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Plus, a lot of the doctors they’re used to seeing don’t take the marketplace plans.\u003c/p>\n\u003cp>“Being told you have to have insurance you can’t afford, and then that doesn’t cover what you need? You are stuck,” says Modoc County resident Althia Cline, who decided to forego coverage – and a surgery she needed for her asthma.\u003c/p>\n\u003cp>Just like the movie theater and bowling alley, most medical specialists are miles away. In Modoc County, there’s nowhere to have a baby. Tessa Anklin, who lives in Canby, Calif., gave birth to her son and daughter over the border in Oregon, an hour and a half away from home.\u003c/p>\n\u003cp>Anklin makes about $33,000 a year as a dental receptionist. Her husband does seasonal work baling hay and herding cattle at local ranches. While their kids are covered by Medi-Cal, neither parent gets health insurance through work, and before the Affordable Care Act passed, Anklin and her husband did without coverage for a while.\u003c/p>\n\u003cfigure id=\"attachment_353608\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-353608 size-medium\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/07/Tessa-front-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Tessa Anklin says Covered California health plans are too expensive for her family. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Two years ago, they bought a plan through Covered California. With a subsidy, they paid just $2 a month for their premium, but their deductible was $10,000.\u003c/p>\n\u003cp>“We paid for all of our medical services and our prescriptions,” she says. “We had no help until we reached the $10,000 deductible. So really, we had nothing.”\u003c/p>\n\u003cp>Then, last year, their monthly premium jumped to $600. The plan was the same, Anklin says, and their household income was the same. But they still faced the same hour and a half drive to see doctors they almost never needed.*\u003c/p>\n\u003cp>Anklin thought of all the other ways she could spend that money.\u003c/p>\n\u003cp>“It makes the car payment. Almost your mortgage payment. Groceries for at least four months,” she says. “That’s a big difference, when you think about how little you actually use the health coverage.”\u003c/p>\n\u003cp>That’s the reason she decided to cancel her health plan this year and go without. But she’ll still have to pay a penalty when the next tax season comes around.\u003c/p>\n\u003cp>“It basically penalizes us one way or the other because we can’t afford the coverage,” she says. “So that’s kind of difficult, to be that middle-class person.”\u003c/p>\n\u003cp>Anklin says she’d be happy to see Republicans get rid of Obamacare.\u003c/p>\n\u003cp>“To me, it’s no good, if you have to force people to pay yet another something out of their paycheck when they’re already trying to survive with what they have,” she says. “It should be an option.”\u003c/p>\n\u003cp>But the Republican repeal and replace plan wouldn’t make things much better for Anklin and her neighbors. Average premiums in California would double under the GOP plan, according to a recent \u003ca href=\"http://www.kff.org/health-reform/issue-brief/premiums-under-the-senate-better-care-reconciliation-act/\">analysis\u003c/a> from the Kaiser Family Foundation. Anklin could end up paying more than $2,000 a month for coverage, according to Kaiser’s \u003ca href=\"http://www.kff.org/interactive/premiums-and-tax-credits-under-the-affordable-care-act-vs-the-senate-better-care-reconciliation-act-interactive-maps/\">county-by-county projections\u003c/a>.\u003c/p>\n\u003cp>That’s not what she had in mind for a fix.\u003c/p>\n\u003cp>“I’d love that insurance could be more affordable for families that need it, for families that work hard for it,” Anklin says.\u003c/p>\n\u003cp>With the Republican bill now in flux, Democrats have been more willing to admit to Obamacare’s flaws. The Dems agree that the rising costs of marketplace plans are the chief complaint they hear about, too.\u003c/p>\n\u003cp>Democrats have also said if the Republican bill fails, they’d be willing to \u003ca href=\"https://www.statnews.com/2017/07/05/health-care-compromise/\">work together on solutions\u003c/a>, but it’s not clear the parties could agree on one that would help people like Anklin.\u003c/p>\n\u003cp>If they can’t, she says she has no choice but to continue to go without coverage. Financially it makes sense in the short term, but it still worries her.\u003c/p>\n\u003cp>“If I ever have a problem,” she says, “I know I will be paying for the rest of my life.”\u003c/p>\n\u003cp>[audio src=\"http://www.kqed.org/.stream/anon/radio/tcr/2017/07/2017-07-11b-tcr.mp3\" Image=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/07/Aaron-car-768x576.jpg\" Title=\"Rural Californians Want Price Relief From GOP Health Bill – But Most Won’t Get It\" program=\"The California Report\"]\u003c/p>\n\u003cp>\u003cem>*Premiums in this region of the state went up an average of 10.6 percent in 2016, according to Covered California’s \u003ca href=\"http://www.coveredca.com/news/\" target=\"_blank\" rel=\"noopener noreferrer\">rate booklet\u003c/a>, and most premium increases are matched with an increase in subsidy, so the most likely explanation for why Anklin’s premium jumped this much is that she lost her subsidy. This can happen if customers, intentionally or unintentionally, do not check a box on their application form that allows the federal government to verify their income, or, if customers do not file tax returns.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "In far northern Lassen and Modoc counties, residents say Obamacare premiums are unaffordable. But under the proposed Senate bill, insurance premiums would increase even more. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Aaron Albaugh peers out from under the brim of his cowboy hat, surveying the acres of hay fields in front of him. The fourth-generation \u003ca href=\"http://www.frostyacres.net/index.html\">rancher\u003c/a> is raising about 450 cattle this year, in this remote corner of Lassen County.\u003c/p>\n\u003cp>His closest neighbor lives a half mile away. “And that’s my brother,” Albaugh says.\u003c/p>\n\u003cp>“If I want to go see a movie, it’s 70 miles round trip,” he adds. “If I want to go bowling, that’s 100 miles round trip.”\u003c/p>\n\u003cp>Living a half day’s drive from civilization, you learn to do without, he explains. If your refrigerator breaks, you put your food on ice until the weekend when you can go buy a new one. With health care, it’s the same thing.\u003c/p>\n\u003cp>“Put a Band Aid on it,” Albaugh says. “I was raised: ‘You don’t need to cry’ and ‘Suck it up, buttercup.’ That’s the way I still live, and I try to treat my kids the same way.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So, when people are already used to doing without health coverage, it’s particularly annoying to have the government say you have to buy it, according to Albaugh and many of his neighbors in Lassen, Modoc and Shasta Counties.\u003c/p>\n\u003cp>While Obamacare is largely viewed as a success in California – the state marketplace, \u003ca href=\"http://www.coveredca.com/\">Covered California\u003c/a>, is one of the most financially stable in the country – it hasn’t worked as well for folks in this rural northeast corner of the state.\u003c/p>\n\u003cp>There are two insurers selling plans in each county here, but residents say that hasn’t created enough competition to bring down prices. Plus, a lot of the doctors they’re used to seeing don’t take the marketplace plans.\u003c/p>\n\u003cp>“Being told you have to have insurance you can’t afford, and then that doesn’t cover what you need? You are stuck,” says Modoc County resident Althia Cline, who decided to forego coverage – and a surgery she needed for her asthma.\u003c/p>\n\u003cp>Just like the movie theater and bowling alley, most medical specialists are miles away. In Modoc County, there’s nowhere to have a baby. Tessa Anklin, who lives in Canby, Calif., gave birth to her son and daughter over the border in Oregon, an hour and a half away from home.\u003c/p>\n\u003cp>Anklin makes about $33,000 a year as a dental receptionist. Her husband does seasonal work baling hay and herding cattle at local ranches. While their kids are covered by Medi-Cal, neither parent gets health insurance through work, and before the Affordable Care Act passed, Anklin and her husband did without coverage for a while.\u003c/p>\n\u003cfigure id=\"attachment_353608\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-353608 size-medium\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/07/Tessa-front-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Tessa Anklin says Covered California health plans are too expensive for her family. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Two years ago, they bought a plan through Covered California. With a subsidy, they paid just $2 a month for their premium, but their deductible was $10,000.\u003c/p>\n\u003cp>“We paid for all of our medical services and our prescriptions,” she says. “We had no help until we reached the $10,000 deductible. So really, we had nothing.”\u003c/p>\n\u003cp>Then, last year, their monthly premium jumped to $600. The plan was the same, Anklin says, and their household income was the same. But they still faced the same hour and a half drive to see doctors they almost never needed.*\u003c/p>\n\u003cp>Anklin thought of all the other ways she could spend that money.\u003c/p>\n\u003cp>“It makes the car payment. Almost your mortgage payment. Groceries for at least four months,” she says. “That’s a big difference, when you think about how little you actually use the health coverage.”\u003c/p>\n\u003cp>That’s the reason she decided to cancel her health plan this year and go without. But she’ll still have to pay a penalty when the next tax season comes around.\u003c/p>\n\u003cp>“It basically penalizes us one way or the other because we can’t afford the coverage,” she says. “So that’s kind of difficult, to be that middle-class person.”\u003c/p>\n\u003cp>Anklin says she’d be happy to see Republicans get rid of Obamacare.\u003c/p>\n\u003cp>“To me, it’s no good, if you have to force people to pay yet another something out of their paycheck when they’re already trying to survive with what they have,” she says. “It should be an option.”\u003c/p>\n\u003cp>But the Republican repeal and replace plan wouldn’t make things much better for Anklin and her neighbors. Average premiums in California would double under the GOP plan, according to a recent \u003ca href=\"http://www.kff.org/health-reform/issue-brief/premiums-under-the-senate-better-care-reconciliation-act/\">analysis\u003c/a> from the Kaiser Family Foundation. Anklin could end up paying more than $2,000 a month for coverage, according to Kaiser’s \u003ca href=\"http://www.kff.org/interactive/premiums-and-tax-credits-under-the-affordable-care-act-vs-the-senate-better-care-reconciliation-act-interactive-maps/\">county-by-county projections\u003c/a>.\u003c/p>\n\u003cp>That’s not what she had in mind for a fix.\u003c/p>\n\u003cp>“I’d love that insurance could be more affordable for families that need it, for families that work hard for it,” Anklin says.\u003c/p>\n\u003cp>With the Republican bill now in flux, Democrats have been more willing to admit to Obamacare’s flaws. The Dems agree that the rising costs of marketplace plans are the chief complaint they hear about, too.\u003c/p>\n\u003cp>Democrats have also said if the Republican bill fails, they’d be willing to \u003ca href=\"https://www.statnews.com/2017/07/05/health-care-compromise/\">work together on solutions\u003c/a>, but it’s not clear the parties could agree on one that would help people like Anklin.\u003c/p>\n\u003cp>If they can’t, she says she has no choice but to continue to go without coverage. Financially it makes sense in the short term, but it still worries her.\u003c/p>\n\u003cp>“If I ever have a problem,” she says, “I know I will be paying for the rest of my life.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>*Premiums in this region of the state went up an average of 10.6 percent in 2016, according to Covered California’s \u003ca href=\"http://www.coveredca.com/news/\" target=\"_blank\" rel=\"noopener noreferrer\">rate booklet\u003c/a>, and most premium increases are matched with an increase in subsidy, so the most likely explanation for why Anklin’s premium jumped this much is that she lost her subsidy. This can happen if customers, intentionally or unintentionally, do not check a box on their application form that allows the federal government to verify their income, or, if customers do not file tax returns.