SACRAMENTO, Calif. (AP) — The state Legislature on Saturday passed a major piece of the federal Affordable Care Act, opting to expand Medicaid to 1.4 million low-income Californians even as Republican lawmakers raised concerns about the program's future costs.
The voting in the Democratically controlled Assembly and Senate came as part of the final votes on the state budget for the coming fiscal year.
Several Democratic lawmakers called the vote historic.
"We don't know for certain that this will contain the costs; that's certainly the goal. But ... we also make sure that health care is not considered a privilege of the fortunate few but as a basic human right," said Sen. Mark Leno, D-San Francisco. "That's what we're implementing today. This is a big deal."
Republicans raised concerns about whether California can afford the expansion over the long run, especially once the federal government drops its commitment from 100 percent to 90 percent.
Democrats included a provision in the legislation that allows for future lawmakers to reconsider the expansion if the federal government's share drops below 70 percent.
Republican Assemblyman Tim Donnelly called the expansion a potentially debilitating move for the state's finances.
"We are shackling future legislators to the decisions we are making here today," he said.
The federal government will pay the full cost of expanding the low-income health program, which is called Medi-Cal in California, for the first three years. It will gradually reduce payments to 90 percent starting in 2020, putting the rest of the cost on the states that adopt the expansion.
Legislative Analyst Mac Taylor has estimated that by taking on new enrollees, the state could be responsible for between $300 million and $1.3 billion a year starting in 2020.
The Medi-Cal vote came a day after the Legislature passed the main bill to enact California's $96.3 billion spending plan for the fiscal year that starts July 1. Lawmakers were approving so-called trailer bills that implement certain parts of the budget on Saturday, their deadline to send a balanced budget to the governor.
