“Nothing about the ACA is easy or quick to explain.” Veronica E. Todd, MBA, FACHE
Photos: Nadin and Tom Abbott
Video: Tom Abbott, editing, Nadin Abbott
Jan 15, 2017 (San Diego) This press conference was called for by members of Congress Scott Peters (D-52) and Susan Davis (D-53). Other people present were Dan Gross, Vice President of the Sharp Healthcare, Vernita E. Todd, Senior Vice President of Health Center Partners, and people directly affected by the repeal. These were Timothy Mork, a skin cancer survivor, Stefani McMahon, who’s daughter has cancer, and finally Elizabeth Silva, who has an autoimmune disorder that will require a double lung transplant if she hopes to survive.
The first question is what is the Affordable Care Act. It was passed in 2010 and it extended insurance to 20 million people who did not have insurance before. According to Gross, Sharp Healthcare is the largest provider of healthcare in San Diego County. “Sharp Healthcare mission is to serve our communities, and provide caring, convenient, cost-efficient, accessible care to all San Diegans.”
Gross went on as to how the repeal would affect care. “Our mission is threatened, therefore we stand with Congresswoman Susan Davis and Congressman Scott Peters who represent our hospitals, health plan, services, physicians, and employees, to show our support of their efforts in Washington D.C.”
How could their mission be threatened? Or for that matter the American health care delivery system? Gross answered this, “in 2010 hospitals across America agreed to help pay for Affordable Care Act programs that sought to expand health insurance and access to care.” Hospitals believe that all people should have health care coverage, and later Silva said that this is a human right.
Gross also said that while the law is not perfect, a point that later on both Davis and Peters would repeat, “the Affordable Care Act has successfully increased health care coverage, access and the very quality of the care delivered in this country.”
Gross added some policy plans that Sharp wants to see.
- Health care coverage for more than 20 million newly insured Americans must remain.
- Any future replacement must maintain this achievement.
- If it is repealed, without a comprehensive coverage strategy, Sharp wants to see legislation that will refund his system $300 million dollars that Sharp needs to spend over the next 10 years in ACA programs. Sharp and other health care systems will need these resources to cover the rise in the uninsured. (The Congressional Budget Office expects to see 25 million by 2025, with 8 million getting insurance through their employers with a net gain of 17 million uninsured Americans.)
- Changes to the Medicaid program must ensure that the funding to the State of California not go down and keep pace with inflation. Provider reimbursement must cover the cost of care.
Davis emphasized that hospitals, clinics, and countless others “have spent the last six years planning and investing in making sure that our healthcare law works.” She did emphasize that “no law is ever perfect.” She admitted that there is much to improve the system. But then she went to cite he statistics of how many people have benefited from the law.
- 5 Million Californians have insurance for the first time in their lives.
- The uninsured rate in the United States is the lowest it has ever been.
- 300,000 San Diegans could lose access to healthcare.
- Many of them are veterans who do not necessarily get care when they leave the service. The ACA gave them access to care. Their uninsured rate has gone down by half. (Only those who did a full career, or have service-related injuries have the opportunity to receive care after service)
- Childhood uninsured rate has gone down by half.
- People with disabilities have also gained coverage.
- Repeal will affect virtually every American who has health insurance.
“We cannot allow ourselves to be caught in the politics of the moment and ignore the human tragedy of repealing health care.” The conversation in Washington does skip over the real impact the repeal will have on our communities. She has spoken to San Diegans who are “scared to death of losing their care.”
Davis also noted the situation before the ACA was passed.
- Lifetime Caps, as well as annual caps for treatment.
- Women paid more for their insurance.
- Seniors paid more for medications thought the donut hole.
- Preexisting conditions prevented people from even qualifying for insurance.
- The medical system is going to lose millions of dollars if the law is repealed, this represents 20 percent of the economy. At Sharp alone this is in the hundreds of millions. This will affect jobs. As we wrote last week, in California alone this means 100, 000 jobs lost by the end of the year.
