Plan de Salud Republicano Podría Afectar a Millones de Latinos

March 16, 2017 by · Leave a Comment 

Millones de latinos, en especial los ancianos y aquellos de bajos recursos, se verían afectados si se aprueba el nuevo plan sanitario republicano que reemplazaría al Obamacare, alertaron activistas.

“No se equivoquen: este plan dañará a los latinos, los estadounidenses que trabajan e, irónicamente, a los partidarios de Trump que estaban pidiendo su derogación”, dijo a EFE el presidente del movimiento de líderes hispanos Latino Victory Fund, Cristóbal J. Alex.

Las advertencias y las criticas aumentaron tras el reporte publicado este lunes por la Oficina de Presupuesto del Congreso (CBO) que asegura que la aprobación del nuevo proyecto republicano de seguro de salud que reemplazaría la Ley de Cuidado de Salud Asequible (ACA), conocida como “Obamacare”, dejaría sin un seguro de salud a 14 millones de personas ya en 2018.

Las proyecciones para los próximos años tampoco son alentadoras. El número de personas sin cobertura médica aumentaría a 24 millones en 2026.

Aunque el reporte no habla de la comunidad hispana, antes de la implementación de Obamacare, al menos 4.2 millones de hispanos lograron obtener un plan de salud bajo el programa de ACA, y esta cobertura representa la diferencia entre la vida y la muerte para muchos hispanos como Guadalupe Guerrero.

Hace un año y medio la joven fue sometida a un transplante de corazón. Su plan de salud de Obamacare le ha permitido obtener las medicinas y controles que necesita.

“Por muchos años no tuve seguro médico y por eso no pudieron detectar mi condición a tiempo, yo soy el ejemplo de lo que pasa cuando no tienes medicina preventiva”, aseguró a EFE Guerrero, de 28 años.

Entre 2013 y 2016, la población latina logró reducir en 11 puntos porcentuales el número de personas que carecían de cobertura médica, al pasar del 26.2% al 15.1%, lo que la convierte en la segunda comunidad más favorecida después de la afroamericana.

La salud de las latinas también estaría en riesgo con la nueva propuesta republicana, que elimina fondos a Planned Parenthood, la mayor organización de planificación familiar de Estados Unidos. Con Obamacare 17 millones de hispanas lograron tener acceso a controles de cáncer cervical, mamogramas y a pastillas anticonceptivas.

“Desde que tengo consciencia he sabido que las hispanas confían en Planned Parenthood para que les brinde servicios a bajo costo, esto sería devastador para nuestra salud y para prevenir enfermedades graves”, apuntó a EFE Hortencia Armendariz, vocera del sindicato SEIU-United Healthcare Workers West.

Alex, al igual que congresistas demócratas, sostiene que los republicanos criticaron ACA durante siete años y ahora, en lugar de mejorar el proyecto para ayudar a los que aún no han obtenido un plan de salud, optaron por eliminar la cobertura de los miembros más vulnerables de la sociedad.

En California, el golpe a la salud de latinos sería “devastador”, pues un tercio de los 1.4 millones de asegurados bajo el programa Covered California es hispano.

“Hemos visto que hay mucho miedo entre los hispanos a perder la cobertura”, advirtió Yurina Melara, vocera de Covered California.

La zozobra ante la posibilidad de perder el seguro de salud también afecta a residentes de estados como Florida, donde Donald Trump ganó en las elecciones pasadas y donde al menos 1.6 millones de residentes del estado están en riesgo.

Para Martha Baker, enfermera y directora del sindicato SEIU local, la revocación de ACA mandaría a miles de hispanos a las salas de emergencia, lo que llevará a se llegue a pagar por la amputación de una pierna en vez de pagar por la insulina de un diabético.

Pero la preocupación no es sólo para los que pagan un seguro por medio de Obamacare, el Comisionado de Seguros de California Dave Jones advirtió que al menos cinco millones de personas amparadas con Medicaid, se verán afectados por los recortes, y 150,000 niños hispanos del estado dorado fueron incluidos el año pasado en este servicio.

“Nuestros abuelitos tendrán que pagar más y recibir menos beneficios de atención médica, mientras que los individuos y corporaciones más ricos de este país recibirán un recorte de impuestos de $900,000 millones”, lamentó Alex.

Las organizaciones que representan Armendaríz, Baker y Axel, junto a otras decenas, trabajando ya para detener la derogación de Obamacare y la implementación del plan republicano. El 23 de marzo el Congreso votará la medida, en abril será el turno del Senado.

“La única solución a futuro es que sostengan Obamacare y que ayuden con más recursos para poder extender la cobertura, no hay otro camino”, aseguró Armendariz.

