LOS ANGELES – The Los Angeles County Board of Supervisors voted unanimously Tuesday to push back against the threatened repeal of the Affordable Care Act, widely known as Obamacare.
Supervisor Mark Ridley-Thomas recommended strong opposition, telling his colleagues, “The erosion has already begun … it’s not just the loud voices in Congress, it’s not just the loud voice on Pennsylvania Avenue.”
Ridley-Thomas cited an executive order issued by President Donald Trump that grants exemptions from the ACA and delays further implementation. The Internal Revenue Service has since said it won’t reject filings from taxpayers who fail to state whether they have paid for health insurance mandated by the law.
In addition to pressing legislators not to repeal Obamacare, the board directed the county’s CEO, Sachi Hamai, and the head of the county hospital system, Dr. Mitchell Katz, to explore other options.
Katz told the board that some changes are likely.
Nobody thought that the ACA was perfect … how do we improve on it?” Katz asked the board. He said premiums are too high and 85 percent of working people cannot afford insurance unless it’s subsidized.”
Katz mentioned some ways he believed healthcare costs could be reduced, including the possibility of controlling drug costs. Offering another example, Katz said some elderly patients might be happier in assisted living, but Medicare only covers more expensive nursing home care.
The state manages Medicaid and will be front and center in addressing changes to the healthcare system. However, Katz and others said Los Angeles County should have a big role given its outsize population and control of one of the state’s most active public hospital systems.
“We are the second-largest public health system in the country,” Hamai said. She said the county receives about $900 million in federal funding for its healthcare system.
A recent study by the UCLA Center for Health Policy Research and UC Berkeley Labor Center warned a repeal could trigger a loss of $5.8 billion in gross domestic product and eliminate 63,000 jobs in healthcare and other industries in Los Angeles County alone.
Speaker Paul Ryan has said House Republicans “are working to repeal and replace Obamacare to help people who are struggling with these higher premiums, to help people who have lost their plan or their doctor or both, to help people left with just one insurer to choose from, as is the case with one out of every three counties in America.”
“This is not what the country was promised — far from it,” Ryan, R-Wisconsin, said at a Washington news conference earlier this month. “More and more, we see things getting worse. More and more, we see this law collapsing in front of us. So we could do one of two things. We could just sit back and watch the collapse happen and see people get hurt, or we could step in and conduct a rescue mission, which is to rescue the American health care system from the collapse that is coming because of Obamacare.”
Ryan and new Department of Health and Human Services Secretary Tom Price have proposed changing Medicaid — which was expanded in many states under the ACA — from a co-funded federal and state program to one paid for by a block grant of federal dollars.
Proponents say block grants would allow those closest to the patient population to control costs and treatment. Opponents say block grants would cut funding without cutting costs.
Ridley-Thomas called the proposal the most serious budget issue either the state or county had faced in years.
Supervisor Janice Hahn urged those who see the benefits of the ACA to attend town halls and be vocal in their support.
In addition to roughly 1.2 million county residents who gained health insurance under the ACA, many more benefited from provisions that allowed children to stay on their parents’ policies until age 26, prohibited insurers from denying coverage based on pre-existing conditions, eliminated caps on catastrophic illnesses and required more employers to offer insurance, Ridley-Thomas said.
–
William says
First things first.
1st. we gotta educate the public, especially the uneducated people that trump loves, that the ACA and Obamacare are the EXACT SAME GD THING.
Then, just maybe, we can discuss it.
roger says
The 5 worst policies in American history (in any order you like):
1). the Civil War
— e.g., the Federal government spent 20 times what it would have otherwise cost, buying slaves to freedmen status.
2). Simpson-Mazzoli Act of 1986 (aka: IRCA)
— e.g., Ronald Reagan’s amnesty bill; Mexican nationals overwhelm border agents bum-rushing the policy, en mass; population of Los Angeles doubled, overnight.
3). Korea & Vietnam
— e.g., point of departure; where America came off the rails.
4). the Patriot Act
— e.g., the greatest crime ever perpetrated upon our Founding Father’s constitution; America’s 4th, 5th, 6th and 8th amendments effectively overturned; America’s 1st and 2nd amendments precariously teeter on a knife-edge, at the brink of annihilation.