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>California Sen. Kamala Harris toured the state Monday, rallying supporters against the Republican-backed health care plan in the Senate as she searched for stories to highlight when debate over the bill returns to Congress next week.\u003c/p>\n\u003cp>After speaking at a citizenship ceremony in Los Angeles, Harris held \u003ca href=\"http://www.latimes.com/politics/essential/la-pol-ca-essential-politics-updates-kamala-harris-greets-supporters-at-1499107605-htmlstory.html\" target=\"_blank\" rel=\"noopener noreferrer\">a rally\u003c/a> at the Harbor-UCLA Medical Center in Torrance to oppose the Better Care Reconciliation Act currently in Senate. She then flew to San Francisco to meet with seniors at the Institute on Aging.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Harris said she heard stories all day “from people who want to live with dignity, who want to work hard, but they want to afford to be able to pay for their asthma medication and also keep their home.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Without coverage, they can’t do both,” she said. \u003c/span>\u003c/p>\n\u003cp>The event in San Francisco focused on the impact the Senate bill would have on Californians who receive care through Medi-Cal, the state’s Medicaid program for the poor and disabled. The Senate proposal would reduce federal payments to Medicaid, leaving states on the hook for more of the cost.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Last week, the State Department of Health Care Services \u003ca href=\"http://www.dhcs.ca.gov/Documents/BCRA_Impact_Memo_062717.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">estimated \u003c/a>that the Senate plan would shift $30.3 billion of Medi-Cal costs to California over the next decade.\u003c/p>\n\u003cp>Harris attended a roundtable of patients and providers, who emphasized that Medi-Cal covers critical services that older Californians can’t get through Medicare, the health care program for the elderly.\u003c/p>\n\u003cp>“Home care is the most striking example,” said Jeff Wilkins, a social worker at the Institute. “Medicare does not pay for home care.”\u003c/p>\n\u003cp>The most memorable exchanges of the afternoon came from the handful of seniors who spoke with Harris as she toured the Institute.\u003c/p>\n\u003cp>Huiquing Chen told the senator through an interpreter that the biggest difference between the current Affordable Care Act, and the Republican plans in the House and Senate, is the lack of the word ‘affordable.’\u003c/p>\n\u003cp>“We’re getting old, which is becoming a pre-existing condition,” Chen quipped.\u003c/p>\n\u003cp>Clem McCoy, 83, chatted up Harris on a different topic.\u003c/p>\n\u003cp>“Y’all need to get the president up out of there!” he said.\u003c/p>\n\u003cp>“One day at a time,” Harris replied.\u003c/p>\n\u003cblockquote class=\"twitter-video\">\n\u003cp dir=\"ltr\" lang=\"en\">At \u003ca href=\"https://twitter.com/IOASFBAY\">@IOASFBAY\u003c/a>, 83 year old Clem McCoy tells \u003ca href=\"https://twitter.com/SenKamalaHarris\">@SenKamalaHarris\u003c/a> to get President Trump “up outta here.” \u003ca href=\"https://t.co/kuWgyFZ3QQ\">pic.twitter.com/kuWgyFZ3QQ\u003c/a>\u003c/p>\n\u003cp>— Guy Marzorati (@GuyMarzorati) \u003ca href=\"https://twitter.com/GuyMarzorati/status/881997765894590465\">July 3, 2017\u003c/a>\u003c/p>\u003c/blockquote>\n\u003cp>The Republican plan in the Senate stalled over the July 4 holiday, with \u003ca href=\"https://www.apnews.com/769b99020b034b55a395e9e131003ac5/White-House:-Trump-backs-repeal-only-health-bill-as-'option'\" target=\"_blank\" rel=\"noopener noreferrer\">at least nine senators\u003c/a> opposing the bill. In response, President Trump has expressed some support for repealing the legislation without a replacement plan in place.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I’m frankly not clear on what their strategy is,” Harris said in response to that idea. “Over 30 million Americans, if it is repealed, will lose their coverage.” \u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California Sen. Kamala Harris toured the state Monday, rallying supporters against the Republican-backed health care plan in the Senate as she searched for stories to highlight when debate over the bill returns to Congress next week.\u003c/p>\n\u003cp>After speaking at a citizenship ceremony in Los Angeles, Harris held \u003ca href=\"http://www.latimes.com/politics/essential/la-pol-ca-essential-politics-updates-kamala-harris-greets-supporters-at-1499107605-htmlstory.html\" target=\"_blank\" rel=\"noopener noreferrer\">a rally\u003c/a> at the Harbor-UCLA Medical Center in Torrance to oppose the Better Care Reconciliation Act currently in Senate. She then flew to San Francisco to meet with seniors at the Institute on Aging.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Harris said she heard stories all day “from people who want to live with dignity, who want to work hard, but they want to afford to be able to pay for their asthma medication and also keep their home.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Without coverage, they can’t do both,” she said. \u003c/span>\u003c/p>\n\u003cp>The event in San Francisco focused on the impact the Senate bill would have on Californians who receive care through Medi-Cal, the state’s Medicaid program for the poor and disabled. The Senate proposal would reduce federal payments to Medicaid, leaving states on the hook for more of the cost.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Last week, the State Department of Health Care Services \u003ca href=\"http://www.dhcs.ca.gov/Documents/BCRA_Impact_Memo_062717.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">estimated \u003c/a>that the Senate plan would shift $30.3 billion of Medi-Cal costs to California over the next decade.\u003c/p>\n\u003cp>Harris attended a roundtable of patients and providers, who emphasized that Medi-Cal covers critical services that older Californians can’t get through Medicare, the health care program for the elderly.\u003c/p>\n\u003cp>“Home care is the most striking example,” said Jeff Wilkins, a social worker at the Institute. “Medicare does not pay for home care.”\u003c/p>\n\u003cp>The most memorable exchanges of the afternoon came from the handful of seniors who spoke with Harris as she toured the Institute.\u003c/p>\n\u003cp>Huiquing Chen told the senator through an interpreter that the biggest difference between the current Affordable Care Act, and the Republican plans in the House and Senate, is the lack of the word ‘affordable.’\u003c/p>\n\u003cp>“We’re getting old, which is becoming a pre-existing condition,” Chen quipped.\u003c/p>\n\u003cp>Clem McCoy, 83, chatted up Harris on a different topic.\u003c/p>\n\u003cp>“Y’all need to get the president up out of there!” he said.\u003c/p>\n\u003cp>“One day at a time,” Harris replied.\u003c/p>\n\u003cblockquote class=\"twitter-video\">\n\u003cp dir=\"ltr\" lang=\"en\">At \u003ca href=\"https://twitter.com/IOASFBAY\">@IOASFBAY\u003c/a>, 83 year old Clem McCoy tells \u003ca href=\"https://twitter.com/SenKamalaHarris\">@SenKamalaHarris\u003c/a> to get President Trump “up outta here.” \u003ca href=\"https://t.co/kuWgyFZ3QQ\">pic.twitter.com/kuWgyFZ3QQ\u003c/a>\u003c/p>\n\u003cp>— Guy Marzorati (@GuyMarzorati) \u003ca href=\"https://twitter.com/GuyMarzorati/status/881997765894590465\">July 3, 2017\u003c/a>\u003c/p>\u003c/blockquote>\n\u003cp>The Republican plan in the Senate stalled over the July 4 holiday, with \u003ca href=\"https://www.apnews.com/769b99020b034b55a395e9e131003ac5/White-House:-Trump-backs-repeal-only-health-bill-as-'option'\" target=\"_blank\" rel=\"noopener noreferrer\">at least nine senators\u003c/a> opposing the bill. In response, President Trump has expressed some support for repealing the legislation without a replacement plan in place.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“I’m frankly not clear on what their strategy is,” Harris said in response to that idea. “Over 30 million Americans, if it is repealed, will lose their coverage.” \u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Small Town Clinics – and Businesses – Fear Economics of Obamacare Repeal",
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"content": "\u003cp>Three years ago, Carol Morris was put in charge of a massive remodel of the new Mountain Valleys health clinic in Burney, a small town in mountains in eastern Shasta County.\u003c/p>\n\u003cp>She painted the new exam rooms in muted greens and browns, to reflect the pine forest and cattle ranches outside, and she made a series of equipment upgrades: new sonogram and retina scanning machines, a designer vaccine refrigerator, and a fleet of cushy new exam tables.\u003c/p>\n\u003cp>“Some of the staff will come in and nap on one at lunchtime,” Morris says, stroking the leather table.\u003c/p>\n\u003cp>The new Burney clinic is three times as big as the old one, Morris says. They’ve doubled the number of patients they see, and they’ve doubled their staff.\u003c/p>\n\u003cp>All thanks to money from the Affordable Care Act.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I guess it's true, build it and they will come,” Morris says.\u003c/p>\n\u003cp>[audio src=\"http://www.kqed.org/.stream/anon/radio/tcr/2017/06/2017-06-29a-tcr.mp3\" Image=\"https://u.s.kqed.net/2017/06/29/Stethoscope.jpg\" Title=\"Small Town Clinics – and Businesses – Fear Economics of Obamacare Repeal\" program=\"The California Report\"]\u003c/p>\n\u003cp>President Obama’s signature health law provided grants for capital construction at rural clinics, and increased payments for treating patients on Medi-Cal, the state’s health program for low-income people. The law also expanded who qualified for Medi-Cal, adding close to 4 million Californians to the rolls, many of them from \u003ca href=\"https://ww2.kqed.org/stateofhealth/2017/06/28/obamacare-inspires-unlikely-political-action-in-californias-rural-republican-territory/\" target=\"_blank\" rel=\"noopener noreferrer\">rural, Republican counties\u003c/a> in the state, like Shasta, Lassen, and Siskiyou, where Mountain Valleys clinics operate.\u003c/p>\n\u003cp>With many of their previously uninsured patients now covered by Medi-Cal, the clinic is making money instead of losing it.\u003c/p>\n\u003cp>“That was a real boon to us,” says Dave Jones, CEO of \u003ca href=\"http://mtnvalleyhc.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Mountain Valleys clinics\u003c/a>. “We went from struggling payday to payday, to actually having a reserve at this point.”\u003c/p>\n\u003cp>In addition to moving into the new medical clinic in Burney, Jones was able to buy a dental building next door, expand mental health and drug counseling services, and hire a range of new administrative staff.\u003c/p>\n\u003cp>[contextly_sidebar id=\"uO0r77wi0xkfHFV79VI4jRtVOZYGMW8u\"]\u003c/p>\n\u003cp>Across Shasta County, the Obamacare Medi-Cal expansion helped create more than 900 jobs in the health care sector and beyond, according to an economic impact report commissioned by \u003ca href=\"http://www.partnershiphp.org/Pages/PHC.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">Partnership Health Plan\u003c/a>, the insurer that manages Medi-Cal in far northern California.\u003c/p>\n\u003cp>One of the Burney clinic’s newest hires is Laura Hodge. The clinic had noticed a lot of patients who got health coverage for the first time were going to the Emergency Room more -- for simple things, like a headache or Band-Aid.\u003c/p>\n\u003cp>They brought Hodge on to start a program aimed at reducing overuse of the ER. She sat in her office on a recent afternoon calling patients, asking them if they wanted to participate in the new program.\u003c/p>\n\u003cp>“I would be your liaison with the doctors,” she explains over the phone. “If you feel like you're not being listened to, or if you have any questions and you don't feel like you're being answered, you could come to me.”\u003c/p>\n\u003cp>The new job is a huge economic help for Hodge. Her husband is a trucker and they have three kids. Hodge’s salary is critical to keeping the household going.\u003c/p>\n\u003cp>And that’s critical to Burney. After the logging company, the clinic is one of the largest employers in town. A lot of the money Hodge and her coworkers make goes straight back into the community.\u003c/p>\n\u003cp>“The grocery store, the tire shop, the gas station,” Hodge lists the places she spends her paycheck. “Our little theater, the bowling alley, Kristi’s Unique Boutique.”