Impulsores de Nueva Ley de Salud Defienden Plan Para Eliminar Obamacare

March 9, 2017 by · Leave a Comment 

Los congresistas republicanos Greg Walden y Kevin Brady, impulsores del nuevo plan para cambiar el sistema de salud, aseguraron hoy que ataja dos asuntos fundamentales que preocupaban a los estadounidenses, devolver el control a los estados y la libertad de elección a los consumidores.

En una rueda de prensa conjunta, Walden y Brady defendieron los principios de sus dos proyectos de ley, que desvelaron este lunes y que tienen como objetivo desmantelar la reforma sanitaria promulgada por el expresidente Barack Obama.

Brady insistió en que la ley actual, conocida como Obamacare, “es una ley fallida” que no le permite a los estadounidenses pagar los costes sanitarios ni los copagos, por lo que la ciudadanía necesita “un alivio inmediato” como el que ellos plantean.

“Esta propuesta le devuelve el poder a la gente para tomar sus propias decisiones sobre su cobertura de salud”, insistió el congresista, presidente del Comité de Medios y Arbitrios de la Cámara de Representantes, que este miércoles comenzará a debatir las nuevas piezas legislativas.

Por su parte, Walden insistió en que la propuesta que han diseñado, y que hoy obtuvo el respaldo de la Casa Blanca, es fundamental para “avanzar en crear más opciones de mercado”, de manera que cada ciudadano pueda escoger su plan sanitario.

La propuesta, largamente esperada después de las promesas reiteradas de derogación y reemplazo de la reforma sanitaria, desmantela las disposiciones básicas de Obamacare, incluyendo sus subsidios para ayudar a la gente a adquirir sus seguros y la expansión del Medicaid, programa para el acceso sanitario a la gente con bajos recursos.

Asimismo, termina con los mandatos de adquisición de coberturas, que obligaban a los individuos que no contaban con ningún tipo de seguro a adquirir uno si no querían ser multados, además de retirar los fondos para Planned Parenthood, la mayor organización de clínicas que ofrecen el derecho al aborto en el país.

No obstante, la propuesta ya ha encontrado detractores en las propias filas republicanas: por un lado, de aquellos conservadores más moderados cuyos estados se vieron beneficiados por el Obamacare; y por otro, los más conservadores, como Rand Paul, que lo han calificado como una versión “Light” del sistema actual.

“Hemos escuchado muy cuidadosamente a los republicanos de la Cámara de Representantes sobre cómo hacer lo mejor para devolver el control a los estados, regresar a un mercado libre y hacer eso equilibrando el presupuesto”, defendió Brady, quien dijo convencido que este nuevo plan ampliaría aun más las coberturas.

Con una mayoría republicana muy ajustada en el Senado, los conservadores podrían ver bloqueada esta nueva propuesta en la Cámara Alta, lo que prevé un largo y agrio debate en el Legislativo, al que se sumará la oposición demócrata.

Además, la oficina presupuestaria no partidista del Congreso (CBO, en inglés) aún no ha analizado el contenido e impacto de los proyectos legislativos, por lo que no existe una previsión clara de su efectividad.

En ese sentido, la líder de la minoría demócrata de la Cámara Baja, Nancy Pelosi, requirió a los republicanos que no comiencen el debate este miércoles, como tienen previsto, hasta que no se emita dicho informe.

If Obamacare Is Being Repealed, Do The Uninsured Still Face Penalties?

February 9, 2017 by · Leave a Comment 

California Healthline – In some recent emails, readers asked about what to expect as Republicans move to overhaul the health law. Should people bother paying the penalty for not having health insurance when they file their taxes this year? Will they be able to sign up on the exchange for 2018 after their COBRA benefits end? Here are some answers.

  1. I didn’t have health insurance for part of last year and thought I’d get stuck paying a penalty. Now the new administration is talking about not enforcing the insurance requirement. Could I really be off the hook at tax time?

As long as the “individual mandate” — which requires most people to have health coverage or face a tax penalty — is the law of the land, you should pay the fine for not having coverage in 2016 unless you qualify for an exemption, said Tara Straw, a senior policy analyst at the Center on Budget and Policy Priorities. Straw also manages a Volunteer Income Tax Assistance site, part of an Internal Revenue Service program that provides free tax filing services for low and middle income taxpayers.

Straw said she has heard that some tax preparers are advising taxpayers either not to pay the penalty or to delay filing because they anticipate changes in the law.

Bad idea. “It’s not a thing a reputable tax preparer would do,” Straw said. “The requirement that people have health insurance or an exemption [from the mandate] is still in effect.”

