Resistance State: California in the Age of Trump
Between Sacramento and Washington D.C. sits the rest of the country, and a chasm. On immigration and taxes, guns and healthcare, cannabis and climate change, California is the federal government’s equal and opposite reaction. One year into President Trump’s first term, the push and pull continues—playing out under the Capitol dome, in the courts and on Twitter.
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California Attorney General Xavier Becerra moved today to intervene in a Texas lawsuit aimed at undoing Obamacare. Becerra and 15 other attorneys general joined forces to file their motion to prevent “immediate and irreparable harm,” as Becerra put it, to California and other states.
At stake is an estimated $160 billion in federal dollars for California’s health care system, with a combined potential loss of about $500 billion for 15 states and the District of Columbia, according to Becerra. The Trump administration and the Republican-controlled Congress repeatedly have tried to unravel or eliminate Obamacare, with mixed results.
“The Affordable Care Act changed the world,” Becerra said. “We can’t and we won’t go back.”
He pointed out that roughly 5 million people were signed to insurance coverage in California through Obamacare, under the Covered California exchange and the state’s expansion of Medi-Cal ranks. Before Obamacare, he also noted, many health conditions weren’t covered even if patients had insurance, and some patients were denied care based on pre-existing conditions. But all of that changed under the Affordable Care Act.
If Obamacare is overturned, the federal dollars that go with it will evaporate. That includes subsidies for insurance bought through the Covered California exchange, and a large share of the cost for California’s Medi-Cal expansion.
The 16 Democratic attorneys general hope to be allowed to participate fully in the court debate, which affects states outside of Texas.
“Striking down the Affordable Care Act would cause immediate and irreparable harm to California and the nation,” Becerra said. “If this lawsuit goes forward, it will cause chaos. It’s our intent to protect families in California.”
Texas et al. v. United States et al. argues the Affordable Care Act is no longer valid because the recent tax overhaul by Congress eliminated the requirement that individuals have health insurance or pay a fine. Without that penalty, Obamacare no longer includes a tax imposed by Congress, and that spells the end of it, according to the lawsuit.
“Once the heart of the ACA—the individual mandate—is declared unconstitutional,” the Texas complaint says, “the remainder of the ACA must also fall.”
“The repeal of the Affordable Care Act would have devastating consequences for California and the nation,” said Gerald Kominski, director of the UCLA Center for Health Policy Research. “The (Texas) lawsuit seems frivolous, because Congress modifies existing law all the time, but that does not invalidate the original law being modified.”
Becerra noted that the ACA’s constitutionality already has been upheld by the U.S. Supreme Court.
The other attorneys general joining the motion to intervene are from Connecticut, Delaware, Hawaii, Illinois, Kentucky, Massachusetts, North Carolina, New Jersey, New York, Oregon, Rhode Island, Virginia, Vermont, Washington and the District of Columbia.
California’s sanctuary law—by limiting how much state and local law enforcement could cooperate with federal immigration agents—engaged in a we-won’t-hold-‘em policy that outraged the Trump administration. Now its federal border patrol agents reportedly have upped the ante.
Those agents have begun refusing to turn over suspects wanted by California law enforcement agencies for crimes such as sexual assault and drug possession, instead either charging them with immigration-related federal crimes or simply deporting them, according to a story in the Los Angeles Times.
This latest escalation of the power struggle between the Trump administration and California worries some immigration advocates and legal experts.
“It does seem to be a tit for tat,” said Jean Reisz of the University of Southern California’s Gould School of Law. “And that doesn’t serve anyone well.”
Jon Rodney of the California Immigrant Policy Center, a nonprofit advocacy group in Sacramento, had stronger words: “This move underscores the deeply hypocritical, manipulative and deceptive nature of the federal government’s deportation force.”
At the root of Reisz’ concern is not just the escalation of rhetoric, or any political maneuvering that might be going on. The law is written for its victims, she said, who may not feel they got justice if the accused is sent back home.
“It’s illegal to leave the country if there’s a pending criminal case against you,” Reisz said. Reportedly, convicted felons who were accused of serious crimes such as sex offenses were deported rather than turned over to California police.
The details about these particular deportations isn’t clear—the Times affected Southern California sheriff’s departments declined to comment, saying federal authorities hadn’t provided them enough information to identify which suspects they had refused to transfer.
Some police officers and sheriffs from conservative cities and counties have lambasted California’s sanctuary policy and called for it to be overturned.
Both the state’s sanctuary law and the apparent federal retaliation against it mark a departure from the cooperation that once existed between California police and sheriffs and immigration agents.
We have another lawsuit.
With a new filing this morning, California Attorney General Xavier Becerra brought the state’s total number of legal challenges against the Trump administration to 33. That’s two lawsuits per month since the president assumed office.
The question at issue this time: did the Environmental Protection Agency violate federal procedures when it reversed an Obama-era rule requiring agricultural companies to train their workers about the hazards of pesticides? This is the eighth case brought against the agency or its administrator, Scott Pruitt.
Track all of California’s lawsuits against the Trump administration here.
California already has taken its first shot at countering the Trump administration’s plan to deny funding for reproductive health services to any organization that provides abortions or makes referrals for the procedure.
This week California led a coalition of 19 states and the District of Columbia in backing a Planned Parenthood motion for an injunction to halt the federal plan. The states’ brief was filed in the U.S. District Court for the District of Columbia.
The Trump administration today is expected to release the details of its proposal to change the requirements for the funds, known as Title X money, effectively taking it away from groups like Planned Parenthood and instead awarding it to groups advocating natural family-planning methods and abstinence-only education.
According to California Attorney General Xavier Becerra, California receives about $20.4 million a year in Title X money, which helps provide family-planning and other reproductive health services to roughly 1 million low-income Californians.
“Medical care is a matter between a woman and her doctor, not the President or the Vice President,” Becerra said in a March 18 statement.
According to reports from the New York-based nonprofit Guttmacher Institute, a research and policy group, roughly half of the pregnancies in the U.S. are unintended. The rate of unintended pregnancies would jump by 66% without publicly funded contraceptive services, a Guttmacher report said—and unplanned pregnancy rates for teens would be 73% higher.
The Institute said Planned Parenthood is the source of birth control for about a third of all low-income women who get it through the Title X program.
“Title X is not abortion care,” said Jennifer Conti, a Stanford physician who provides abortions. “One of the things even my close friends and relatives don’t understand is that Title X funds have never been used to provide abortion care. This seems like a punitive rule for groups like Planned Parenthood.”
Conti said what rankles her most about the proposed rule is the restriction on discussing where patients can get an abortion.
“This new rule would force us to lie to our patients,” she said. “Not that we couldn’t discuss abortion—but not being able to discuss how to carry out an abortion or where to get it, I think that puts patients’ lives in danger.”