\u003c/p>\n\u003cfigure id=\"attachment_348515\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-348515\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/06/Laura-Hodge-sips-red-bull-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Laura Hodge sips a blended Red Bull at her favorite coffee shop in Burney. \u003ccite>(April Dembosky)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Hodge takes me to one of her favorite haunts, the drive-thru window of the Mt. Burney Coffee Co.\u003c/p>\n\u003cp>“I will take a blended Red Bull,” she says, mulling over the list of flavors, deciding on the Fruit Loop – club soda with passion fruit, peach, and red raspberry syrup mixed in the blender with ice and a can of Red Bull.\u003c/p>\n\u003cp>“The first time I drank one, oh my gosh,” Hodge laughs, “I went home and I cleaned everything in my house.”\u003c/p>\n\u003cp>Staff from the health clinic are regulars at the coffee shop, says barista Abby Fristine.\u003c/p>\n\u003cp>“Most of them come through everyday, before or after work,” she says.\u003c/p>\n\u003cp>The money earned and spent by the health clinic staff ripples through the local economy. And all the people they’ve hired in recent years makes a difference in a small town like this, says Jones, the clinic CEO.\u003c/p>\n\u003cp>“I'm sure over the last two or three years it's been worth a couple million dollars to the community,” he says.\u003c/p>\n\u003cp>That’s why Jones is sounding the alarm on attempts to repeal the Affordable Care Act.\u003c/p>\n\u003cp>He and other clinic directors have managed to convince conservative officials, like the Shasta County Board of Supervisors, to \u003ca href=\"https://ww2.kqed.org/stateofhealth/2017/06/28/obamacare-inspires-unlikely-political-action-in-californias-rural-republican-territory/\" target=\"_blank\" rel=\"noopener noreferrer\">formally oppose the Republican health bill\u003c/a>, in part because of the potential economic impacts. The Siskiyou board is considering a similar move.\u003c/p>\n\u003cp>Together, both counties stand to lose close to $200 million in business revenue from a rollback to Medicaid funding, hitting not just clinics, but local shops and restaurants, too.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“If we have to revert back to where we were,” Jones says, “it could be disastrous.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Three years ago, Carol Morris was put in charge of a massive remodel of the new Mountain Valleys health clinic in Burney, a small town in mountains in eastern Shasta County.\u003c/p>\n\u003cp>She painted the new exam rooms in muted greens and browns, to reflect the pine forest and cattle ranches outside, and she made a series of equipment upgrades: new sonogram and retina scanning machines, a designer vaccine refrigerator, and a fleet of cushy new exam tables.\u003c/p>\n\u003cp>“Some of the staff will come in and nap on one at lunchtime,” Morris says, stroking the leather table.\u003c/p>\n\u003cp>The new Burney clinic is three times as big as the old one, Morris says. They’ve doubled the number of patients they see, and they’ve doubled their staff.\u003c/p>\n\u003cp>All thanks to money from the Affordable Care Act.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>President Obama’s signature health law provided grants for capital construction at rural clinics, and increased payments for treating patients on Medi-Cal, the state’s health program for low-income people. The law also expanded who qualified for Medi-Cal, adding close to 4 million Californians to the rolls, many of them from \u003ca href=\"https://ww2.kqed.org/stateofhealth/2017/06/28/obamacare-inspires-unlikely-political-action-in-californias-rural-republican-territory/\" target=\"_blank\" rel=\"noopener noreferrer\">rural, Republican counties\u003c/a> in the state, like Shasta, Lassen, and Siskiyou, where Mountain Valleys clinics operate.\u003c/p>\n\u003cp>With many of their previously uninsured patients now covered by Medi-Cal, the clinic is making money instead of losing it.\u003c/p>\n\u003cp>“That was a real boon to us,” says Dave Jones, CEO of \u003ca href=\"http://mtnvalleyhc.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Mountain Valleys clinics\u003c/a>. “We went from struggling payday to payday, to actually having a reserve at this point.”\u003c/p>\n\u003cp>In addition to moving into the new medical clinic in Burney, Jones was able to buy a dental building next door, expand mental health and drug counseling services, and hire a range of new administrative staff.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Across Shasta County, the Obamacare Medi-Cal expansion helped create more than 900 jobs in the health care sector and beyond, according to an economic impact report commissioned by \u003ca href=\"http://www.partnershiphp.org/Pages/PHC.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">Partnership Health Plan\u003c/a>, the insurer that manages Medi-Cal in far northern California.\u003c/p>\n\u003cp>One of the Burney clinic’s newest hires is Laura Hodge. The clinic had noticed a lot of patients who got health coverage for the first time were going to the Emergency Room more -- for simple things, like a headache or Band-Aid.\u003c/p>\n\u003cp>They brought Hodge on to start a program aimed at reducing overuse of the ER. She sat in her office on a recent afternoon calling patients, asking them if they wanted to participate in the new program.\u003c/p>\n\u003cp>“I would be your liaison with the doctors,” she explains over the phone. “If you feel like you're not being listened to, or if you have any questions and you don't feel like you're being answered, you could come to me.”\u003c/p>\n\u003cp>The new job is a huge economic help for Hodge. Her husband is a trucker and they have three kids. Hodge’s salary is critical to keeping the household going.\u003c/p>\n\u003cp>And that’s critical to Burney. After the logging company, the clinic is one of the largest employers in town. A lot of the money Hodge and her coworkers make goes straight back into the community.\u003c/p>\n\u003cp>“The grocery store, the tire shop, the gas station,” Hodge lists the places she spends her paycheck. “Our little theater, the bowling alley, Kristi’s Unique Boutique.”\u003c/p>\n\u003cfigure id=\"attachment_348515\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-348515\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/06/Laura-Hodge-sips-red-bull-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Laura Hodge sips a blended Red Bull at her favorite coffee shop in Burney. \u003ccite>(April Dembosky)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Hodge takes me to one of her favorite haunts, the drive-thru window of the Mt. Burney Coffee Co.\u003c/p>\n\u003cp>“I will take a blended Red Bull,” she says, mulling over the list of flavors, deciding on the Fruit Loop – club soda with passion fruit, peach, and red raspberry syrup mixed in the blender with ice and a can of Red Bull.\u003c/p>\n\u003cp>“The first time I drank one, oh my gosh,” Hodge laughs, “I went home and I cleaned everything in my house.”\u003c/p>\n\u003cp>Staff from the health clinic are regulars at the coffee shop, says barista Abby Fristine.\u003c/p>\n\u003cp>“Most of them come through everyday, before or after work,” she says.\u003c/p>\n\u003cp>The money earned and spent by the health clinic staff ripples through the local economy. And all the people they’ve hired in recent years makes a difference in a small town like this, says Jones, the clinic CEO.\u003c/p>\n\u003cp>“I'm sure over the last two or three years it's been worth a couple million dollars to the community,” he says.\u003c/p>\n\u003cp>That’s why Jones is sounding the alarm on attempts to repeal the Affordable Care Act.\u003c/p>\n\u003cp>He and other clinic directors have managed to convince conservative officials, like the Shasta County Board of Supervisors, to \u003ca href=\"https://ww2.kqed.org/stateofhealth/2017/06/28/obamacare-inspires-unlikely-political-action-in-californias-rural-republican-territory/\" target=\"_blank\" rel=\"noopener noreferrer\">formally oppose the Republican health bill\u003c/a>, in part because of the potential economic impacts. The Siskiyou board is considering a similar move.\u003c/p>\n\u003cp>Together, both counties stand to lose close to $200 million in business revenue from a rollback to Medicaid funding, hitting not just clinics, but local shops and restaurants, too.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“If we have to revert back to where we were,” Jones says, “it could be disastrous.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Obamacare Inspires Unlikely Political Action in Red California",
"title": "Obamacare Inspires Unlikely Political Action in Red California",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>Modoc County, in the northeast corner of California, is roughly the size of Connecticut. It's so sparsely populated, the entire county has just one stoplight. The nearest Wal-Mart is more than an hour's drive, across the Oregon border. Same with hospitals that deliver babies.\u003c/p>\n\u003cp>Greta Elliott runs a tiny health \u003ca href=\"http://canbyclinic.org/\" target=\"_blank\" rel=\"noopener noreferrer\">clinic\u003c/a> in Canby, on the edge of the national forest. \"Rural\" doesn’t begin to describe the area, she says. This is \"the frontier.\"\u003c/p>\n\u003cp>“There are more cows in Modoc than there are people,” Elliott says.\u003c/p>\n\u003cp>There's a frontier mentality, too. People take care of each other, and they take care of themselves. They don’t like being told what to do. Being forced to buy insurance made Obamacare a dirty word.\u003c/p>\n\u003cp>Even Elliott, the head of a health clinic, decided against buying coverage for herself.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It's too expensive,” she says. “I choose to put my money back into paying the bills of the whole family.”\u003c/p>\n\u003cp>[audio src=\"http://www.kqed.org/.stream/anon/radio/tcr/2017/06/2017-06-28a-tcr.mp3\" Image=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/03/BloodPressure-768x512.jpg\" Title=\"Obamacare Inspires Unlikely Political Action in Red California\" program=\"The California Report\"]\u003c/p>\n\u003cp>Overall, the Affordable Care Act helped 25,000 people in far Northern California buy plans through the state marketplace, \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Covered California\u003c/a>. But the law helped three times as many people, 75,000, enroll in Medi-Cal, the state’s Medicaid program that provides free health coverage for low-income residents.\u003c/p>\n\u003cp>“The data shows it's the rural communities that have greatly benefited from the Medicaid expansion. That’s the irony,” says Dean Germano, CEO of the \u003ca href=\"https://www.shastahealth.org\" target=\"_blank\" rel=\"noopener noreferrer\">Shasta Community Health Center\u003c/a>. “These are places that voted much more heavily for Donald Trump.”\u003c/p>\n\u003cp>In Modoc and Lassen counties, 70 percent of people voted for Trump in the November election. In neighboring Shasta County, Trump won 64 percent of the vote.\u003c/p>\n\u003cp>But now a \u003ca href=\"http://thehanc.org/\" target=\"_blank\" rel=\"noopener noreferrer\">coalition\u003c/a> of clinics from across the Northeast corner of the state is lobbying local officials to take an unpopular position in this conservative land: defend Obamacare.\u003c/p>\n\u003cp>And the right-leaning Shasta County Board of Supervisors took them up on it.\u003c/p>\n\u003cp>[contextly_sidebar id=\"Nl4j8x6j7iRmpWflZsVooGaqsbbbOLuA\"]\u003c/p>\n\u003cp>“We thought ‘Whoa! That is really bold,’” Germano says. “I was surprised.”\u003c/p>\n\u003cp>The board sent a letter to the local Republican congressman, \u003ca href=\"https://lamalfa.house.gov/\" target=\"_blank\" rel=\"noopener noreferrer\">Doug La Malfa\u003c/a>, asking him to vote against the initial GOP repeal and replace bill, because it would hurt local people.\u003c/p>\n\u003cp>“We have an obligation to say something,” says Supervisor David Kehoe. “And if it may be mildly offensive from a political standpoint for some, well, we’re not going to be intimidated by politics.”\u003c/p>\n\u003cp>But Congressman La Malfa still voted in favor of dismantling Obamacare.\u003c/p>\n\u003cp>La Malfa didn't return calls and emails for this story, but, in May, \u003ca href=\"https://ww2.kqed.org/news/2017/05/06/what-your-california-representative-says-about-the-gop-health-bill/\" target=\"_blank\" rel=\"noopener noreferrer\">he told KQED\u003c/a> that skyrocketing premiums were the main driver behind his vote.\u003c/p>\n\u003cp>\"Unfortunately, the reality is that too many young and healthy individuals are deciding they’d rather pay the penalty than sign up for care, citing financial barriers and lack of choice,\" he said in a statement. \"A 28 year old making $45,000 a year with no major health concerns is not going to pay upwards of $400 a month for a plan that does not even work for them.