Reporting San Diego asked specifically on these macroeconomic effects. Davis said that “This is a fifth of the economy. and when that happens, a lot of people are affected by that. People who may not think that it will matter for them. Maybe they have employer insurance. But it is going to make a difference for everyone. Particularly the predictability” She added that it is critical that this is done in a sensible way, and that people engage.
The consequences of a repeal, from reading the effects, in places like the Commonwealth Club, are simple. This will lead to a rise in unemployment and recessionary pressures. This is according, to among others, Michael Hiltzik, writing for the Los Angeles Times.
Access has improved, and she also remarked “in some cases it has saved their lives.” She added, “how many no longer have to chose between paying for their mortgage or getting needed treatment.”
Peters addressed a few other aspects of this. First off, he is “committed to critical fixes to the Affordable Care Act.” He also said that we cannot go back to the time when people with pre-existing conditions and other issues, had trouble with healthcare. He did state that “many of my colleagues in Congress have fastracked the repeal of the law wtiout any plan for a replacement.”
He added, that it would not just leave millions of Americans without heal care insurance, “but would also blow a crater sized hole in the federal budget. It would add $350 billion dollars to the national debt over the next 10 years.” (For those of you who have seen the 9.1 trillion, that is for the full budget resolution presented this week, over the same period).
This “makes it one of the most fiscally irresponsible actions that this Congress could make.” He did ask Speaker Paul Ryan to make improvements and work with Democrats. Among them he proposed reducing cost and investing in preventative medicine. He also mentioned that over the last renewal period, 128,000 San Diegans signed up or renewed their coverage.
Covered California serviced 1.4 million, while Medical has survived 3.7 million people. “A healthy workforce is a productive workforce,” he added.
The law has allowed people to move from one job to another, and for some to start businesses, that otherwise they could not have done before.
We are embedding the video of both Members of Congress speaking. They are Gross, Davis and Peters in order.
Todd addressed a few more policy matters. She represents Health Center Partners, a voluntary association of private non profit medical providers. These health centers serve more than 825,000 people in a 125 locations across three counties. As you might suspect, the future of the ACA matters to them.
She remarked that they see the impact of the ACA on the health of their patients. Their mission has been to increase access for over fifty years. They support the Patient Protection and Affordable Care Act. She also said, “Nothing about the ACA is easy or quick to explain. Partly becuase each topic is multifaceted with interdependent moving parts.”
Todd added, that this is not “an easy sound byte discussion. Nor should the decision for its repeal be.” She said the debate should focus on three things, policy, price and people.
She repeated some of the reasons on how the ACA protected citizens, most already covered above. Some were not.
- Insurance companies are required to spend premiums in healthcare. They are not to spend money on marketing, overhead or bonuses.
What is more important is that those who have employer provided healthcare are also protected by these policies and will be affected adversely with the repeal.
She also said that this week the repeal process started with a direct attack on parts of the bill that have a price tag. This will affect all of us, including a control on the employer based market. Meaning, insurance rates will rise. This is also attacking the Medical expansion that affects people who live just above the poverty line. Offering people health savings accounts and tax credits is senseless for people struggling to survive and pay the rent. A single person in San Diego needs to make under $15,800 a year, before taxes.
A single parent, with two kids needs to make under $27,813 before taxes, living in San Diego. This is also about the American people, and our shared interest as a society.
We are also embedding a video. The first person speaking is Doctor Dunford, the second is Todd.
We are also aware that all these numbers do not mean much until you put a face. So we are also embedding two videos with the stories of individual San Diegans and how the ACA has benefited them.
Mork was diagnose with a rare form of skin carcinoma. He was able to obtain insurance that allowed him to see specialists due to the ACA and the fact that no insurance can refuse him becuase of preexisting conditions.
McMahon has a young 3 year old, who was diagnosed with Cancer. Her daughter only was tread becuase they had insurance bought though the exchange. They are fully employed with good jobs. They are a middle class family, and without the ACA their daughter might not have gotten the treatment she needed.
Finally Elizabeth Silva, who has a rare condition on both her lungs. She is not a smoker, but her autoimmune disease led to her needing a double lung transplant if she is to survive and see her five year old son grow up.