 
Putting this in perspective, $20 billion represents nearly 18% of all state general fund spending, projected at $113 billion this year. That amount is also roughly what the state already pays from its general fund for Medi-Cal costs. Even a nation-state like California cannot absorb an 18% budget shortfall without severely damaging public health and its economy.
 
Repeal presents a greater risk to California than any other state, not only because of its large population, but also because the state fully embraced the promise of health insurance reform.