The confusion stems from uncertainty over Republican officials’ comments that they may do away with the individual mandate when they overhaul the health law. In addition, President Donald Trump signed an executive order in January that required federal agencies to waive or exempt health law-related provisions that would impose costs or penalties on individuals, to the extent permitted by law.

One strategy that has been discussed has been to broaden the hardship exemption so more people would qualify for it, which the secretary of Health and Human Services has the authority to do.

However, Straw says that approach might run into trouble. “A hardship has to mean something, you can’t say that everyone has a hardship,” she said. “Complying with the law is not considered a hardship.”

Some experts say changing the rules now could create even more confusion, since some people have already filed their returns. Those taxpayers might have to file amended returns, an extra expense if they use a tax preparer.

“Since the 2016 tax season is already underway, I would think it unlikely that the Treasury Department would say, ‘Don’t bother paying the penalty,’” said Mark Luscombe, a principal federal tax analyst at Wolters Kluwer Tax & Accounting, an information services company.

KHN contributing columnist Michelle Andrews writes the series Insuring Your Health, which explores health care coverage and costs.

Foul-Up Means Thousands On State Exchange Surprised By Higher Premiums

January 26, 2017 by · Leave a Comment 

California Healthline – Thousands of Covered California enrollees face higher-than-expected bills from their insurers because the exchange sent incorrect tax credit information to the health plans.

The exchange confirmed it gave insurers wrong subsidy information for about 25,000 policy holders, resulting in inaccurate bills. Insurers are now sending out new bills correcting the errors, and in most cases that means higher premiums than consumers had initially anticipated.

“It feels like this is a bait-and-switch,” said Beth Freeman, 53, of San Bruno. “Now what am I going to do? I don’t know if I can afford it.”

Freeman said she owes about $330 per month more on her premium than she had expected.

Covered California said it doesn’t know what caused the problem. “We are focused on reaching [enrollees] and making sure they know what to expect,” said spokeswoman Lizelda Lopez. “We will do an analysis afterwards to understand all the details.”

Lopez said Covered California originally sent consumers their correct tax credit amounts in notices during the renewal period, but it gave the incorrect amounts to their insurers.

However, Kevin Knauss, an insurance agent in Sacramento, said a Covered California representative told him in a phone conversation that consumers had found incorrect tax credit amounts when they signed onto their online Covered California accounts.

Tax credits are the income-based subsidies that about 90 percent of Covered California enrollees receive to lower their monthly premiums.

In another mistake related to tax credits, Covered California discovered in December that about 24,000 policy holders hadn’t provided consent for the agency to verify their income, even though the agency thought they had. Without that consent, thousands of consumers lost their 2017 tax credits, at least temporarily.

“I don’t know what’s going on,” Knauss said. “2015 and 2016 went fairly smoothly. Now we’re starting to see these weird glitches.”

Lopez said most consumers affected by the latest mistake will owe more out of pocket than they originally thought, and that health plans are entitled to bill them for the difference.

“Some may,” she said. “Some may not.”

The recent tax credit error has left consumers like Freeman feeling shocked and frustrated.

She had struggled through administrative headaches with her Covered California plan last year, so when it came time to renew it — or choose a new one — for 2017, “I was very cautious and nervous. I shopped around and got information from the folks at Covered California and Blue Shield,” she said.

She said Covered California gave her inconsistent information about the amount of tax credits she would receive. So she called the exchange twice to confirm the number, and was told both times it would be $800 a month. That was more than she expected, and it allowed her to afford a more expensive plan with better coverage, she said.

After receiving an updated bill last week that showed her actual tax credits were hundreds of dollars less than expected, Freeman called Covered California again and was told the problem had been caused by a “computer data error,” she said. The agent told her there was nothing Covered California could do and that she should try to negotiate directly with Blue Shield, she said.

“I subscribed to Blue Shield based on the information given to me and confirmed by Covered California,” she said. “It’s unethical that Covered California is unwilling to accommodate me so I can stay in my contracted plan.”

Enrollees in this situation can call Covered California’s special hotline at 844-623-2070 for more information.

If their updated premiums are unaffordable, there’s still time for enrollees to switch health plans before open enrollment ends on Jan. 31, Knauss said.

But Freeman already has seen new doctors with her new plan. “Why must the consumer carry the burden of these errors?” she asked.

“Covered California continues to mismanage and, worse, misinform the public when they make errors. And there’s no accountability, no follow up.”