\"\u003c/p>\n\u003cp>When clinic representatives met with La Malfa's staffers, they were told the Congressman's office was flooded with calls like this.\u003c/p>\n\u003cp>But poor folks on Medi-Cal didn’t call to say how much they appreciate that program. In fact, clinics struggled getting people to sign up for Medi-Cal, at first.\u003c/p>\n\u003cp>“They feel like it's a handout and they're too proud, they don’t want to,” says Carol Morris, an enrollment counselor for the \u003ca href=\"http://mtnvalleyhc.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Mountain Valleys\u003c/a> health clinics in Shasta county.\u003c/p>\n\u003cp>One way clinic workers get around the stigma is to avoid calling it Medi-Cal. Instead, they promote the name of the insurer that manages the Medi-Cal contract in that region. People get a card for \u003ca href=\"http://www.partnershiphp.org/Pages/PHC.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">\"Partnership Health Plan\" \u003c/a>and may not realize they’re actually covered by a government program.\u003c/p>\n\u003cp>“It feels like it's more of an insurance,” Morris says. “It’s like a laminated, wallet-sized card that's got your numbers on it. It just looks exactly like an insurance card.”\u003c/p>\n\u003cp>One patient at the Mountain Valleys clinic in Beiber, Kay Roope, 64, knew she had Medi-Cal, and she liked it.\u003c/p>\n\u003cp>“It did me good,” she says.\u003c/p>\n\u003cp>[contextly_sidebar id=\"swxoiuaBwIFNHC8PbxRB3kfDYxOKFLOH\"]\u003c/p>\n\u003cp>Now she has a subsidized commercial plan through Covered California, with modest premiums and co-pays, and she likes that, too.\u003c/p>\n\u003cp>“It’s okay. 'Cause I’m at the doctor’s at least once a month,” she says.\u003c/p>\n\u003cp>But when asked what she thinks of Obamacare overall, she says she doesn’t like it.\u003c/p>\n\u003cp>“Because of Obama himself,” she says with a laugh. “I rest my case.”\u003c/p>\n\u003cp>The confusion and the contradictions are common among patients, explains Morris, the enrollment counselor.\u003c/p>\n\u003cp>“People just don't understand the different names,” she says. “But, of course, it's the same thing.”\u003c/p>\n\u003cp>Morris has seen the difference Obamacare has made for people in the region. She’s seen patients get treatment for diabetes and breast cancer, or get knee surgery that they otherwise wouldn’t have gotten.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Those patients won’t fight for Obamacare, Morris says, so that’s why the clinics have to.\u003c/p>\n\n",
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"excerpt": "Under the ACA, 75,000 people enrolled in Medi-Cal in the state's northeast. 'The data shows it’s the rural communities that have greatly benefited from the Medicaid expansion.'",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Modoc County, in the northeast corner of California, is roughly the size of Connecticut. It's so sparsely populated, the entire county has just one stoplight. The nearest Wal-Mart is more than an hour's drive, across the Oregon border. Same with hospitals that deliver babies.\u003c/p>\n\u003cp>Greta Elliott runs a tiny health \u003ca href=\"http://canbyclinic.org/\" target=\"_blank\" rel=\"noopener noreferrer\">clinic\u003c/a> in Canby, on the edge of the national forest. \"Rural\" doesn’t begin to describe the area, she says. This is \"the frontier.\"\u003c/p>\n\u003cp>“There are more cows in Modoc than there are people,” Elliott says.\u003c/p>\n\u003cp>There's a frontier mentality, too. People take care of each other, and they take care of themselves. They don’t like being told what to do. Being forced to buy insurance made Obamacare a dirty word.\u003c/p>\n\u003cp>Even Elliott, the head of a health clinic, decided against buying coverage for herself.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It's too expensive,” she says. “I choose to put my money back into paying the bills of the whole family.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Overall, the Affordable Care Act helped 25,000 people in far Northern California buy plans through the state marketplace, \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Covered California\u003c/a>. But the law helped three times as many people, 75,000, enroll in Medi-Cal, the state’s Medicaid program that provides free health coverage for low-income residents.\u003c/p>\n\u003cp>“The data shows it's the rural communities that have greatly benefited from the Medicaid expansion. That’s the irony,” says Dean Germano, CEO of the \u003ca href=\"https://www.shastahealth.org\" target=\"_blank\" rel=\"noopener noreferrer\">Shasta Community Health Center\u003c/a>. “These are places that voted much more heavily for Donald Trump.”\u003c/p>\n\u003cp>In Modoc and Lassen counties, 70 percent of people voted for Trump in the November election. In neighboring Shasta County, Trump won 64 percent of the vote.\u003c/p>\n\u003cp>But now a \u003ca href=\"http://thehanc.org/\" target=\"_blank\" rel=\"noopener noreferrer\">coalition\u003c/a> of clinics from across the Northeast corner of the state is lobbying local officials to take an unpopular position in this conservative land: defend Obamacare.\u003c/p>\n\u003cp>And the right-leaning Shasta County Board of Supervisors took them up on it.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“We thought ‘Whoa! That is really bold,’” Germano says. “I was surprised.”\u003c/p>\n\u003cp>The board sent a letter to the local Republican congressman, \u003ca href=\"https://lamalfa.house.gov/\" target=\"_blank\" rel=\"noopener noreferrer\">Doug La Malfa\u003c/a>, asking him to vote against the initial GOP repeal and replace bill, because it would hurt local people.\u003c/p>\n\u003cp>“We have an obligation to say something,” says Supervisor David Kehoe. “And if it may be mildly offensive from a political standpoint for some, well, we’re not going to be intimidated by politics.”\u003c/p>\n\u003cp>But Congressman La Malfa still voted in favor of dismantling Obamacare.\u003c/p>\n\u003cp>La Malfa didn't return calls and emails for this story, but, in May, \u003ca href=\"https://ww2.kqed.org/news/2017/05/06/what-your-california-representative-says-about-the-gop-health-bill/\" target=\"_blank\" rel=\"noopener noreferrer\">he told KQED\u003c/a> that skyrocketing premiums were the main driver behind his vote.\u003c/p>\n\u003cp>\"Unfortunately, the reality is that too many young and healthy individuals are deciding they’d rather pay the penalty than sign up for care, citing financial barriers and lack of choice,\" he said in a statement. \"A 28 year old making $45,000 a year with no major health concerns is not going to pay upwards of $400 a month for a plan that does not even work for them.\"\u003c/p>\n\u003cp>When clinic representatives met with La Malfa's staffers, they were told the Congressman's office was flooded with calls like this.\u003c/p>\n\u003cp>But poor folks on Medi-Cal didn’t call to say how much they appreciate that program. In fact, clinics struggled getting people to sign up for Medi-Cal, at first.\u003c/p>\n\u003cp>“They feel like it's a handout and they're too proud, they don’t want to,” says Carol Morris, an enrollment counselor for the \u003ca href=\"http://mtnvalleyhc.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Mountain Valleys\u003c/a> health clinics in Shasta county.\u003c/p>\n\u003cp>One way clinic workers get around the stigma is to avoid calling it Medi-Cal. Instead, they promote the name of the insurer that manages the Medi-Cal contract in that region. People get a card for \u003ca href=\"http://www.partnershiphp.org/Pages/PHC.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">\"Partnership Health Plan\" \u003c/a>and may not realize they’re actually covered by a government program.\u003c/p>\n\u003cp>“It feels like it's more of an insurance,” Morris says. “It’s like a laminated, wallet-sized card that's got your numbers on it. It just looks exactly like an insurance card.”\u003c/p>\n\u003cp>One patient at the Mountain Valleys clinic in Beiber, Kay Roope, 64, knew she had Medi-Cal, and she liked it.\u003c/p>\n\u003cp>“It did me good,” she says.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Now she has a subsidized commercial plan through Covered California, with modest premiums and co-pays, and she likes that, too.\u003c/p>\n\u003cp>“It’s okay. 'Cause I’m at the doctor’s at least once a month,” she says.\u003c/p>\n\u003cp>But when asked what she thinks of Obamacare overall, she says she doesn’t like it.\u003c/p>\n\u003cp>“Because of Obama himself,” she says with a laugh. “I rest my case.”\u003c/p>\n\u003cp>The confusion and the contradictions are common among patients, explains Morris, the enrollment counselor.\u003c/p>\n\u003cp>“People just don't understand the different names,” she says. “But, of course, it's the same thing.”\u003c/p>\n\u003cp>Morris has seen the difference Obamacare has made for people in the region. She’s seen patients get treatment for diabetes and breast cancer, or get knee surgery that they otherwise wouldn’t have gotten.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Those patients won’t fight for Obamacare, Morris says, so that’s why the clinics have to.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Feinstein: Health Care of 14 Million Californians At Risk Under GOP Plan",
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"content": "\u003cp>Though Senate Republicans decided Tuesday to delay a vote on their controversial health plan until after the July 4 recess, Democrats in California are calling on residents to keep up their resistance to the plan.\u003c/p>\n\u003cp>Gov. Jerry Brown joined Sens. Dianne Feinstein and Kamala Harris for a call with reporters early Tuesday. Brown said the GOP bill's proposed Medicaid cuts, and its rollback of Obamacare's insurance regulations, would be disastrous for millions of Californians.\u003c/p>\n\u003cp>Feinstein said one in three Californians are covered by Medi-Cal. The loss of funding could put up to 14 million Californians at risk of losing health coverage or critical medical services, she said.\u003c/p>\n\u003cp>\"One of the things we all try not to do is never turn the haves or the have-nots against each other ... and this bill does that,\" she said.\u003c/p>\n\u003cp>\"This is a bad plan through and through and through, she added. \"There aren’t one or two amendments that can fix it. So it’s got to be defeated.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Brown condemned the Senate bill, saying it \"will be the most divisive maneuver, cutting right into the heart of what is already a divided nation.\"\u003c/p>\n\u003cp>He noted it would cut billions of federal dollars from the Medi-Cal budget and that if California couldn't take care of low-income people, there would be ripple effects.\u003c/p>\n\u003cp>\"There's no doubt this bill will exacerbate homelessness, crime,\" Brown said. \"[The bill hurts] the kinds of people who really need help and are getting it under the Medi-Cal program.\"\u003c/p>\n\u003cp>The Senate is expected to reconvene on July 10, and the House or Representatives on July 11.\u003c/p>\n\u003cp>Congress needs to work on improving health care, not taking it away, said Feinstein, noting Democrats' strategy was \"to defeat this [GOP bill] solidly.\"\u003c/p>\n\u003cp>\"I've always believed there are a couple of things that maybe should be fixed in Obamacare, but the basic bill is a good bill. It has worked,\" she said.\u003c/p>\n\u003cp>In a statement late Tuesday, California Republican Rep. Ken Calvert said the Senate bill was like the House legislation that passed in May, aiming \"to refocus Medicaid on the most vulnerable Americans, while not pulling the rug out from anyone who has benefited from the Medicaid expansion.\"\u003c/p>\n\u003cp>That contradicts the \u003ca href=\"https://www.cbo.gov/system/files/115th-congress-2017-2018/costestimate/52849-hr1628senate.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">analysis\u003c/a> released Monday by the nonpartisan Congressional Budget Office. That report said the number of people covered by Medicaid would decrease by 15 million over the next decade, and federal payments for Medicaid would be cut by $772 billion.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"In the long run, massive expansions of expensive government programs like Medicaid are simply not fiscally sustainable,\" Calvert said.\u003c/p>\n\n",
