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"However, health policy researchers at the UC Berkeley Labor Center have cautioned that premium requirements in other states' Medicaid programs have historically led to significant coverage losses, with disenrollment rates ranging from 12 to 25 percent among affected populations."

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Federal Medicaid rules impose limits on premiums for enrollees below 150 percent of the federal poverty level, meaning California would need to obtain a Section 1115 waiver from the Centers for Medicare and Medicaid Services to implement the proposal.