 

California Retira Petición Para Acceso de Indocumentados A Planes de Salud

January 26, 2017 by · Leave a Comment 

Los legisladores en Sacramento han frenado un esfuerzo, el primero en la nación, para que California amplíe el acceso a la cobertura de salud para los inmigrantes indocumentados.

A instancias de la Legislatura estatal, Covered California, el mercado de seguros del estado, retiró su solicitud de vender planes de salud sin subsidio a personas indocumentadas.

Bajo la Ley de Cuidado de Salud Asequible (ACA), las personas que no pueden demostrar que están en el país legalmente tienen prohibido comprar cobertura en el mercado de seguros.

Los inmigrantes en esta situación habían depositado sus esperanzas en la solicitud del estado de una exención a esa regla, presentada el otoño pasado al gobierno federal. Si se hubiera aprobado, se les habría permitido a los californianos indocumentados comprar planes bajo Covered California y unirse a los aproximadamente 1,3 millones de personas actualmente inscritas.

El senador estatal Ricardo Lara (demócrata de Bell Gardens) y otros demócratas encabezaron el esfuerzo para ampliar el acceso. La legislación fue aprobada el año pasado y el gobernador Jerry Brown firmó la medida en junio, autorizando que Covered California presentará una solicitud a los funcionarios federales para renunciar a la prohibición de tales ventas.

Pero las posibilidades de aprobación federal se atenuaron considerablemente con la elección de Donald Trump, quien se ha comprometido a deportar a los inmigrantes que estén en el país sin documentos oficiales, y a derogar la ley de salud.

Peter Lee, director ejecutivo de Covered California, se negó a comentar sobre el retiro de la solicitud del estado. Él se refirió a una carta del mercado de seguros enviada el miércoles 18 de enero a la administración de Barack Obama, que decía que la propuesta fue archivada a petición de Lara.

Lara dijo en una declaración escrita que estaba retirando el plan porque temía que el gobierno de Trump pudiera usar la información con el propósito de deportar a inmigrantes indocumentados.

El plan para venderle cobertura a inmigrantes indocumentados sería “la primera víctima de California de la presidencia de Trump”, escribió Lara. “Tomo en serio las palabras de Trump de que cualquier persona está sujeta a deportación en cualquier momento, y California no será parte de una campaña inhumana contra los inmigrantes que están trabajando duro y siguiendo las reglas”.

La decisión de dejar al lado el plan llega justo cuando el futuro de la salud de millones de californianos pende de un hilo, ya que los líderes republicanos en Washington, D.C. intentan derogar las principales disposiciones de la ley de salud.

Anthony Wright, director ejecutivo del grupo de defensa del consumidor Health Access California, dijo que el movimiento del estado refleja una reorganización de prioridades. Lo que es urgente ahora, dijo, es preservar las ganancias actuales en la cobertura de salud de los californianos. Y para traer inmigrantes indocumentados a Covered California, los funcionarios deben asegurarse primero de que el intercambio sobreviva, explicó Wright.

“No queríamos que esta solicitud de exención, que seguramente será rechazada, impidiera la defensa de estos programas básicos que brindan cobertura a tantos”, dijo.

Era inesperado que la venta de planes de salud de Covered California a inmigrantes sin estatus legal aumentara significativamente la inscripción en el mercado. Esa población, a diferencia del aproximadamente 90 por ciento de los afiliados actuales, no habría calificado para subsidios federales para reducir sus pagos.

Esto le habría dificultado a muchos el pagar las pólizas. Por otra parte, los inmigrantes que están en el estado ilegalmente ya pueden comprar un seguro de salud en el mercado privado, y las opciones de cobertura y las costos son similares a la de los planes vendidos en el mercado de intercambio.

El pasado agosto, Covered California estimó que sólo 17.000 californianos habrían ganado cobertura de salud como resultado de la expansión del mercado a la población indocumentada.

Muchos expertos y defensores de los consumidores acordaron que el esfuerzo fue en gran parte un gesto simbólico, pero importante, para muchas personas.

Los partidarios dijeron que el permitirle a los inmigrantes indocumentados comprar cobertura en el mercado habría abordado un problema para muchas familias, aquellas que tienen miembros con y sin documentos. La propuesta habría permitido a esas familias de “estatus mixto” comprar sus seguros juntos a través de Covered California, simplificando el proceso. Muchos argumentaron que era discriminatorio prohibirle a los inmigrantes sin papeles comprar un seguro a través del mercado estatal.

Lara y otros patrocinadores del esfuerzo lo vieron como un paso importante hacia la expansión de la cobertura de salud a todos los californianos, independientemente de su estatus migratorio.