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"excerpt": "Though Senate Republicans have delayed a vote on their health bill, California Dems are urging people to keep up the pressure.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Though Senate Republicans decided Tuesday to delay a vote on their controversial health plan until after the July 4 recess, Democrats in California are calling on residents to keep up their resistance to the plan.\u003c/p>\n\u003cp>Gov. Jerry Brown joined Sens. Dianne Feinstein and Kamala Harris for a call with reporters early Tuesday. Brown said the GOP bill's proposed Medicaid cuts, and its rollback of Obamacare's insurance regulations, would be disastrous for millions of Californians.\u003c/p>\n\u003cp>Feinstein said one in three Californians are covered by Medi-Cal. The loss of funding could put up to 14 million Californians at risk of losing health coverage or critical medical services, she said.\u003c/p>\n\u003cp>\"One of the things we all try not to do is never turn the haves or the have-nots against each other ... and this bill does that,\" she said.\u003c/p>\n\u003cp>\"This is a bad plan through and through and through, she added. \"There aren’t one or two amendments that can fix it. So it’s got to be defeated.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Brown condemned the Senate bill, saying it \"will be the most divisive maneuver, cutting right into the heart of what is already a divided nation.\"\u003c/p>\n\u003cp>He noted it would cut billions of federal dollars from the Medi-Cal budget and that if California couldn't take care of low-income people, there would be ripple effects.\u003c/p>\n\u003cp>\"There's no doubt this bill will exacerbate homelessness, crime,\" Brown said. \"[The bill hurts] the kinds of people who really need help and are getting it under the Medi-Cal program.\"\u003c/p>\n\u003cp>The Senate is expected to reconvene on July 10, and the House or Representatives on July 11.\u003c/p>\n\u003cp>Congress needs to work on improving health care, not taking it away, said Feinstein, noting Democrats' strategy was \"to defeat this [GOP bill] solidly.\"\u003c/p>\n\u003cp>\"I've always believed there are a couple of things that maybe should be fixed in Obamacare, but the basic bill is a good bill. It has worked,\" she said.\u003c/p>\n\u003cp>In a statement late Tuesday, California Republican Rep. Ken Calvert said the Senate bill was like the House legislation that passed in May, aiming \"to refocus Medicaid on the most vulnerable Americans, while not pulling the rug out from anyone who has benefited from the Medicaid expansion.\"\u003c/p>\n\u003cp>That contradicts the \u003ca href=\"https://www.cbo.gov/system/files/115th-congress-2017-2018/costestimate/52849-hr1628senate.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">analysis\u003c/a> released Monday by the nonpartisan Congressional Budget Office. That report said the number of people covered by Medicaid would decrease by 15 million over the next decade, and federal payments for Medicaid would be cut by $772 billion.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"In the long run, massive expansions of expensive government programs like Medicaid are simply not fiscally sustainable,\" Calvert said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>Updated 3:30 p.m. ET\u003c/strong>\u003c/p>\n\u003cp>Facing a perilous path for their health care bill, Senate Republican leaders have decided to push off a vote until after Congress returns from next week’s July Fourth recess, GOP aides confirm to NPR’s Susan Davis.\u003c/p>\n\u003cp>“We’re still working toward getting at least 50 people in a comfortable place,” Senate Majority Leader Mitch McConnell said on Tuesday. Despite the delay, McConnell confirmed that Republican senators were heading to the White House to meet with President Trump later in the afternoon to continue work on the issue.\u003c/p>\n\u003cp>If three Republicans oppose the bill, it cannot pass. The GOP holds 52 seats, with Vice President Mike Pence as a potential tie-breaker. The delay was announced with at least five Republicans indicating they were against bringing the bill to the floor this week.\u003c/p>\n\u003cp>[contextly_sidebar id=”ZRTrHV0lrDJshV1rQ5I96AmHTDlvmW9R”]\u003c/p>\n\u003cp>“Several of them want more time,” McConnell added. “We have a number of different discussions going on, that have been going on for six weeks. They continue.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>He made the announcement during Senate Republicans’ weekly lunch, which was attended by Pence. White House Chief of Staff Reince Preibus and press secretary Sean Spicer were in the Capitol on Tuesday as well. It’s expected the bill will be altered and get a new score from the Congressional Budget Office before it comes back up.\u003c/p>\n\u003cp>Leaders had been pressing hard for a vote before the holiday. Majority Whip John Cornyn of Texas \u003ca href=\"https://twitter.com/JohnCornyn/status/879364669907099648\">tweeted Monday\u003c/a> morning, “I am closing the door. We need to do it this week before double-digit premium increases are announced for next year.”\u003c/p>\n\u003cp>There has been speculation that McConnell had been prepared to bring the bill to the floor, even if it can’t pass, so the Senate can move onto its next big priority: tax reform.\u003c/p>\n\u003cp>Sen. Susan Collins, R-Maine, said late Monday that \u003ca href=\"https://twitter.com/SenatorCollins/status/879471862694256641\">she would vote “no” on a motion to proceed\u003c/a>, a procedural step that needs to be taken before a floor debate can even begin on the bill. If two more Republicans were to have voted no on that motion, the bill would have died.\u003c/p>\n\u003cp>https://twitter.com/SenatorCollins/status/879472221202391040\u003c/p>\n\u003cp>Collins cited \u003ca href=\"http://www.npr.org/2017/06/26/534432433/gop-senate-bill-would-cut-health-care-coverage-by-22-million\">a report from the Congressional Budget Office released Monday\u003c/a> that said the bill would result in 22 million fewer people with health care coverage over the next decade, compared with under the Affordable Care Act, also known as Obamacare. Much of that reduction would be because of the rollback of the ACA’s expansion of Medicaid, which Collins and other Republicans in states that took up the expansion funds have expressed serious reservations over.\u003c/p>\n\u003cp>Alaska Sen. Lisa Murkowski had similar concerns to Collins. “I need to understand really what we’re talking about, with some of the conclusions that we saw yesterday with the CBO score,” she told MSNBC. “Taking the time to get it right is where we should be.”\u003c/p>\n\u003cp>Democrats held a protest on Capitol Hill Tuesday. Senate Minority Leader Chuck Schumer told reporters, “We know the fight is not over. That is for sure. We’re not resting on any laurels, nor do we feel any sense yet of accomplishment, other than we are making progress because the American people are listening to our arguments.”\u003c/p>\n\u003cp>But the hurdle for McConnell remains divisions within his own party. Conservative Republicans, including Sens. Mike Lee of Utah, Ted Cruz of Texas and Rand Paul of Kentucky, had indicated they were very likely to vote no, as they push for greater spending cuts and reduction of regulations on health insurers.\u003c/p>\n\u003cp>Other GOP senators who appear strongly opposed include Dean Heller of Nevada, who excoriated the bill at a press conference on Friday mostly over its cuts, and Ron Johnson of Wisconsin, who had been urging leaders to wait on a vote until after next week’s recess.\u003c/p>\n\u003cp>[contextly_sidebar id=”VhSZnQ7oBkrgFZuGgGq7e9zxZLKy1E33″]\u003c/p>\n\u003cp>The House failed to advance a bill to repeal and replace Obamacare in late March, and it was seen as a spectacular failure on the GOP’s most persistent pledge to voters for the past seven years. After rounds of negotiations and amendments, the House passed its bill in early May.\u003c/p>\n\u003cp>The outlook for delaying the bill is tricky. Leaders have been insistent that they need to move on to other issues. To take up tax reform or funding the government in 2018, Senate procedure would require them to scrap the health care effort altogether.\u003c/p>\n\u003cp>Republicans have expressed grave warnings about what that could mean politically. Polls have shown the Republican health care effort is very unpopular overall, with even GOP support for the House bill at just 34 percent in an NBC/Wall Street Journal poll released last week. But that same poll showed that 71 percent of Republicans support repealing the Affordable Care Act, and it would be risky for the GOP to head into the 2018 midterms having failed their base on that pledge.\u003c/p>\n\u003cp>“I would not bet against Mitch McConnell,” House Speaker Paul Ryan, R-Wis., told reporters Tuesday morning when asked about the bill’s fate — but before news broke of McConnell’s announcement that he was pushing the vote back. “He is very, very good at getting things done through the Senate, even with this razor-thin majority. I have every expectation that the Senate — I don’t know what day —but I have every expectation the Senate will move this bill.”\u003c/p>\n\u003cp>The speaker nodded to the political pressure the party is under to deliver on their signature campaign pledge. “Every Republican senator campaigned on repealing and replacing this law,” he said.\u003c/p>\n\u003cp>[contextly_sidebar id=”hapQ6Vi3wewi0oe57liVFWkEYjgs7zWs”]\u003c/p>\n\u003cp>The Senate bill repeals the individual mandate to carry health care coverage and the employer mandate for businesses with at least 50 employees to offer coverage. It also repeals most of the taxes enacted under the ACA, which mostly affect high-income earners and corporations, in addition to rolling back federal subsidies and the expansion of Medicaid.\u003c/p>\n\u003cp>It would allow people up to age 26 to remain on their parents’ plans, and it would bar insurance companies from denying coverage to those with pre-existing conditions. Republicans revised the bill on Monday to add a penalty aimed at preventing people from signing up for coverage only once they are sick, which most experts predict would sink the insurance market.\u003c/p>\n\u003cp>“I’m a ‘no’ on it unless the bill changes,” Paul said to reporters on Monday. He has called the bill “Obamacare Lite” and is seeking a fuller rollback of the ACA. But the changes he wants seem unlikely to be included or would risk losing too many moderates because they would further reduce benefits from the federal government. Paul had a noon meeting at the White House scheduled on Tuesday, at which Trump had been expected to appeal for his support.\u003c/p>\n\u003cp>One frequent critic of Trump, Sen. Lindsey Graham, R-S.C., was quoted by \u003cem>The Hill\u003c/em> as saying Monday, “If you’re counting on the president to have your back, you need to watch it.” The president confirmed reports last week that he had privately criticized the House version of the health care bill as “mean,” even though he invited Ryan and members of the House GOP leadership over to the White House Rose Garden for a celebration after it passed. Graham also has said that waiting until after next week’s recess is not likely to make it any easier to pass a bill.\u003c/p>\n\u003cp>The White House led criticism of the CBO report on Monday, assailing its ability to estimate effects on coverage. But Ryan defended the Congressional Budget Office, which has also come under fire by outside conservatives and some Republicans in Congress. “It is important that we have a scorekeeper,” he said. “We can always complain about the nature of the score. I think their coverage numbers — there’s more to the story than the number implies. Having said that, it’s important that we have a referee.”\u003c/p>\n\u003cp>Many Republicans have taken issue with the CBO forecast, arguing that they believe more Americans will be inclined to sign up if cheaper plans are available. Republicans often note that millions of Americans have opted to pay fines in lieu of signing up for coverage under the ACA.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>NPR’s Susan Davis contributed to this report. \u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Senate+GOP+Leaders+Push+Off+Health+Care+Vote+After+July+4th&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "President Trump invited Senate Republicans to the White House to continue work on the issue. The bill is expected to undergo changes before a vote in mid-July.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Updated 3:30 p.m. ET\u003c/strong>\u003c/p>\n\u003cp>Facing a perilous path for their health care bill, Senate Republican leaders have decided to push off a vote until after Congress returns from next week’s July Fourth recess, GOP aides confirm to NPR’s Susan Davis.