OAKLAND, Calif. – The Congressional Budget Office (CBO) analysis of the Republican plan to “repeal and replace” the Affordable Care Act, released March 13, doesn’t paint a pretty picture for Californians – or anyone else, for that matter.
The CBO said some 14 million people across the country would lose coverage in the first year, with the nationwide total rising to 24 million by the end of a decade. In California alone, four to five million people are predicted to lose coverage.
The so-called American Health Care Act would shred many of the important patient protections embedded in the ACA, also known as Obamacare.
Among its provisions: federal funds for the Medicaid expansion, taken up by 31 states including California, would phase out in 2020. Older, poorer people living where health care costs are higher would suffer the most. Insurance companies could charge older people up to five times for coverage as younger people, compared to three times under the Affordable Care Act.
The Republican proposal would break the promises made by President Trump and members of Congress, who said they would replace the Affordable Care Act with a plan covering more people at lower cost, Rachel Linn-Gish wrote on the Health Access coalition’s blog March 13. “In particular, this GOP proposal viciously cuts and caps Medicaid, when President Trump said many times he would not cut this crucial program that covers over a third of Californians, including over half our children and two-thirds of our nursing home residents,” she wrote.
Linn-Gish said Californians would be impacted the most, because the state worked hard to expand coverage under the Medicaid expansion, cutting its uninsured rate the most of any state, to a record low of 7.1 percent. Some 14 million Californians – and nearly half the people in the strongly agricultural Central Valley – are now covered under the program, known here as Medi-Cal.
Analysts predict that the roughly 1.2 million Californians who have individual plans under the state’s exchange, Covered California, would end up with higher premiums and smaller subsidies than at present.
These potential impacts were on the minds of participants in a March 10 Emergency Response rally at UCSF Benioff Children’s Hospital in Oakland.
Alameda County Supervisor Wilma Chan warned a crowd of physicians, nurses and patients’ families that repealing the Affordable Care Act would result in a “death toll” in the county, which covers much of the East Bay across from San Francisco. She said that since the ACA started in 2010, 170,000 new patients have been enrolled in the county, with 100,000 of them served by Medi-Cal.
“We’ve heard so many stories about people who if they had not had this insurance would probably have died in the Emergency Room from a heart attack or some other catastrophic ailment,” Chan said. “But because they had a doctor, their lives were saved. We don’t want to go backwards here.”
Dr. Michael Mangahas, a pediatrician at the hospital and a member of the Committee of Interns and Residents, said the GOP proposal “will cause many children to lose much-needed insurance and access to preventive and primary care.” He said that over 60 percent of California children are covered by Medi-Cal. “In my clinic alone, here in this public safety-net hospital, the number is closer to 90-95 percent.”
Speaking of one patient, a four-month-old girl with a rare genetic disorder, he added, “How can you expect me as a physician to look her in the eye and say, ‘Soon there won’t be enough money through the Medi-Cal budget to provide you with much-needed services, and you’re not allowed to learn how to walk and to talk and to eat.’”
Two days later, Supervisor Chan joined a panel of East Bay state legislators and local elected officials at an Emergency Town Hall in Berkeley, organized by U.S. Representative Barbara Lee, a Democrat whose district covers Oakland, Berkeley and surrounding communities.
There, several hundred people heard their legislators and area health care analysts lay out the consequences to their communities if the ACA is devastated. They were also encouraged to share accounts of how the ACA has helped them, and urged to sign up for phone-banking and other fightback activities.
“We’ve done the most under the Affordable Care Act, so that means we have the most to lose,” Sarah de Guia, executive director of the California Pan Ethnic Health Network, told the crowd.
“Low income families and adults – particularly communities of color – who have been cut off from coverage for decades, now have opportunities through the expansion of Medi-Cal,” she said.
“Don’t think everyone is safe, just because you’re covered in the private market or through your employer-based coverage, they’re coming after that as well…this won’t just affect those on Medi-Cal, it will affect us all.”
The loudest applause was reserved for Rep. Lee, who received a standing ovation as she took the microphone.
“Things aren’t going very well for the Republicans this week,” Lee, a member of the House Appropriations and Budget Committees, told the gathering. “They have learned that repealing health care and taking it away from 30 million people is a very difficult task. Even their constituents have benefited from it”
Poor and low-income individuals, people of color, working men and women will be “disproportionately impacted by this cold-hearted attack,” she added. “Here in the East Bay, we know health care is a basic human right, and we will not be quiet!”