SACRAMENTO — The State Legislature passed a major piece of the federal Affordable Care Act on Saturday, opting to expand Medicaidto 1.4 million low-income people in California as it rushed to meet its deadline to complete a state budget.
The action came a day after lawmakers passed the main budget bill outlining a $96.3 billion spending plan for the fiscal year that starts in July.
Several Democratic lawmakers called Saturday’s vote historic.
“We don’t know for certain that this will contain the costs; that’s certainly the goal,” said Senator Mark Leno, a Democrat from San Francisco. But he said the action was also intended to “make sure that health care is not considered a privilege of the fortunate few, but as a basic human right. 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.
“I worry about expectations that we set out for individuals with A.C.A. in California and having the rug pulled out from underneath us without a funding mechanism,” said Senator Ted Gaines, a Republican of Rocklin. “Can we as a state handle that financial burden? I’m very concerned about this.”
Democrats said the expansion would help save lives, keep workers healthy and attract billions of dollars from the federal government into the state.
The president pro tem of the Senate, Darrell Steinberg, a Democrat of Sacramento, noted that taxpayers and those who have health insurance already are paying for the medical care of those who now go without insurance. The Medicaid expansion will cover many of those who now receive uncompensated care, he said.