Obamacare grows in California but suffers a defeat nationally. Kaiser mental health workers go on strike to protest lack of resources.
Good morning, California.
“We’ll be exploring in our commission the hybrids in the rest of the world and consider tenets that may work in California.”—Gov.Gavin Newsom, announcing the creation of his Healthy California for All Commission to study a single-payer form of health care.
- The commission will meet first in January, report back in July, and deliver a final report in February 2021, after the next president is inaugurated.
An Affordable Care Act success
California’s version of the Affordable Care Act is experiencing significant enrollment increases, while participants’ health is improving and costs are being contained. Such was the message put out Wednesday by Gov. Gavin Newsom and Peter Lee, who oversees Covered California.
California extended the deadline to Friday for signing up for coverage starting Jan. 1.
Fueling a surge in new enrollees: Newsom and legislators decided to use state tax money to subsidize premiums of Californians whose income makes them ineligible for federal subsidies.
Newsom’s predecessor, Jerry Brown, did not take that step.
Some facts, provided by Covered California:
- California experienced the biggest drop in uninsured people of any state.
- In 2013, 17% of Californians had no health insurance.
- Now, 7.2% of Californians are not insured. Many of them are ineligible because they are undocumented immigrants.
- Only 3% of Californians who are eligible for health insurance are not insured.
- Premiums will rise 0.8%.
Meanwhile: The U.S. 5th Circuit Court of Appeals, with jurisdiction over Southern states, on Wednesday declared the Affordable Care Act requirement that people buy health insurance—the individual mandate—is unconstitutional.
That ruling doesn’t impact California for now, though Newsom said President Trump is “hellbent” on gutting the law.
- Unaffected: California lawmakers approved a state-only individual mandate, imposing a state tax penalty of $2,000 for a family of four for failing to buy health insurance.
An Affordable Care Act defeat
Attorney General Xavier Becerra vowed Wednesday to appeal an appellate court decision striking down the individual mandate requirement that Americans carry health insurance.
Remind me: Becerra, who helped write the law a decade ago when he was in Congress, is taking the lead on behalf of states controlled by Democrats in defending the Affordable Care Act against a broad legal challenge.
On behalf of Republican states, Texas Attorney General Ken Paxton seeks to have the entire entire law declared unconstitutional. The Trump administration sided with Texas and refuses to defend the law.
On Wednesday, the U.S. 5th Circuit Court of Appeals in New Orleans handed Paxton and Trump a partial victory.
By a 2-1 margin, the appellate court judges concluded that the mandate that people buy health insurance was rendered unconstitutional in 2017 when Congress, then fully controlled by Republicans, passed Trump’s tax cut legislation that eliminated the penalty for failing to be insured.
The judges left the remainder of the Affordable Care Act in place. For now, federal law requires that insurance companies provide coverage for people who have preexisting conditions, offer mental health care coverage, and let young adults up to age 26 stay on their parents’ health plans.
Judicial appointments: Presidents George W. Bush and Trump appointed the two judges who struck down the individual mandate. President Jimmy Carter appointed the dissenter.
Becerra intends to file an appeal to the U.S. Supreme Court:
- “It’s time to get rid of the uncertainty.”
Money matters: Becerra’s political operation emailed a fundraising appeal late Wednesday citing the ruling and urging people to “chip in today to stop President Trump’s reckless Republican agenda.”
Mental health parity protest
Kaiser Permanente mental health care clinicians are on a five-day strike, protesting long patient wait times and strenuous working conditions for providers.
CalMatters contributor Jocelyn Wiener reports that strikers say children and adults with serious mental health needs, including schizophrenia, anxiety and severe depression, are often waiting 6 to 8 weeks — sometimes longer — to see a therapist.
They intend to march from the Capitol to the Department of Managed Health Care today to protest what they called “the agency’s failure to enforce parity legislation.”
Kaiser spokesman Marc Brown called the strikes “disruptive to patient access, operational care and service and…frankly irresponsible.”
School bond and education equity
California’s proposed $15 billion education bond proposal, Proposition 13, includes a focus on funding equity that could have the biggest impact on public schools in poorer districts, CalMatters education reporter Ricardo Cano writes.
Remind me: If approved by voters, Proposition 13 on the March 3 ballot would be the largest school bond ever in California. Authored by Assemblyman Patrick O’Donnell of Long Beach and Sen. Steve Glazer of Orinda, the bond would earmark $9 billion for K-12 schools and $6 billion spread among the California State University, University of California and community college systems.
The change: Funding would be prioritized for poor public school districts that historically have been shut out, as Cano detailed earlier this year.
The top priority: Schools with critical health and safety projects, such as Trinity County’s Burnt Ranch Elementary School. Teachers at the small, cash-strapped school district taught students in portables for nearly three years while dealing with a mold crisis.
Notable: Many districts in need are in red parts of California.
Gov. Gavin Newsom, who signed the bill placing the bond on the ballot, says the measure seeks to alter that inequity.
- “You go into some of these parking lots, these sheds without air conditioning and lead, they’ve got asbestos in those facilities – that’s not who we are. We’re capable of so much more.”
To read Cano’s story, please click here.
Newsom’s many top priorities
Does Gov. Gavin Newsom have too many top priorities to focus on housing? That’s the issue CalMatters’ Matt Levin and The L.A. Times’ Liam Dillon focus on in the latest the latest episode of “Gimme Shelter: The California Housing Crisis Podcast.”
Californians have identified homelessness and housing as the most important issue confronting the state.
Newsom, seeking to show he is acting, has touted steps he has taken:
- Expedited funding to shelter homeless people
- Retained Matthew Doherty, the homelessness expert pushed out by the Trump administration. (Details of the scope of his work remain to be determined)
- Announced a 100-day challenge for local governments to target homelessness among young adults and veterans
Levin and Dillon interviewed Ben Metcalf, former head of the Housing and Community Development Department, who believes Newsom’s ambitious agenda beyond housing makes it difficult to focus on the task at hand:
- “There are more than a handful, a couple of handfuls, of really high-priority things for (Newsom) and his administration that he’s trying to all get done at the same time.”
- “It is hard for any human being in any elected office to be really able to push forward on so many different fronts all at the same time.”
To hear the Gimme Shelter podcast, please click here.
Commentary at CalMatters
Robert Lempert, RAND Corporation: As California and our nation head into uncharted territory due to climate change, all of us will need to learn how to adjust in response to changing risks. We will all need to become more adaptive by acting, learning and responding. To survive our changing climate, we will need to understand that even what looks familiar no longer is.
Dan Walters, CalMatters: State officials want to declare a $1 billion financial information system complete, even though it’s just half-baked and lacks essential features.
See you tomorrow.