Magdalena Velázquez, de San José, quien trabaja como voluntaria en el grupo de apoyo de Servicios, Derechos de Inmigrantes y Red de Educación (SIREN), ha estado siguiendo el tema de cerca. Aunque no tiene un estatus legal en los Estados Unidos, tiene cobertura de salud a través del empleador de su esposo. Pero muchos de sus familiares y amigos no tienen seguro médico.

“Tristemente, una vez más estamos viendo que la lucha por nuestros derechos de salud tiene que ser pausada”, dijo Velázquez.

Cuando California presentó su solicitud al gobierno federal el año pasado, los partidarios esperaban que la administración Obama la revisara rápidamente, aumentando sus posibilidades de aprobación, dijo Wright. Pero hasta el martes, el proceso de solicitud sólo había pasado por una revisión preliminar.

Algunos expertos en atención de salud creen que la aprobación no se habría garantizado incluso si la administración Obama hubiera completado su revisión antes de que Trump asumiera el cargo. En primer lugar, excluir a los inmigrantes sin papeles fue un compromiso que ayudó a que ACA avanzara en el Congreso, señalaron, y los funcionarios de Obama hubieran sido reacios a renunciar a ella.

Budget Scorekeepers Say GOP Plan Would Raise The Number Of Uninsured By 32M

January 19, 2017 by · Leave a Comment 

The bill considered the most likely prototype for partial repeal of the Affordable Care Act would result in as many as 32 million more people without health insurance and would double premiums in the individual insurance market, budget scorekeepers said Tuesday.

The estimate by the Congressional Budget Office and the Joint Committee on Taxation was on the impact of the bill passed by the Republican Congress in 2015 and vetoed by President Barack Obama last January. The analysis was conducted at the request of Senate Democrats.

“The number of people who are uninsured would increase by 18 million in the first new plan year following enactment of the bill,” said the report. That increase could reach 32 million in 2026.

At the same time, CBO and JCT estimate, premiums for those who purchased coverage in the individual insurance market would increase by 20 to 25 percent in the first year, “and premiums would about double by 2026.”

Republicans called last year’s bill a “dress rehearsal” for what they might try this year, because it was a “budget reconciliation” bill that needs only 51 votes to pass in the Senate and cannot be filibustered. Last week the House and Senate passed a budget resolution instructing specific committees to begin work on dismantling the health law, using the same budget reconciliation process.

Only items that directly impact the federal budget can be included in such a bill, however. That meant last year’s legislation would have repealed most of the ACA taxes that help fund the health law’s programs, the penalty for individuals who don’t have coverage and the tax subsidies for people to purchase coverage, as well as the funding to expand the Medicaid program. But it could not change the health law’s regulation of the insurance market, including the provision requiring insurers to sell to people with pre-existing health conditions.

The result, said CBO, would have been fewer healthy people purchasing coverage, which would leave the insurance pool with higher percentage of sick enrollees and drive premiums up. Insurers, according to the report, would likely stop offering coverage in the individual insurance market.

Senate Minority Leader Mitch McConnell, R-KY., heads to his office in the U. S. Capitol on September 30, 2013. The House of Representatives passed a continuing resolution with language to defund U.S. President Barack Obama’s national health care plan (Obamacare) two days ago. (Douglas Graham/CQ Roll Call)

Senate Majority Leader Mitch McConnell and other Republican leaders called last year’s bill a “dress rehearsal” for what they might try this year. (Douglas Graham/CQ Roll Call via Getty Images)

“CBO and JCT estimate that about half of the nation’s population lives in areas that would have no insurer participating in the nongroup market in the first year after the repeal of the marketplace subsidies took effect,” said the report. And that would rise to “about three-quarters of the population by 2026.”

Democrats were quick to pounce on the estimate as evidence that Republicans are on a dangerous path.

“Repeal and delayed replacement is repeal,” outgoing Health and Human Services Secretary Sylvia Burwell told reporters at a briefing. “CBO has just stated with analytics and real numbers what happens during that interim period” when part of the law is taken away and part remains.

“Today’s CBO report is a clear repudiation of the Republicans’ misguided plan to repeal the Affordable Care Act,” said Rep. Richard Neal, D-Mass., the ranking Democrat on the House Ways and Means Committee.

Republicans cautioned, however, that last year’s bill might not be a good reflection of what will happen in the coming weeks and months.

“The CBO can’t score the replacement because it hasn’t been drafted,” wrote GOP health policy analyst Avik Roy in Forbes. “But its estimates of the impact of (last year’s bill) are largely meaningless without consideration of what the GOP’s replacement will look like.”

