Obamacare repeal could affect insurance for 150,000 Sonoma County residents

Sonoma County health care officials Tuesday warned the newly introduced Obamacare replacement bill could upend the local health care system, leading to the loss of health coverage or dramatic benefits cuts to nearly 150,000 residents, and cost thousands of jobs and $200 million in economic losses.

The plan, introduced Tuesday by House Republicans and endorsed by President Donald Trump, is already receiving strong opposition from conservatives, who said it failed to establish a free-market health care system, and liberals, who feared it would cause millions of Americans to become uninsured.

Billed the American Health Care Act, the GOP’s plan also included language that would defund Planned Parenthood and restrict abortion coverage. That drew condemnation from abortion rights advocates at rallies at congressional district offices across the country, including at Rep. Mike Thompson’s in Santa Rosa.

“Defunding Planned Parenthood would be devastating to the reproductive health care of women in Sonoma County,” Kim Clement, a volunteer and community organizer, said at a gathering of about 100 people, many carrying signs supporting the organization that also provides birth control, pregnancy screening and testing for sexually transmitted disease to mostly low-income patients.

The GOP plan seeks to “repeal and replace” Obamacare. Some 23,000 county residents are newly insured through the state’s Covered California health exchange, while another 35,000 residents have new coverage through Obamacare’s expansion of Medi-Cal, California’s version of the federal Medicaid program. A total of about 150,000 Sonoma County residents are enrolled in private insurance through Covered California or government insurance.

The replacement plan calls for rolling back the Medicaid expansion by 2020. It also calls for capping future spending by funding Medicaid through state block grants.

That would almost certainly cause a future reduction in Medi-Cal services or enrollment, said Barbie Robinson, director of Sonoma County Health Services. Robinson, who has worked at the federal Centers for Medicare and Medicaid Services in Atlanta and San Francisco, said “block-granting” Medicaid would essentially shift the financial responsibility to states and counties.

That, she said, would most likely lead to Medi-Cal cuts.

“It would put us on the hook for reducing the number of individuals who have coverage,” Robinson said.

Supervisor Shirlee Zane agreed.

“It’s a cost shift down to states and local governments,” Zane said. “Anybody who knows anything about funding knows it’s bad news. It means a decrease in funding.”

Under the GOP plan, Obamacare subsidies in the individual market would be replaced with individual tax credits to help people buy their own insurance. Also, the controversial individual mandate would be eliminated.

To encourage people to purchase health insurance the plan would allow insurance companies to impose a 30 percent penalty if coverage lapses beyond 63 days.

On Tuesday, some statewide health care groups blasted the GOP proposal, warning it would cause some to lose their health coverage while others face higher costs.

“California has the most to lose because we had the greatest expansion of coverage under the Affordable Care Act,” Anthony Wright, executive director of the Sacramento-based advocacy group Health Access, said on a conference call with reporters.

More than 1 million Californians bought coverage through a new health insurance marketplace, Covered California, while nearly 4 million more joined Medi-Cal, which is jointly funded by the state and federal government.

The Affordable Care Act has led to a drop in the state’s uninsured rate from 17.2 percent in 2013, before the law fully took effect, to ?7.4 percent in 2016, said Ken Jacobs, chairman of the UC-Berkeley Center for Labor Research and Education, who also participated in the teleconference.

According to University of California health officials, a repeal could cost Sonoma County 2,000 jobs and an economic loss of nearly $200 million.

Thompson, D-St. Helena, who also held a teleconference Tuesday afternoon from Washington, D.C., said he had deep concerns about the GOP, which he said rushed the replacement bill through the House of Representatives without proper analysis of its impact.

“Estimates are that if (Obamacare is) repealed, California could lose 350,000 jobs,” he said. “Without hearings or appropriate analysis, we don’t know that for sure. It’s pretty clear that the tax provisions will be a windfall to some corporations and billionaires.”

On Monday, Rep. Jared Huffman, D-San Rafael, convened a panel of health care experts at a Petaluma town hall where he offered a scathing review of GOP plans.

Nearly 1,000 people packed into the Petaluma Veterans Memorial Hall to share their concerns about a changing health care landscape as Huffman promised to fight potential “irresponsible” actions.

He said while the Affordable Care Act has its shortcomings, he recognized its help providing quality health care and boosting coverage.

“We should try to improve it, not repeal it,” he said. “It’s very clear to me that if we were to repeal this law, and certainly without putting an adequate and comprehensive replacement in place first, the impacts would be devastating for millions of people.”

Dave Hodges, a Santa Rosa-based broker with Vantreo Insurance Brokerage, said the GOP plan could lead some to drop their health insurance, particularly those in the middle-income range currently subsidized by Obamacare.

Hodges is no fan of Obamacare, but said he likes the replacement plan’s inclusion of health savings accounts that allow individuals to self-insure for health care. He said the plan also eliminates some of Obamacare’s bureaucratic reporting requirements.

But Hodges said the plan does not resonate with conservative values, as it keeps many of Obamacare’s key components.

“In my opinion, it isn’t a real replacement of Obamacare,” he said.

Aside from potentially increasing the number of uninsured, Sonoma County Health Services’ Robinson said the GOP plan could result in cuts to local community health centers, which saw tremendous growth and financial support under the Affordable Care Act. Many of the newly insured, both through Covered California and the expansion of Medi-Cal, are now treated at local health centers.

These health centers, which employ 1,000 people, provide primary care, dental and mental health to 100,000 Sonoma County residents annually. The loss of Medi-Cal dollars could be devastating.

“Clearly, we’re looking at pre-ACA levels of service,” Robinson said.

Naomi Fuchs, CEO of Santa Rosa Community Health Centers, one of the largest health care providers in the county, said gutting Medi-Cal would hurt more than just the area’s most vulnerable residents

“The economic fallout to Sonoma County would be tremendous both in lost jobs, missed work due to illness and increased premiums to everyone as the cost of care rises,” Fuchs said.

Statewide, Planned Parenthood serves about 850,000 people, about 80 percent of whom are considered low-income, Clement said. About 3 percent of all patients get abortions, she said.

Local numbers were not available.

Under current law, no federal money pays for abortions, but Republican lawmakers inserted a provision barring Planned Parenthood from receiving subsidies if it continued performing them. That would threaten many other essential services the health center provides, supporters said.

“It’s very shortsighted,” said Jacqueline Abdalla, a Santa Rosa family medicine doctor who attended Tuesday’s rally. “Financially, it doesn’t make sense in the long run.”

This story contains information from the Associated Press. Hannah Beausang of the Petaluma Argus-Courier and Staff Writer Paul Payne contributed to this story. You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @renofish.