On March 23, 2010, after a long congressional debate, President Barack Obama signed into law comprehensive federal health care reform legislation, known as the Affordable Care Act or ACA. But the enactment of the law did not end the debate. Even the law’s strongest proponents acknowledge the need for improvements. And across the country, state legislators and Governors have been urged to slow or stop work on implementation of key provisions. The courts are considering legal challenges to the law. Members of Congress will consider attempts to repeal both the law as a whole and its key provisions. This year, California's elected officials will face their own choices regarding proposals to repeal or roll back existing law. This report examines the costs and benefits of repeal for the taxpayers, consumers, and businesses of our state.