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

El Senado de EE.UU. Aprueba Primera Medida Para Eliminar ‘Obamacare’

January 19, 2017 by · Leave a Comment 

El Senado aprobó una resolución el 12 enero considerada un primer paso para revocar la reforma sanitaria del todavía presidente, Barack Obama, conocida popularmente como el “Obamacare”, de la que se benefician unos 20 millones de ciudadanos.

Con 51 votos a favor y 48 en contra, la resolución da luz verde a varios comités del Congreso para que empiecen a preparar la legislación que desmantelará “Obamacare”, una de las principales promesas electorales del presidente electo, Donald Trump, y caballo de batalla de los republicanos desde su aprobación en 2010.

La resolución, aprobada como medida presupuestaria, pide a los comités que tengan lista esa legislación para el 27 de enero, lo que permitiría al Congreso revocar “Obamacare”, o parte de ella, en febrero, a los pocos días de la asunción de Trump.

Se espera que la Cámara de Representantes, que los republicanos controlan con holgura, apruebe también esta resolución mañana, viernes.

La medida representa una jugada legislativa que eventualmente permitirá a los republicanos revocar “Obamacare” con una mayoría simple en el Senado -que controlan 52 a 48- gracias a su carácter presupuestario y no con los 60 votos que se necesitan para rechazar muchas normas y que requeriría el apoyo de algunos demócratas.

Aunque la mayoría de republicanos coinciden en el propósito de revocar “Obamacare”, muchos han expresado reparos por la prisa de hacerlo antes de tener pactado su reemplazo.

En una entrevista el martes con el The New York Times, Trump llamó a los legisladores republicanos a derogar de forma inmediata “Obamacare” y poner en marcha un plan alternativo rápidamente.

El presidente electo confió entonces en que el Congreso ponga fin a lo que calificó como “catastrófico” programa en los próximos días y dijo que su reemplazo debería llegar “muy rápida o simultáneamente”, en un plazo inferior a “semanas”.

Promulgado en 2010, “Obamacare” establece la obligatoriedad de contar con un seguro médico y es considerada el mayor logro legislativo de los ocho años de mandato de Obama.

Defensores de Niños Advierten Contra Modificación de Obamacare

December 29, 2016 by · Leave a Comment 

Un nuevo reporte publicado el 6 de diciembre muestra que una enmienda parcial del Obamacare (o Affordable Care Act en inglés) podría tener serias consecuencias para muchos Californianos.

El reporte del Instituto Urban afirma que eso pondrá en peligro a muchos de los niños del estado.

En enero, el Congreso dirigido por republicanos tendrá en la mira la Ley de Cuidado Asequible o Ley de Cuidado a Precio Accesible, (Affordable Care Act o “Obamacare” en inglés). El reporte del Instituto Urban sugiere que aunque solo se enmienden partes de la ley, eso podría dejar a 4.9 millones de Californianos sin seguro.

Kally Hardy, de “Children Now”, con base en California, dice que se trata de avances que se perderán incluso para las familias, incluyendo a mas de medio millón de niños actualmente asegurados.

“Más y más muchachos han estado obteniendo cobertura de salud,” dijo Hardy quien agregó que eso también disminuye la preocupación entre los padres de los jóvenes acerca de sus finanzas.

Foto de Archivo

En un lapso de 10 años, el estado también podría perder mas de $160 millones en fondos federales para asegurar la salud. (Foto de Archivo)

Los detractores de la ACA refutan este argumento como una táctica de miedo, y Paul Ryan, Vocero del Congreso, dijo recientemente que una enmienda parcial permitiría, un “buen periodo de transición” a los millones de personas que obtuvieron cobertura debido al plan.

Joan Alker, del Centro para Niños y Familias (Center for Children and Families) en la Universidad de Georgetown, comenta que hay mucha desinformación sobre el ACA. Un gran numero de indocumentados en el estado, por ejemplo, ni siquiera están cubiertos por esta ley y les aconseja al publico a informarse, porque los cambios pueden venir pronto.

“Los lideres del Congreso se movilizarán muy rápido para tratar de resolver esto en enero, en cuanto regresen de las fiestas,” dijo Alker. “La gente no se da cuenta de que esto puede pasar tan rápido y tampoco ven las consecuencias.”

El reporte del Instituto Urban predice que esas consecuencias incluyen una enorme ruptura en la industria de los seguros, y un incremento en el número de estadounidenses sin seguro a comparación de las cifras previas al vigor del Affordable Care Act.

Para más información o para leer el reporte en inglés haga click aquí. 

