Gov. Jerry Brown and Insurance Commissioner Dave Jones couldn’t have differed more in the style of their recent responses to House Majority Leader Kevin McCarthy’s request for “ideas” on the pending repeal of the Affordable Care Act. But the substance, in both cases, was sobering.
Both boiled down to a fairly clear message: Finding a real alternative is fine, but repealing Obamacare with no viable replacement will wreck insurance markets, send premiums soaring, blow a hole in the state budget and return us to a time when millions were just one health emergency away from the poorhouse.
Both also hinted at an increasingly pointed question for the Bakersfield Republican who was sent to Congress to defend this state’s interests: Just whom is McCarthy looking out for, anyway?
Some 5 million Californians – and 20 million Americans – “have health insurance coverage they would not have, but for the Affordable Care Act,” Jones noted in his letter. Nine out of ten Californians are insured, thanks in part to the law, and the proportion of uninsured Californians has been halved since 2013 to 8.6 percent, a historic low.
A big reason for that success is the expansion of Medicaid to cover not just the poorest of the poor, but the working poor also. Of the newly insured in this state, 3.7 million people – or about four in five – got their insurance via the Obamacare expansion of Medicaid, known in California as Medi-Cal.
Few have benefited more than Central Valley families like those in McCarthy’s district, which includes most of Kern and Tulare counties. Some 400,000 people from San Joaquin to Kern counties are newly insured due to the Medi-Cal expansion, including an estimated 70,000 in McCarthy’s district. Overall, 55 percent of Tulare County’s residents and more than 45 percent of Kern County rely on Medi-Cal.
President-elect Donald Trump said Sunday that he’s putting the finishing touches on a plan for “insurance for everybody,” whatever that means. But congressional Republicans want, among other things, to slash Medicaid and Medi-Cal spending. If that happens, few Californians will pay more dearly than McCarthy’s constituents.
Also hurt will be tens of thousands of Kern and Tulare County residents who are insured through this state’s Obamacare exchange, Covered California. Nine out of 10 can afford the premium payments because they receive subsidies.
Congressional Republicans are talking about replacing those subsidies with a tax credit that many, if not most, of those families won’t qualify for because they earn too little to pay taxes. What will happen to their health care if those subsidies go away?
Those are just two of the outsized ways people in the Central Valley are about to be betrayed by Republican representatives in Congress. Unemployment in Kern and Tulare counties runs about twice the state average. Roughly a quarter of their residents live in poverty, according to the U.S. Census. These points were underscored in Jones’ letter to McCarthy.
Another GOP plan would allow insurance to be sold across state lines, essentially reducing regulation to the lowest common denominator, so that consumers would no longer benefit here from California’s tough insurance protections. Yet another would segregate sick people with pre-existing conditions in expensive “high-risk” pools, which have been tried before, including in this state, and were miserable failures.
McCarthy has a safe seat, but still, what is he thinking? What politician risks harming constituents?
Not to mention the national trauma. McCarthy’s own Congressional Budget Office estimated this week that 18 million Americans would lose their health insurance in Year One of the repeal of the Affordable Care Act.
Maybe someone should send the majority leader a memo reminding him where he’ll be running in 2018.