\u003c/p>\n\u003cp>“We’re still working toward getting at least 50 people in a comfortable place,” Senate Majority Leader Mitch McConnell said on Tuesday. Despite the delay, McConnell confirmed that Republican senators were heading to the White House to meet with President Trump later in the afternoon to continue work on the issue.\u003c/p>\n\u003cp>If three Republicans oppose the bill, it cannot pass. The GOP holds 52 seats, with Vice President Mike Pence as a potential tie-breaker. The delay was announced with at least five Republicans indicating they were against bringing the bill to the floor this week.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“Several of them want more time,” McConnell added. “We have a number of different discussions going on, that have been going on for six weeks. They continue.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>He made the announcement during Senate Republicans’ weekly lunch, which was attended by Pence. White House Chief of Staff Reince Preibus and press secretary Sean Spicer were in the Capitol on Tuesday as well. It’s expected the bill will be altered and get a new score from the Congressional Budget Office before it comes back up.\u003c/p>\n\u003cp>Leaders had been pressing hard for a vote before the holiday. Majority Whip John Cornyn of Texas \u003ca href=\"https://twitter.com/JohnCornyn/status/879364669907099648\">tweeted Monday\u003c/a> morning, “I am closing the door. We need to do it this week before double-digit premium increases are announced for next year.”\u003c/p>\n\u003cp>There has been speculation that McConnell had been prepared to bring the bill to the floor, even if it can’t pass, so the Senate can move onto its next big priority: tax reform.\u003c/p>\n\u003cp>Sen. Susan Collins, R-Maine, said late Monday that \u003ca href=\"https://twitter.com/SenatorCollins/status/879471862694256641\">she would vote “no” on a motion to proceed\u003c/a>, a procedural step that needs to be taken before a floor debate can even begin on the bill. If two more Republicans were to have voted no on that motion, the bill would have died.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>Collins cited \u003ca href=\"http://www.npr.org/2017/06/26/534432433/gop-senate-bill-would-cut-health-care-coverage-by-22-million\">a report from the Congressional Budget Office released Monday\u003c/a> that said the bill would result in 22 million fewer people with health care coverage over the next decade, compared with under the Affordable Care Act, also known as Obamacare. Much of that reduction would be because of the rollback of the ACA’s expansion of Medicaid, which Collins and other Republicans in states that took up the expansion funds have expressed serious reservations over.\u003c/p>\n\u003cp>Alaska Sen. Lisa Murkowski had similar concerns to Collins. “I need to understand really what we’re talking about, with some of the conclusions that we saw yesterday with the CBO score,” she told MSNBC. “Taking the time to get it right is where we should be.”\u003c/p>\n\u003cp>Democrats held a protest on Capitol Hill Tuesday. Senate Minority Leader Chuck Schumer told reporters, “We know the fight is not over. That is for sure. We’re not resting on any laurels, nor do we feel any sense yet of accomplishment, other than we are making progress because the American people are listening to our arguments.”\u003c/p>\n\u003cp>But the hurdle for McConnell remains divisions within his own party. Conservative Republicans, including Sens. Mike Lee of Utah, Ted Cruz of Texas and Rand Paul of Kentucky, had indicated they were very likely to vote no, as they push for greater spending cuts and reduction of regulations on health insurers.\u003c/p>\n\u003cp>Other GOP senators who appear strongly opposed include Dean Heller of Nevada, who excoriated the bill at a press conference on Friday mostly over its cuts, and Ron Johnson of Wisconsin, who had been urging leaders to wait on a vote until after next week’s recess.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The House failed to advance a bill to repeal and replace Obamacare in late March, and it was seen as a spectacular failure on the GOP’s most persistent pledge to voters for the past seven years. After rounds of negotiations and amendments, the House passed its bill in early May.\u003c/p>\n\u003cp>The outlook for delaying the bill is tricky. Leaders have been insistent that they need to move on to other issues. To take up tax reform or funding the government in 2018, Senate procedure would require them to scrap the health care effort altogether.\u003c/p>\n\u003cp>Republicans have expressed grave warnings about what that could mean politically. Polls have shown the Republican health care effort is very unpopular overall, with even GOP support for the House bill at just 34 percent in an NBC/Wall Street Journal poll released last week. But that same poll showed that 71 percent of Republicans support repealing the Affordable Care Act, and it would be risky for the GOP to head into the 2018 midterms having failed their base on that pledge.\u003c/p>\n\u003cp>“I would not bet against Mitch McConnell,” House Speaker Paul Ryan, R-Wis., told reporters Tuesday morning when asked about the bill’s fate — but before news broke of McConnell’s announcement that he was pushing the vote back. “He is very, very good at getting things done through the Senate, even with this razor-thin majority. I have every expectation that the Senate — I don’t know what day —but I have every expectation the Senate will move this bill.”\u003c/p>\n\u003cp>The speaker nodded to the political pressure the party is under to deliver on their signature campaign pledge. “Every Republican senator campaigned on repealing and replacing this law,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The Senate bill repeals the individual mandate to carry health care coverage and the employer mandate for businesses with at least 50 employees to offer coverage. It also repeals most of the taxes enacted under the ACA, which mostly affect high-income earners and corporations, in addition to rolling back federal subsidies and the expansion of Medicaid.\u003c/p>\n\u003cp>It would allow people up to age 26 to remain on their parents’ plans, and it would bar insurance companies from denying coverage to those with pre-existing conditions. Republicans revised the bill on Monday to add a penalty aimed at preventing people from signing up for coverage only once they are sick, which most experts predict would sink the insurance market.\u003c/p>\n\u003cp>“I’m a ‘no’ on it unless the bill changes,” Paul said to reporters on Monday. He has called the bill “Obamacare Lite” and is seeking a fuller rollback of the ACA. But the changes he wants seem unlikely to be included or would risk losing too many moderates because they would further reduce benefits from the federal government. Paul had a noon meeting at the White House scheduled on Tuesday, at which Trump had been expected to appeal for his support.\u003c/p>\n\u003cp>One frequent critic of Trump, Sen. Lindsey Graham, R-S.C., was quoted by \u003cem>The Hill\u003c/em> as saying Monday, “If you’re counting on the president to have your back, you need to watch it.” The president confirmed reports last week that he had privately criticized the House version of the health care bill as “mean,” even though he invited Ryan and members of the House GOP leadership over to the White House Rose Garden for a celebration after it passed. Graham also has said that waiting until after next week’s recess is not likely to make it any easier to pass a bill.\u003c/p>\n\u003cp>The White House led criticism of the CBO report on Monday, assailing its ability to estimate effects on coverage. But Ryan defended the Congressional Budget Office, which has also come under fire by outside conservatives and some Republicans in Congress. “It is important that we have a scorekeeper,” he said. “We can always complain about the nature of the score. I think their coverage numbers — there’s more to the story than the number implies. Having said that, it’s important that we have a referee.”\u003c/p>\n\u003cp>Many Republicans have taken issue with the CBO forecast, arguing that they believe more Americans will be inclined to sign up if cheaper plans are available. Republicans often note that millions of Americans have opted to pay fines in lieu of signing up for coverage under the ACA.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>NPR’s Susan Davis contributed to this report. \u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Senate+GOP+Leaders+Push+Off+Health+Care+Vote+After+July+4th&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"title": "Feinstein: Health Care Bill Would Cut Coverage for 4 Million Californians",
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"headTitle": "Feinstein: Health Care Bill Would Cut Coverage for 4 Million Californians | KQED",
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"content": "\u003cp>Up to 4 million people in California would lose health coverage over the next decade under the Republican health care bill being proposed in the Senate, Sen. Dianne Feinstein said Tuesday.\u003c/p>\n\u003cp>About 1.6 million people would lose coverage next year, and by 2026 the state would lose $24 billion in federal money for Medi-Cal, the state’s Medicaid health care plan for the poor, Feinstein told reporters in a conference call with fellow Democrats Gov. Jerry Brown and Sen. Kamala Harris.\u003c/p>\n\u003cp>“It’s the most indefensible bill I’ve actually seen in 24 years in the Senate,” Feinstein said.\u003c/p>\n\u003cp>The numbers came from the liberal think tank Center for American Progress, Congress’ Joint Economic Committee and the state of California, according to Feinstein’s office.\u003c/p>\n\u003cp>Republican leaders had hoped for a vote on this bill this week but \u003ca href=\"https://ww2.kqed.org/news/2017/06/27/senate-gop-leaders-push-off-health-care-vote-after-july-4th/\" target=\"_blank\" rel=\"noopener noreferrer\">said Tuesday they’ll delay it\u003c/a> until after the July 4 recess.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=”ZGTbysN9iZUQZxJxb4OV10sNRNfoCRGg”]\u003c/p>\n\u003cp>The GOP bill would roll back much of former President Barack Obama’s 2010 health care law, ending a tax penalty for people who don’t buy insurance and allowing states to opt out of requirements that insurers cover certain services.\u003c/p>\n\u003cp>It would phase out extra federal money that California and 30 other states get to expand Medicaid and put annual caps on federal funding for the program.\u003c/p>\n\u003cp>Taxes on the wealthy and medical companies, which funded Obama’s law, would be eliminated.\u003c/p>\n\u003cp>Brown said the bill would eliminate funding for drug treatment, exacerbating homelessness and crime.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“This thing is bad for people,” Brown said. “Millions and millions of people are going to suffer. That’s a crazy thing for elected representatives to inflict on people.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Up to 4 million people in California would lose health coverage over the next decade under the Republican health care bill being proposed in the Senate, Sen. Dianne Feinstein said Tuesday.\u003c/p>\n\u003cp>About 1.6 million people would lose coverage next year, and by 2026 the state would lose $24 billion in federal money for Medi-Cal, the state’s Medicaid health care plan for the poor, Feinstein told reporters in a conference call with fellow Democrats Gov. Jerry Brown and Sen. Kamala Harris.\u003c/p>\n\u003cp>“It’s the most indefensible bill I’ve actually seen in 24 years in the Senate,” Feinstein said.\u003c/p>\n\u003cp>The numbers came from the liberal think tank Center for American Progress, Congress’ Joint Economic Committee and the state of California, according to Feinstein’s office.\u003c/p>\n\u003cp>Republican leaders had hoped for a vote on this bill this week but \u003ca href=\"https://ww2.kqed.org/news/2017/06/27/senate-gop-leaders-push-off-health-care-vote-after-july-4th/\" target=\"_blank\" rel=\"noopener noreferrer\">said Tuesday they’ll delay it\u003c/a> until after the July 4 recess.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The GOP bill would roll back much of former President Barack Obama’s 2010 health care law, ending a tax penalty for people who don’t buy insurance and allowing states to opt out of requirements that insurers cover certain services.\u003c/p>\n\u003cp>It would phase out extra federal money that California and 30 other states get to expand Medicaid and put annual caps on federal funding for the program.