State Senate’s Health Chairman Vows To Defend California Coverage Gains

November 22, 2016 by · Leave a Comment 

A key state health care figure vowed Thursday to defend the coverage gains California has seen under the Affordable Care Act in the face of widely expected efforts by President-elect Donald Trump to overturn much of the health reform law.

“I want to assure you, your staff and Californians that we stand ready to fight to keep what is working in this state,” Sen. Ed Hernandez (D-West Covina), chairman of the Senate Health Committee, told the board members of Covered California, the state’s health insurance exchange, in their first public meeting since Trump was elected on Nov. 8.

“What we have is too important to lose,” said Hernandez, an optometrist. He cited examples of people who had come into his optometry office for the first time because of their newly gained health coverage.

Any rollback in coverage, Hernandez said, would hurt millions of Americans.

California’s rate of uninsurance has been cut roughly in half since 2014, when federally subsidized health plans sold through the exchange first took effect and eligibility for Medicaid, the health care program for low-income individuals, was expanded. Both are key features of the Affordable Care Act, also known as Obamacare.

Health advocates who addressed the board Thursday sent the same message as Hernandez, expressing support for the ongoing efforts of the exchange to sign Californians up for coverage in the fourth annual open enrollment period, which started Nov. 1 and ends Jan. 31.

Covered California officials said that Trump’s plan to “repeal and replace” the Affordable Care Act has created confusion among enrollees but that people are still signing up.

In the first two weeks of open enrollment, 44,885 new people have enrolled in health insurance through Covered California, according to numbers provided by the board. That’s down from about 50,000 in the same period last year.

But Peter V. Lee, the exchange’s executive director, noted that Covered California did not run ads at the beginning of this enrollment period because it didn’t want to compete with the election campaign. He said the new numbers are in line with Covered California’s projection of approximately 400,000 new exchange enrollees next year.

This week, the Centers for Medicare and Medicaid Services announced that more than 1 million people had selected plans on Healthcare.gov, the federal exchange website, during the first 12 days of open enrollment. Of those, 250,000 were new to the exchange. The number of people who selected plans was up 53,000 from the same period last year, according to CMS.

Covered California is the largest state-run marketplace. It has 1.4 million members, nearly 90 percent of whom receive federal tax subsidies to help pay their premiums.

Consumer advocates who spoke at the board meeting expressed optimism that California would maintain its status as a leader in health care reform, though many are also changing the conversation to focus on what parts of the Affordable Care Act might be kept.

It is unclear how far Trump will go in dismantling the health law. He conceded last week that he would like to keep some aspects of it — in particular, allowing young adults to stay on their parents’ health plans and banning insurance companies from refusing to cover people with preexisting medical conditions.

Health experts who addressed the Covered California board made it clear that everything is up in the air: The only thing they’d be willing to bet on is that the Republican replacement for the health reform law won’t be called Obamacare

Ian Morrison, a health care consultant and futurist, told board members that the Republicans’ sweep of the White House and Congress will probably mean a less regulated insurance market, the end of mandates to buy insurance, smaller federal subsidies for the uninsured and greater state control over Medicaid — which also means less federal funding for the program.

Both Trump and House Speaker Paul Ryan (R-Wis.) have endorsed the idea of transforming Medicaid into a block grant program, in which states would get fixed allotments from the federal government and would be responsible for any health spending above those amounts.

“When you hear the term block grant, that is code for less money,” Morrison said. “No one talks about block grants and more money.”

The overarching question, Morrison said, is this: Will health coverage for 20 million people be significantly eroded?

He also said he found it hard to understand how guaranteed coverage for people with preexisting conditions could be kept if buying insurance was no longer a requirement for all. The authors of the health reform law believed that a lot of young, healthy people needed to be in the insurance pool in order to ensure that the sick ones didn’t drive up the cost of premiums.

John Bertko, Covered California’s chief actuary, said people should be looking to 2018, since any changes in 2017 are highly unlikely.

“I suspect with the big rate increases, 2017 is going to be a good year for plans that are in exchanges,” Bertko said. He said that was “a bit ironic” given the cloud now hanging over Obamacare.

California Faces Major Reversal If Trump, Congress Scrap Health Law

November 10, 2016 by · Leave a Comment 

California has a lot to lose if President-elect Donald Trump and the Republican-led Congress fulfill their campaign pledge to repeal Obamacare.

The Golden State fully embraced the Affordable Care Act by expanding Medicaid coverage for the poor and creating its own health insurance exchange for about 1.4 million enrollees. Supporters held California up as proof the health law could work as intended.

But now President Barack Obama’s signature law is in serious jeopardy and California officials are left wondering what Republicans in Washington may put in its place.

