The answer is not clear. The key driver of increased cost to California are the broadening eligibility standards for Medicaid (called Medi-Cal in California). Although California recently passed a proposition to increase taxes, California still faces a shortfall of $1.9 billion for fiscal year 2013-14.The L.A. Times reports that ACA cost estimates have varied widely :
In 2010, the year the Affordable Care Act was signed, state officials said California could be on the hook for $2.7 billion annually. The nonpartisan legislative analyst estimated this fall that initial costs would be in the “low hundreds of millions of dollars” annually for the next several years. A recent study from the nonprofit Kaiser Family Foundation pegged the price at nearly $14 billion over the next decade.
The main cost is expected to come from a sharp increase in the number of Medi-Cal enrollees. Sacramento and Washington split the bill for those Californians, who currently number roughly 8 million. The state’s share was about $14.6 billion this year.
Sacramento will be responsible for half the cost of many new Medi-Cal recipients. That number could be anywhere from 200,000 to 440,000 people in 2014, according to Ken Jacobs, chairman of the Labor Center at UC Berkeley.
Although the ACA will reduce the number of insured Californians, it will not provide universal coverage. Currently, 8.2 million Californians are uninsured. Studies from UC-Berkeley project that the number of uninsured will fall by half by 2019.