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Monica Soni, Covered California’s chief medical officer, worries federal spending cuts could soon bring turbulence to the state’s Affordable Care Act marketplace.

They've often positioned themselves saying, “We fixed health care with the Affordable Care Act, and now all we need to do is protect it.”

The Affordable Care Act used Medicaid to cover the poorest uninsured Americans, those with incomes up to 138% of the federal poverty level, or about $21,597 this year.

“The pieces are there,” said Monica Soni, chief medical officer of Covered California, the state’s Affordable Care Act health insurance marketplace.

California’s Affordable Care Act health insurance exchange covers nearly 2 million residents and 89% of them receive federal subsidies that reduce their premiums.