“There is no doubt that Obamacare is dead,” said Robert Laszewski, a health care consultant and expert on the California insurance market. “The only question is just exactly how Republicans will get rid of it.”

Health policy experts don’t expect Republicans to immediately kick millions of people off their insurance policies. Instead, they predict lawmakers may repeal parts of the law and allow for some transition period for consumers while a replacement plan is put together.

Still, the personal and financial impact for the state could be jarring. The number of uninsured Californians would more than double to 7.5 million people if the Affordable Care Act was repealed, according to a recent study by the Urban Institute.

Researchers also said California stands to lose an estimated $15 billion annually in federal funding for Medicaid expansion and insurance subsidies — more than any other state. That loss of federal money would make it difficult for California to pursue health reform on its own.

State Sen. Ed Hernandez, (D-West Covina), chairman of the Senate Health Committee, said it’s difficult to predict what the next iteration of the Affordable Care Act may look like.

“Will there be federal subsidies? Will the state legislature pay for subsidies to ensure Californians have coverage? Those are open questions,” Hernandez said. “I will do everything I can to make sure California continues to take the lead on this issue.”

Congress already has voted to eliminate funding for Medicaid expansion and premium tax credits to dismantle two key pillars of the health law. Obama vetoed that legislation earlier this year, but Trump made the repeal of Obamacare a centerpiece of his campaign.

If repeal goes through, state leaders and consumer advocates may look to the ballot box, asking voters to fund expanded health coverage through higher taxes or fees. In Tuesday’s election, Californians backed the extension of a hospital fee to help pay for Medi-Cal, the state’s Medicaid program.

State officials could aim even higher and try for a government-funded single-payer health system at the state level. But that’s expensive, disruptive to the current system and a tough sell to the public. Colorado voters soundly rejected a state single-payer initiative during Tuesday’s election.

Some Republican lawmakers in California would applaud a reversal on Medi-Cal expansion. They have argued that state and federal spending increases on the program are unsustainable.

The state’s Medi-Cal program now covers about a third of all Californians. The health law’s Medicaid expansion has added about 3.5 million Californians to the program since January 2014 and total enrollment stands at more than 13 million.

Molina Healthcare, a Long Beach-based insurer, is a major player in Medicaid managed care nationwide and also covers about 600,000 people through exchanges in California and eight other states. The company’s chief executive, Dr. J. Mario Molina, said he thinks Covered California and other exchanges will become a smaller part of health reform under a Republican plan and coverage expansion will shift more to Medicaid.

Molina said Republicans in Congress could grant governors more flexibility on Medicaid benefits to keep costs down while maintaining guaranteed access to coverage regardless of preexisting conditions, a popular provision of the health law.

“Republicans have the benefit of looking back at the experiment of Obamacare and seeing what worked and what didn’t work,” Molina said in an interview. “I think the Republicans will negotiate a deal where Medicaid gets expanded with more state control and exchanges will play a different role. The most cost effective way to do coverage expansion is through Medicaid.”

Consumer advocates acknowledged the financial challenges posed by repeal but also encouraged Californians to keep signing up for coverage in the meantime.

“Californians should continue to enroll in Covered California this open enrollment season, in Medi-Cal, and all the benefits they are still entitled to–and then fight like hell to keep them,” said Anthony Wright, executive director of Health Access California, a consumer advocacy group.

But some Covered California policyholders expressed concern about what a Trump administration might mean for their coverage.

“I worry it will be gone, and I don’t know what I will do for insurance,” said Jane Henning Childress, 61, who lives in Calaveras County.

Taking into account her federal subsidy, she said she pays about $135 a month for her exchange plan. Earlier this year, she used it to help cover surgery for an ovarian cyst. “It sure helped me out,” she said.

Even before the election, some major health insurers were pulling out of the exchange market nationally and premiums shot up 22 percent, on average, for state and federal exchanges for 2017.

In the Covered California exchange, the average rate increase was 13.2 percent for next year. That’s higher than the 4 percent average rate increases that California negotiated its first two years. Open enrollment started Nov. 1.

Health insurers in California and nationwide face plenty of uncertainty as well from the election outcome. Some analysts said more insurers may exit state marketplaces rather than wait for them to unravel and risk getting stuck with too many expensive patients.

Four big insurers, led by Anthem Inc. and Blue Shield of California, account for about 90 percent of Covered California’s enrollment.

“The unthinkable has happened,” said Ana Gupte, a senior health care research analyst at Leerink Research. “With a Republican sweep of the White House, Senate and the House, we are looking ahead to a 2017 filled with much change and uncertainty in the health care markets.”

Story was originally posted on the CaliforniaHealthline website.

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