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.
Ready for another year? Follow along here.
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 argues the Affordable Care Act is no longer valid because the recent tax overhaul by Congress eliminated the requirement that individuals have health insurance or pay a fine.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 Attorney General Xavier Becerra filed a federal records request today for information about the impact of the Trump administration’s “zero tolerance” policy on immigrant children’s mental and physical wellbeing.
The Freedom of Information Act request seeks all records related to the creation of the policy and the federal government’s determination of its ability to care for the influx of children detained as a result of the policy.
The request follows a hearing last week in which federal health official Jonathan White said he warned the Trump administration of potential negative effects children could suffer if they were parted from their undocumented immigrant parents. “Separation of children from their parents entails significant harm to children,” said White. “There’s no question that separation of children from parents entails significant potential for traumatic psychological injury to the child.”
“Last week’s Congressional hearing shows that this President and his Administration received warnings about the impacts of the family separation policy and still acted,” said Becerra in a press release. “We must have answers and accountability. We all deserve to know what went into the federal government’s inconceivable decision to separate thousands of children from their families.”
Becerra’s request targeted the Justice, Homeland Security and Health and Human Services departments, and included disclosure of senior staff communications—including memorandums, emails, and notes of meetings or calls regarding the “zero tolerance” policy. He specifically is pursuing internal communications from Attorney General Jeff Sessions, Homeland Security Secretary Kirstjen Nielsen and the current and former secretaries of Health and Human Services.
President Trump has defended the policy as necessary to stem what he has characterized as a host of societal ills resulting from illegal immigration. “It’s about keeping families together, while at the same time, being sure that we have a very powerful, very strong border,” he said in a statement.
Note: This post has been revised to correct the number of lawsuits Becerra has filed against the Trump administration.
Legislators in California appear ready to counter a new Trump administration move, this time on health insurance.
Last week, federal officials announced they would expand health insurers’ ability to sell so-called skinny insurance plans, short-term policies that offer only bare-bones benefits. Those plans also are called “junk” plans because of the dearth of conditions and ailments they cover—for instance, most don’t cover maternity care or cancer treatment, and some have high deductibles or exclude pre-existing conditions.
Less expensive because of the “skinny” coverage, the plans were launched under the Obama administration as a bridge to Affordable Care Act plans. They were limited to three months and could not be renewed.
The new federal rules allow low-benefit plans that don’t comply with ACA standards to last a year and be renewed for up to three years.
A proposal making its way through California’s Legislature, which returns from summer recess tomorrow, would ban such insurance in California.
SB 910, by Democratic Sen. Ed Hernandez of Azusa, would outlaw issuance or renewal of any health plan shorter than 12 months in duration. ACA standards require longer-term insurance, bar denial of coverage based on pre-existing conditions and mandate 10 essential health benefits.
The short-term, low-benefit plans are fine as long as you stay well, Hernandez said. But people with those plans who get sick often discover they have to pay for treatment and medication themselves. Basically, he said, that’s not health care coverage.
“California needs to ban junk health insurance policies in our state, not only because they are an affront to the basic principles of the Affordable Care Act, but also because they are dangerous and deceiving,” Hernandez said by email Friday.
Dozens of Republican legislators have either voted No on his bill or abstained, but did not articulate that opposition in hearings. Attempts to contact several of them were unsuccessful Friday.
One health care expert said he had hoped the idea of limited-benefit plans had been put to rest, after the years of policy discussion before and during setup of the Affordable Care Act.
“There are significant costs to having skinny plans,” said Micah Weinberg, president of the Bay Area Council’s Economic Institute, a San Francisco-based business think tank. “People still get medical care, even if it’s not covered, so the hospitals or the state end up holding the bag.”
That means taxpayers are basically subsidizing people on limited-benefit plans, he said.
“It isn’t actually insurance,” Weinberg said. “It provides a sense that you’re insured, but if you need it, you don’t really have it.”
- Short-term insurance expansion 'bad news for small businesses', by Mark Herbert, California Director for Small Business Majority on Aug. 8, 2018
A federal appeals court ruled today that President Trump does not have the authority to withhold federal funding from so-called sanctuary cities and counties.
Upholding a lower court decision, the U.S. 9th Circuit Court of Appeals said the power to allocate federal funding belongs to Congress: “The Executive Branch may not refuse to disperse the federal grants in question without congressional authorization.”
Last year, U.S. District Judge William H. Orrick III in San Francisco issued a national injunction against an executive order that Trump issued five days into his presidency. The president’s order directed that federal monies be withheld from “sanctuary” jurisdictions such as San Francisco.
San Francisco and the County of Santa Clara, which have declared themselves sanctuary jurisdictions, limiting cooperation with federal immigration authorities, sued the Trump administration.
Orrick said Trump’s order was unconstitutional, violating the Separation of Powers doctrine and the Fifth and Tenth amendments.
Today, the 9th Circuit panel of judges agreed but removed his injunction, except in California, citing a lack of evidence to keep it in place elsewhere and returning it for reconsideration. The judges said California, specifically San Francisco and Santa Clara counties, are “likely targets” of Trump’s order and retained it for the state.
The federal Justice Department denounced the decision on funding as “a victory for criminal aliens in California.” The state “will protect them from federal immigration officers whose job it is to hold them accountable and remove them from the country,” spokesman Devin O’Malley said in a written statement.
California laws limiting cooperation with federal immigration agents went into effect this year. Dozens of local governments have dissented, suing the state, joining a federal lawsuit against the policy or taking other actions.