\u003c/p>\n\u003cp>Taxes on the wealthy and medical companies, which funded Obama’s law, would be eliminated.\u003c/p>\n\u003cp>Brown said the bill would eliminate funding for drug treatment, exacerbating homelessness and crime.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“This thing is bad for people,” Brown said. “Millions and millions of people are going to suffer. That’s a crazy thing for elected representatives to inflict on people.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>People in the state’s health industry, from advocates to clinic directors, were left reeling by the new CBO report, which estimated the Senate Republican health plan would create an additional 22 million uninsured Americans by 2026.\u003c/p>\n\u003cp>“Nowhere are the dangers greater than in California, where our Medicaid program (Medi-Cal) covers more than one in three state residents,” said Sandra R. Hernández, president and CEO of the \u003ca href=\"http://www.chcf.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Health Care Foundation.\u003c/a>\u003c/p>\n\u003cp>The Republican bill would radically cut federal funding for Medicaid, even more deeply than what was proposed in the House bill. It would also decrease subsidies for Americans who buy their own insurance on \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Covered California\u003c/a>, but that’s a smaller group, about 1.7 million residents, compared to the 13.5 million residents covered by Medi-Cal.\u003c/p>\n\u003cp>“More Californians will likely delay or defer necessary care, and when they show up at clinics and emergency rooms, they will likely be sicker and costlier to treat,” Hernandez predicted.\u003c/p>\n\u003cp>“States, communities, and families will be forced to make unthinkable choices about providing necessary care for their loved ones,\" she added.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Under the Senate plan, most consumers who shop for subsidized plans on Covered California would see their out-of-pocket costs rise, while also receiving less financial assistance to compensate. In San Francisco, a 60-year-old who earns $30,000 a year would be facing an out-of-pocket premium of $5,570 a year, more than double what she paid under the Affordable Care Act, according to an \u003ca href=\"http://www.kff.org/interactive/premiums-and-tax-credits-under-the-affordable-care-act-vs-the-senate-better-care-reconciliation-act-interactive-maps/\" target=\"_blank\" rel=\"noopener noreferrer\">analysis\u003c/a> by the Kaiser Family Foundation.\u003c/p>\n\u003cp>But a 27-year-old in San Francisco making $40,000 a year would see premiums decrease by 12 percent.\u003c/p>\n\u003cp>In general, older consumers would pay more under the Senate plan, because the bill allows insurers to charge them five times as much as younger people, but also because the subsidy they get decreases by almost $1,000 a year.\u003c/p>\n\u003cp>When it comes to the impacts on Medi-Cal, which covers the lower-income residents, people with disabilities, and many seniors, rural California would bear the brunt, said Doreen Bradshaw, executive director of a \u003ca href=\"http://thehanc.org/\" target=\"_blank\" rel=\"noopener noreferrer\">coalition\u003c/a> of health clinics in northern California.\u003c/p>\n\u003cp>“If you look at a map, 44 out of 58 counties in California are rural,” she said. “We need to maintain [Medicaid] for rural America. This has the potential to be very devastating.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The state’s rural counties provide food, timber, and water for the rest of California and the rest of the country. Bradshaw said cutting health care for rural California workers would have a negative ripple effect on the national economy.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>People in the state’s health industry, from advocates to clinic directors, were left reeling by the new CBO report, which estimated the Senate Republican health plan would create an additional 22 million uninsured Americans by 2026.\u003c/p>\n\u003cp>“Nowhere are the dangers greater than in California, where our Medicaid program (Medi-Cal) covers more than one in three state residents,” said Sandra R. Hernández, president and CEO of the \u003ca href=\"http://www.chcf.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Health Care Foundation.\u003c/a>\u003c/p>\n\u003cp>The Republican bill would radically cut federal funding for Medicaid, even more deeply than what was proposed in the House bill. It would also decrease subsidies for Americans who buy their own insurance on \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Covered California\u003c/a>, but that’s a smaller group, about 1.7 million residents, compared to the 13.5 million residents covered by Medi-Cal.\u003c/p>\n\u003cp>“More Californians will likely delay or defer necessary care, and when they show up at clinics and emergency rooms, they will likely be sicker and costlier to treat,” Hernandez predicted.\u003c/p>\n\u003cp>“States, communities, and families will be forced to make unthinkable choices about providing necessary care for their loved ones,\" she added.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Under the Senate plan, most consumers who shop for subsidized plans on Covered California would see their out-of-pocket costs rise, while also receiving less financial assistance to compensate. In San Francisco, a 60-year-old who earns $30,000 a year would be facing an out-of-pocket premium of $5,570 a year, more than double what she paid under the Affordable Care Act, according to an \u003ca href=\"http://www.kff.org/interactive/premiums-and-tax-credits-under-the-affordable-care-act-vs-the-senate-better-care-reconciliation-act-interactive-maps/\" target=\"_blank\" rel=\"noopener noreferrer\">analysis\u003c/a> by the Kaiser Family Foundation.\u003c/p>\n\u003cp>But a 27-year-old in San Francisco making $40,000 a year would see premiums decrease by 12 percent.\u003c/p>\n\u003cp>In general, older consumers would pay more under the Senate plan, because the bill allows insurers to charge them five times as much as younger people, but also because the subsidy they get decreases by almost $1,000 a year.\u003c/p>\n\u003cp>When it comes to the impacts on Medi-Cal, which covers the lower-income residents, people with disabilities, and many seniors, rural California would bear the brunt, said Doreen Bradshaw, executive director of a \u003ca href=\"http://thehanc.org/\" target=\"_blank\" rel=\"noopener noreferrer\">coalition\u003c/a> of health clinics in northern California.\u003c/p>\n\u003cp>“If you look at a map, 44 out of 58 counties in California are rural,” she said. “We need to maintain [Medicaid] for rural America. This has the potential to be very devastating.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The state’s rural counties provide food, timber, and water for the rest of California and the rest of the country. Bradshaw said cutting health care for rural California workers would have a negative ripple effect on the national economy.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Congressional forecasters say a Senate bill that aims to repeal and replace the Affordable Care Act would leave 22 million more people uninsured by 2026.\u003c/p>\n\u003cp>That’s only slightly fewer uninsured than a \u003ca href=\"http://www.npr.org/2017/05/24/529902300/cbo-republicans-ahca-would-leave-23-million-more-uninsured\">version passed by the House in May\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cbo.gov/publication/52849\" target=\"_blank\" rel=\"noopener noreferrer\">Monday’s report\u003c/a> from the nonpartisan Congressional Budget Office could give moderate senators concerned about health care coverage pause. Senate Republican Leader Mitch McConnell wants a vote on the bill this week, before senators head home for the Fourth of July recess. With Senate Democrats united in opposition, Republicans can afford to lose only two votes on their side and still pass the bill.\u003c/p>\n\u003cp>Republican Sen. Dean Heller of Nevada, who is up for re-election next year, has already expressed reservations about the number of people who could lose coverage under the GOP bill. Four other Republican senators have complained that the bill doesn’t go far enough in rolling back the Affordable Care Act, also known as Obamacare.\u003c/p>\n\u003cp>[contextly_sidebar id=”3VYukjwGuDWleAOvKiiHHmAd7ewuNtF3″]\u003c/p>\n\u003cp>The Senate bill would cut hundreds of billions of dollars in taxes over the coming decade, with most of the savings going to those at the top of the income ladder. At the same time, it would phase out the Affordable Care Act’s Medicaid expansion, while offering less generous subsidies to those who purchase health insurance on the individual market. That combination is expected to reduce the number of people with insurance coverage by 22 million by 2026: Fifteen million fewer on Medicaid and 7 million fewer in the individual market.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Over time, the bill would also make deep cuts to traditional Medicaid, the safety net program for the poor and people with disabilities. The program, which dates to the Great Society of the 1960s, covers nearly one in five Americans — more than Medicare, the better known program for the elderly.\u003c/p>\n\u003cp>For the first time, the Senate bill would cap federal spending on Medicaid in 2020, forcing state governments to either scale back the program or make up the difference out of their own budgets. The Senate bill also assumes that after 2025, medical bills will grow more slowly than they have historically. If that assumption is wrong, states would face an even bigger budget gap that would grow with each passing year.\u003c/p>\n\u003cp>Democratic Sen. Ron Wyden of Oregon worries the CBO report doesn’t fully reflect those long-term effects, since congressional forecasters typically focus on a 10-year budget window. Wyden, the ranking Democrat on the Senate Finance Committee, wrote a \u003ca href=\"https://www.finance.senate.gov/imo/media/doc/062217%20Keith%20Hall%20CBO%20Scoring%20of%20BRCA%20Letter.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">letter\u003c/a> to CBO Director Keith Hall, asking him to assess how the Senate bill would affect Medicaid coverage 20 or 30 years into the future.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It is critical that Senators completely understand legislation and its impact prior to casting a vote,” Wyden wrote.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=GOP+Senate+Bill+Would+Cut+Health+Care+Coverage+By+22+Million&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cp>Senate Republicans on Thursday \u003ca href=\"https://apps.npr.org/documents/document.html?id=3872487-SenateHCBill\">unveiled their plan\u003c/a> to repeal and replace the Affordable Care Act — also known as Obamacare. The long-awaited plan marks a big step toward achieving one of the Republican Party's major goals. (Story continues below chart.)\u003c/p>\n\u003cp>[ACACompare]\u003c/p>\n\u003cp>The Senate proposal is broadly similar to the bill passed by House Republicans last month, with a few notable differences. Senate Majority Leader Mitch McConnell, who has been criticized for drafting the bill in secret with just a dozen Republican Senate colleagues, says the proposal — which he calls a discussion draft — will stabilize insurance markets, strengthen Medicaid and cut costs to consumers.\u003c/p>\n\u003cp>\"We agreed on the need to free Americans from Obamacare's mandates. And policies contained in the discussion draft will repeal the individual mandates so Americans are no longer forced to buy insurance they don't need or can't afford,\" McConnell said.\u003c/p>\n\u003cp>Instead, the bill entices people to voluntarily buy a policy by offering them tax credits based on age and income to help pay premiums.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>This bill is better designed than the House version, according to \u003ca href=\"https://medium.com/@avik\">Avik Roy\u003c/a>, founder of the Foundation for Research on Equal Opportunity, because it offers more help to older people who can't afford insurance while making coverage cheaper for young healthy people.\u003c/p>\n\u003cp>\"The bill will encourage a lot more of those individuals to buy health insurance,\" Roy says. \"That, in turn, will make the risk pool much healthier, which will also lower premiums. And the tax credits in the bill will also be better-designed.\"\u003c/p>\n\u003cp>But Caroline Pearson, a senior vice president at the consulting firm Avalere Health, says the bill bases its tax credits on lower-quality insurance.