California fights back for health care
Audience members react to a question asked by an audience member during a town hall meeting held by Rep. Scott Taylor at Kempsville High School in Virginia Beach, Va. | Kristen Zeis/The Virginian-Pilot via AP

OAKLAND, Calif. – As Congressional Republicans rush their proposed replacement for the Affordable Care Act – also known as Obamacare – through committee hearings, California’s political leaders and health care analysts warn that the measure’s severe cuts and soaring costs could cause millions of people to lose their health coverage.

Speaking to reporters March 8, California’s Insurance Commissioner Dave Jones called the bill “a recipe for disaster for the health insurance market,” and warned that soaring premiums could lead to millions losing coverage.

“Many people will just decide that they don’t need health insurance because they’re healthy,” Jones said. As the insurance market includes a greater proportion of sick people, he said, “that will result in health insurers concluding they just can’t continue to sustain the losses and leaving the individual market,” resulting in a further downward spiral.

Other political leaders including House Minority Leader Nancy Pelosi, D-San Francisco, and U.S. Senators Dianne Feinstein and Kamala Harris, both Democrats, and the state’s Democratic House members, are also expressing concern about the proposed American Health Care Act.

Earlier this year, in an op-ed published by the Los Angeles Daily News, Feinstein warned that nearly 5 million Californians – around one-eighth of the state’s population – would lose their health coverage.

Repealing Obamacare “is not just a matter of politics,” she said. “It is a matter of life and death for millions of Americans.”

And in a statement after the Republicans’ bill was introduced, Pelosi called it the “Make America Sick Again” bill.

The bill would undo the expansion of Medicaid that has made coverage possible for over 10 million people in 31 states It would gut coverage for the poor while shifting resources to the wealthy.

Among the measure’s provisions: ending requirements that everyone must have health insurance and that big employers must cover their workers; no federal funding for the Medicaid expansion; drastic cuts to the subsidies helping middle class families pay for coverage; and allowing insurers to charge older people five times as much as they charge younger people (under the ACA, they may charge up to three times as much). Tax deductions for employers who cover workers would be ended, and federal funds for public health programs dealing with outbreaks of contagious diseases would be cut.

Impact on California

The Health Access coalition, which brings together organizations representing seniors, people with disabilities, children, immigrants, communities of color, health care professionals, people of faith, labor, women, low-income families, and communities throughout California, posted an updated fact sheet the day after the Republican bill was introduced.

Health Access points out that ending the Medicaid expansion would bring an $8 billion cut to Medi-Cal, the state’s Medicaid program, resulting in millions of Californians losing their health coverage. Capping federal funding would cut another $8-$10 billion, with the possibility of total cuts reaching $15 to $20 billion of the $66 billion in federal funds California now receives.

With one in three Californians now covered by Medi-Cal, the coalition says the cuts will impact “virtually every provider.”

“California’s health system has the most to lose, since we had one of the highest uninsured rates in the nation, and then implemented and improved upon the Affordable Care Act to see the greatest percentage reduction of any state,” Health Access Executive Director Anthony Wright wrote in his blog on March 8. “This proposal would undo the progress and the steps California took to implement the law and use it as a platform for additional improvements.”

Impact on the Bay Area

The San Francisco Health Network – the city’s public health care delivery system – provides emergency, primary and specialty care. It operates two hospitals with a total of nearly 1,400 beds and provides some 700,000 visits per year, for outpatient and inpatient services.

SFHN says the Medi-Cal expansion and the state’s health exchange under the Affordable Care Act have cut the city’s uninsured rate nearly in half, from 9.2 percent to 4.8 percent.

Repealing the expansion would cause some 130,000 San Franciscans to lose coverage, SFHN said in a recent fact sheet, and result in the  city health network losong some $125 million a year in revenue.

Meanwhile, the University of California at Berkeley’s Labor Center has pointed out that repeal of the ACA will result in the net loss of about 209,000 jobs in the state – most in the health industry, but with significant job losses in the food industry, janitorial, accounting, and others serving hospitals and clinics.

Democratic legislators in Congress are united in opposing the GOP plan.

And it is no wonder that Republican members of Congress are also feeling the heat. At town halls across the state during last month’s Congressional recess, many were hounded by constituents demanding that the Affordable Care Act remain in place.

Those legislators are still feeling the heat. Some, especially in the Central Valley, have large portions of their population covered by Medi-Cal. Rep. David Valadao, R-Hanford has over 110,000 constituents enrolled in Medi-Cal, while Rep. Jeff Denham, R-Turlock has over 100,000 who are covered.

Even House Majority Leader Rep. Kevin McCarthy, R-Bakersfield – a strong proponent of the new bill – has over 81,000 Medi-Cal enrollees in his district.

Given these developments, it may be no surprise that on the eve of the committee hearings, most California Republicans in Congress were reportedly “still studying” the measure.


Marilyn Bechtel
Marilyn Bechtel

Marilyn Bechtel writes for People’s World from the San Francisco Bay Area. She joined the PW staff in 1986, and currently participates as a volunteer.