5). the Affordable Healthcare Act
— e.g., the Obama-care, shoved straight down your throat, without a referendum; clever implement, cloaked as an insurance mandate, for an end-around assault on your 2nd amendment privilege; America’s best days, well behind her.
You heard it, straight from the horse’s mouth, Barack Obama himself had little choice but begrudgingly concede, ACA is a hopelessly defective policy. He said he’s sorry.
William says
Oh, roger. roger roger roger.
How did you forget the 2 misbegotten wars in Iraq?
Bush 41 LET SADDAM HUSSEIN INVADE KUWAIT thereby making it necessary for us to fight the first Persian Gulf War. Remember now?
Then of course, bush 43 invaded Iraq after 9/11 looking for WMDs that weren’t there. Remember now?
Or, were you born yesterday? I can’t believe you either purposely or unwittingly forget those 2 wars.
Kristopher says
… another baby-step forward in the criminalization of anti-insurance behavior, the Obamacare compels you to pay, 5 times:
1). tax receipts diverted to healthcare subsidies —
2). stratospheric premiums —
3). astronomical co-pays —
4). coinsurance & deductibles —
5). cash-on-the-barrel to the drug-dealers, for your prescription meds —
Crux of the dilemma, vexatious billing by medical professionals gaming the system, insurance is a poor solution for healthcare. We are unequivocally better off internalizing risk, paying cash-on-the-barrel.
Trudy says
I recently read an interview from Noam Chomsky, MIT professor, that discusses ACA repeal. In it, he provides facts, and also insight on the strange complicity and submission from so many Americans that want to repeal ACA, even without having any clear plan on how they will make healthcare affordable. Insurance increases are trending at about 7-9% annually across the country. And insurance is already unaffordable. People who work can’t afford to cover their families right now with insurance, from the private sector.
As a democracy, we must demand better for our families. If I am a working citizen, in a society, and my healthcare is uncertain, and having no insurance, would equate death, that is a tragic society to live in. Over 100 years ago people were dying because there were no cures, now people are dying over profits. If you were diagnosed with cancer today, and could not afford insurance, and/or were in remission, and pre-existing conditions would automatically exclude you, would this be ok?
Before the insurance industry came along, physicians made house calls. I am too young to remember those days, but maybe some of you of medicare age do remember. General practice physicians earned conservative salaries and took their oath for healing with integrity. There are some physicians today that are horrid, and unapologetic. Perhaps, this attitude, stems from our own egoic concerns, and that statistically for every 100 attorneys there is 1 engineer in the US, in Japan its actually reversed. So sue happy people, don’t help our doctors. Cleary 100 years ago, the ideal patient and physician relationship resembled little house on the prairie and no insurance. Now you are luck you can keep your physician in the room for more than 5 minutes, and forget you ask any other questions.
People are quick to claim repeal, perhaps not fully accepting the fragility of your health. In an instant you could find yourself, sick, unemployed and uninsured; also not 65 to qualify for medicare. So understand what you are fighting against. If you prefer death, then by all means continue to comply, but if you prefer to live, then consider what and whom is your champion for living.
Also, question the manner in which the word “Obamacare” is used with those trying to win your submission. Ask them if they are willing to also “Johnsoncare”, which is the same as Medicare, signed by President Lyndon Johnson, on July 30, 1965, with its first card holder President Truman. Better yet, how about we repeal Social Security, which was signed by FDR on August 14, 1935.
Albeit, I am agreeable to a compromise, to an affordable option, or perhaps eliminating insurance all together and going back to a pay as needed system. But as Chomsky describes in his article, why in an American democracy isn’t; the population demanding what it strongly prefers? Why is it allowing a concentrated private capitalist to undermine necessities of life in the interests of profit and power?.
The answer is not that difficult. Our ancestors suffered through hunger, drought, death, famine, and were broken to the brim. Had to stand in bread lines. Lost loved ones due to lack of medicine and medical care. Seniors were left to die without food or shelter. Perhaps our ancestors understood the true meaning of charity, because they had to experience it firsthand. Walk in the shoes of the destitute and forgotten and may your heart be softened.
