What an Obamacare repeal could mean for Monterey County.

Kelly Watson Snyder looks to Washington, D.C., and worries. If the Republican Congress successfully repeals Obamacare with no immediate replacement, she’s afraid her insurance will no longer pay the nearly $500 a month it costs for medication she takes for a digestive disorder called colitis, along with the expensive therapies her 6-year-old son receives for his autism. And her husband, Chris, who is gets his insurance through Medi-Cal, could lose his insurance altogether, putting the family in further financial risk.

Snyder nearly died from pneumonia during a five-day stay in the hospital two years ago, so she knows it only takes one expensive health event to send a family into financial ruin. She estimates her hospital stay was over $100,000. Without insurance, she says, “I don’t think we would have been able to recover from it.”

The Monterey retail manager feels fortunate that she has insurance through her employer, but is also grateful that the Affordable Care Act (the official name for Obamacare) guarantees protections for pre-existing conditions, like her colitis, and her son’s autism. If it’s repealed, she’s not sure they could get continuing coverage.

“I’m trying not to be, but I am terrified for what this could mean. I’m 35, and I would like to live a long life,” she says.

At least 18 million Americans would lose their health insurance in the first year if the Affordable Care Act is repealed without replacement, according to a report from the nonpartisan Congressional Budget Office. In Monterey County, 44,000 have insurance directly through the act, 14,000 who obtained coverage through Covered California, the state health insurance exchange, and nearly 30,000 who are covered by expanded Medi-Cal thanks to the ACA.

Also at risk are the jobs of thousands of health professionals who were hired on to agencies, clinics and hospital in the last several years to serve the influx of new patients. The Central California Alliance for Health, a $1.1 billion nonprofit that coordinates health care insurance for low-income people in Monterey, Santa Cruz and Merced counties, estimates that repealing Obamacare without a replacement could threaten more than $128 million in Medi-Cal funding that pays for those professionals, which in turn would have far-reaching economic impacts.

Of the 155,475 people currently enrolled in Medi-Cal in Monterey County, 21 percent, or 32,798 people, qualified for coverage because of the Obamacare expansion, which changed the qualifying threshold from 100-percent of the federal poverty level to 138 percent. The federal government pays 95 percent of the costs related to those members, so if that money stops, “there is a risk we could see the [32,798 people] be challenged in their coverage,” CCAH CEO Alan McKay says.

One of those people is Chris Snyder, Kelly’s husband.

For now, McKay and Covered California officials are saying that until they are told otherwise, they are going to go right on enrolling new people – the Covered California open enrollment period ends Jan. 31.

“This is all speculation, and we’re actually hopeful that Congress will see the wisdom of covering Americans, and continue their support,” McKay says.