Augustino says
.. hey, everyone! I have an idea! Let’s toss another IOU into social security, print money save who may, and inflate the economy asunder, squandering our national wealth flushing it straight down the Obamacare, subsidizing free healthcare for the hoodlums, the punks, the brothas, and the gangbangers. How about another friendly game, of good old fashioned Washington DC bond Ponzi?
Tim Scott says
Here’s a thought…get an education before you claim to have ideas.
Kristopher says
… the judicial objective of the Obama-care was, establishment of a legal precedent for the criminalization of anti-insurance behavior. In their secret war against America, the government in Washington DC wants to legislate away your right of choice, how you personally choose to externalize or internalize risk. If they can control that, if they can decree a birth contingent insurance mandate (e.g., the act of being born automatically triggers mandatory insurance compliance), poof-gone, there goes your 2nd amendment privilege, automatically. Hinged upon it, once your Founding Father’s 2nd amendment privilege is gone, like dominoes falling, so goes your 1st amendment privilege –
Tim Scott says
BS. There was no “internalizing” of risk. If someone needed medical treatment, they got it, and the public paid for it. That’s been true forever, and was formalized when Ronald Reagan made it outright illegal to turn away people at a hospital emergency room. All the ACA did was push that cost of care off the public (who pay for that emergency treatment through the government) onto the insurance companies, since healthcare paid for by insurance companies generally costs less than emergency room care paid for through the government by the public.
You should probably seek treatment yourself, as it appears your tin foil hat is cutting off circulation to your brain.
William says
People don’t seem to understand the shared risk that insurance is, especially those who say they’ll never need a certain treatment.
However, others are sharing the risk with them for treatments they don’t need but others do. A woman getting pregnancy care shares the risk with a young man who rides a motocycle and gets hurt although she doesn’t ‘ride’.
As for young people who are normally healthy who don’t want to share the risk with older Americans, do they want to pay the full cost later when they are old and young people don’t want to subsidize their health care costs?
Laughing says
I think what was meant by externalizing or internalizing was
I am worried about my health and will get coverage.
I don’t want to be covered and I will just risk it.
Tim Scott says
That’s what was meant, and that’s what is an outright falsehood. The “I don’t want to be covered and I’ll just risk it” healthy hero of today is the “here I am at the ER and you can’t turn me away” sick crybaby of tomorrow.
That’s where the whole “stay out of my healthcare decisions” stance falls apart. The public, through the government, ends up paying either way. Unless we are willing to have emergency rooms say “no insurance, so get out there on the sidewalk and die,” of course. Now, no doubt there are plenty of people like Trump, cut from the “I got mine screw everyone else” cloth, who will claim they are fine with that.
Unfortunately, there are at least two critical aspects that make it completely unworkable. First off, from a marketing standpoint, hospitals can’t do it. Telling people to just get out and go die would destroy their image, and their business, and they know it.
Secondly, from a public health standpoint you can’t tell someone “yeah, you may have a contagious disease but since you don’t have insurance get lost.” Sure, it would be good for the hospital’s business when all the insured people who caught the disease showed up the next day, or week, or month; but is that really a good outcome? Add to that the vermin and diseases that spread from all the uninsured people dying on the sidewalk in front of the hospital and you have the public health crisis that Reagan was avoiding.
Ultimately, individual health is a contributing fact in public health, and there is no way around that.
William says
@Tim Scott
Apparently, those who complain about the ACA don’t know nuttin’ about insurance and such things as ‘cost shifting’ which is what hospitals do to stay in business.
A well-insured patient is paying more in premiums and the hospital ‘cost shifts’ uncompensated care costs to that person’s insurance company.
Or, uncompensated care can be subsidized by higher taxes.
Take yer pick.
Laughing says
I like your reply to me Tim Scott. SPOT ON!
Laughing says
Actually the ACA is part of a maneuver to get everyone on a socialistic system for healthcare. Rumors abound that it also was pushing a big pharma plan for pills on every little thing, but I doubt those rumors as the TV ads seem to be working just fine (go ask your doctor about something you dont need but we told you need and you sucked it right up).
Laughing says
Augustino, as tax payers our taxes go to help the gang members, and other groups you mentioned anyways since hospital emergency rooms are not allowed to turn people away. The inflation will happen, because most people do not understand resetting an economy , but they understand I want more so give me more (minimum wage hikes).