\"If you're paying a similar percentage of income, you're getting a less generous product under this new plan,\" she says.\u003c/p>\n\u003cp>The plan keeps some popular parts of Obamacare. It allows parents keep their children on their policies until age 26 and requires insurers to cover people with pre-existing conditions.\u003c/p>\n\u003cp>But it then allows states to opt out of that requirement.\u003c/p>\n\u003cp>\"The protections around pre-existing conditions are still in place in the Senate bill, but the waiver authority gives states options that could include limiting coverage for people with pre-existing conditions,\" says Pearson.\u003c/p>\n\u003cp>Those waivers would allow state to drop benefits \u003ca href=\"https://www.healthcare.gov/coverage/what-marketplace-plans-cover/\">required by Obamacare\u003c/a>, such as maternity coverage, mental health care and prescription drug coverage.\u003c/p>\n\u003cp>Both bills would eliminate most of the taxes imposed by the Affordable Care Act.\u003c/p>\n\u003cp>And they would bar people from using tax credits to buy policies that pay for abortion and also block Planned Parenthood from getting any money from Medicaid for a year.\u003c/p>\n\u003cp>Perhaps the most sweeping move, however, is that the Senate plan follows the House lead in completely changing how the government pays for health care for the poor and the disabled — and goes even further.\u003c/p>\n\u003cp>Today, Medicaid pays for all the care people need, and state and federal governments share the cost.\u003c/p>\n\u003cp>But Medicaid has been eating up an ever-larger share of federal spending. The Senate Republicans' plan puts a lid on that by rolling back the Obama-era expansion of the program and then granting states a set amount of money for each person enrolled. Republicans also want to change the way the federal government calculates payments to the states starting in 2025, reducing the federal government's contribution to the states.\u003c/p>\n\u003cp>\"The Medicaid cuts are even more draconian that the House bill was, though they take effect more gradually than the House bill did,\" Pearson says. \"So we're going to see very significant reductions in coverage in Medicaid and big cuts in federal funding that will result in significant budget gaps for states.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Several Republican senators have already said they oppose the bill, at least as of now. Senate leaders are aiming for a vote before July 4.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=CHART%3A+Who+Wins%2C+Who+Loses+With+Senate+Health+Care+Bill&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "Senate Republicans are calling their health care bill the Better Care Reconciliation Act. It shares many provisions with the House's American Health Care Act, but goes further in cutting Medicaid.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Senate Republicans on Thursday \u003ca href=\"https://apps.npr.org/documents/document.html?id=3872487-SenateHCBill\">unveiled their plan\u003c/a> to repeal and replace the Affordable Care Act — also known as Obamacare. The long-awaited plan marks a big step toward achieving one of the Republican Party's major goals. (Story continues below chart.)\u003c/p>\n\u003cp>[ACACompare]\u003c/p>\n\u003cp>The Senate proposal is broadly similar to the bill passed by House Republicans last month, with a few notable differences. Senate Majority Leader Mitch McConnell, who has been criticized for drafting the bill in secret with just a dozen Republican Senate colleagues, says the proposal — which he calls a discussion draft — will stabilize insurance markets, strengthen Medicaid and cut costs to consumers.\u003c/p>\n\u003cp>\"We agreed on the need to free Americans from Obamacare's mandates. And policies contained in the discussion draft will repeal the individual mandates so Americans are no longer forced to buy insurance they don't need or can't afford,\" McConnell said.\u003c/p>\n\u003cp>Instead, the bill entices people to voluntarily buy a policy by offering them tax credits based on age and income to help pay premiums.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This bill is better designed than the House version, according to \u003ca href=\"https://medium.com/@avik\">Avik Roy\u003c/a>, founder of the Foundation for Research on Equal Opportunity, because it offers more help to older people who can't afford insurance while making coverage cheaper for young healthy people.\u003c/p>\n\u003cp>\"The bill will encourage a lot more of those individuals to buy health insurance,\" Roy says. \"That, in turn, will make the risk pool much healthier, which will also lower premiums. And the tax credits in the bill will also be better-designed.\"\u003c/p>\n\u003cp>But Caroline Pearson, a senior vice president at the consulting firm Avalere Health, says the bill bases its tax credits on lower-quality insurance.\"If you're paying a similar percentage of income, you're getting a less generous product under this new plan,\" she says.\u003c/p>\n\u003cp>The plan keeps some popular parts of Obamacare. It allows parents keep their children on their policies until age 26 and requires insurers to cover people with pre-existing conditions.\u003c/p>\n\u003cp>But it then allows states to opt out of that requirement.\u003c/p>\n\u003cp>\"The protections around pre-existing conditions are still in place in the Senate bill, but the waiver authority gives states options that could include limiting coverage for people with pre-existing conditions,\" says Pearson.\u003c/p>\n\u003cp>Those waivers would allow state to drop benefits \u003ca href=\"https://www.healthcare.gov/coverage/what-marketplace-plans-cover/\">required by Obamacare\u003c/a>, such as maternity coverage, mental health care and prescription drug coverage.\u003c/p>\n\u003cp>Both bills would eliminate most of the taxes imposed by the Affordable Care Act.\u003c/p>\n\u003cp>And they would bar people from using tax credits to buy policies that pay for abortion and also block Planned Parenthood from getting any money from Medicaid for a year.\u003c/p>\n\u003cp>Perhaps the most sweeping move, however, is that the Senate plan follows the House lead in completely changing how the government pays for health care for the poor and the disabled — and goes even further.\u003c/p>\n\u003cp>Today, Medicaid pays for all the care people need, and state and federal governments share the cost.\u003c/p>\n\u003cp>But Medicaid has been eating up an ever-larger share of federal spending. The Senate Republicans' plan puts a lid on that by rolling back the Obama-era expansion of the program and then granting states a set amount of money for each person enrolled. Republicans also want to change the way the federal government calculates payments to the states starting in 2025, reducing the federal government's contribution to the states.\u003c/p>\n\u003cp>\"The Medicaid cuts are even more draconian that the House bill was, though they take effect more gradually than the House bill did,\" Pearson says. \"So we're going to see very significant reductions in coverage in Medicaid and big cuts in federal funding that will result in significant budget gaps for states.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Several Republican senators have already said they oppose the bill, at least as of now. Senate leaders are aiming for a vote before July 4.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=CHART%3A+Who+Wins%2C+Who+Loses+With+Senate+Health+Care+Bill&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>At last, Republican senators have \u003ca href=\"https://ww2.kqed.org/news/2017/06/22/senate-republicans-reveal-obamacare-repeal-bill/\" target=\"_blank\" rel=\"noopener noreferrer\">unveiled their crafted-in-secret health bill\u003c/a>, and everyone, including other Republican senators, are scrambling to understand the 142-page \"\u003ca href=\"https://www.budget.senate.gov/imo/media/doc/SENATEHEALTHCARE.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Better Care Reconciliation Act of 2017\u003c/a>.\"\u003c/p>\n\u003cp>To know whether it's truly \"better care,\" and for which patients, if any, we still need the Congressional Budget Office to weigh in. But some California advocates say the “discussion draft” is clear enough to conclude that the bill would be “disproportionately devastating” for California’s health care system.\u003c/p>\n\u003cp>“If the House bill was mean, as the President termed it, the Senate bill was actually meaner and crueler,” said Anthony Wright, executive director of Health Access California. “It has harsher cuts, especially to the Medicaid program that covers 14 million Californians.\"\u003c/p>\n\u003cp>In the meantime, here are my five takeaways from the bill:\u003c/p>\n\u003cp>\u003cstrong>1. 'Repeal and Replace' Rhetoric Should Be … Repealed\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>At this point, it’s inaccurate and misleading. The Republican bill doesn’t repeal all of President Obama's health care law known as the Affordable Care Act, or Obamacare. Nor does it replace it with anything. The bill maintains the basic mechanics of the ACA but rolls back the financial assistance and some of the consumer protections. In addition, a huge part of this bill has nothing to do with Obamacare: It proposes a radical dismemberment of Medicaid as we know it.\u003c/p>\n\u003cp>Let’s describe what the bill actually does: It’s an Obamacare \u003cem>rollback\u003c/em> and a Medicaid \u003cem>cutback\u003c/em>.\u003c/p>\n\u003cp>\u003cstrong>2. Much Less Aid for Medicaid\u003c/strong>\u003c/p>\n\u003cp>The Senate bill will phase out one of the ACA’s most visible accomplishments: the \u003cem>expansion\u003c/em> of Medicaid (Medi-Cal in California) to poor, uninsured adults. That means 3.7 million Californians who got Medi-Cal since 2014 will eventually lose it.\u003c/p>\n\u003cp>But there's more. The Senate plan will also cut funding for \u003cem>traditional\u003c/em> Medi-Cal, and the cuts will be deeper, over time, than even the House Republicans proposed.\u003c/p>\n\u003cp>In California, Medi-Cal covers one-third of all residents, half of all children, and two-thirds of seniors in nursing homes.\u003c/p>\n\u003cp>Who pays for their care if the feds pay less? The short answer is no one -- or state taxpayers.\u003c/p>\n\u003cp>\u003cstrong>3. What About Covered California? Could It help?\u003c/strong>\u003c/p>\n\u003cp>Not really. The Senate version tries to assuage pre-Medicare seniors (below age 65) who were alarmed that the House bill would have given them only a maximum tax credit of $4,000 to buy a plan, no matter the plan’s price. The Senate bill reverts to the ACA mechanism of offering tax credits based on income, not age. But, insurers can still charge older people five times what they charge younger people.\u003c/p>\n\u003cp>And tax credits would only be offered to people with incomes below 350 percent of the federal poverty level, down from the ACA’s 400 percent. Do you make $42,000-$48,000 a year? You would no longer qualify for any subsidies on Covered California.\u003c/p>\n\u003cp>That’s not all. Other complicated changes to the exchanges mean premiums and deductibles would go up, and special ACA grants that help reduce those deductibles disappear.\u003c/p>\n\u003cp>\u003cstrong>4. Winners? Or Just Losers: Pre-existing conditions vs. Planned Parenthood\u003c/strong>\u003c/p>\n\u003cp>The Senate bill appears to drop a wildly unpopular provision that is still in the House bill -- the possibility that your state might allow insurers to refuse to cover people with pre-existing conditions, or charge them much more. That seems like good news for cancer survivors and millions of others with chronic illnesses. They can't be denied coverage, or charged more up front.\u003c/p>\n\u003cp>But experts who have read the bill closely say there are loopholes that would allow individual states to loosen regulations on insurers -- enabling those insurers to carve away coverage that people with pre-existing conditions need. As Kaiser Health News \u003ca href=\"http://khn.org/news/promises-made-to-protect-preexisting-conditions-prove-hollow/\" target=\"_blank\">reports\u003c/a>: \u003c/p>\n\u003cblockquote>\u003cp>Somebody with cancer might be able to buy insurance but find it doesn’t cover expensive chemotherapy. A plan might pay for opioids to control pain but not recovery if a patient became addicted. People planning families might find it hard to get childbirth coverage.\u003c/p>\u003c/blockquote>\n\u003cp>The Senate bill also retains a proposal to eliminate all federal funding for Planned Parenthood, for one year. The feds never paid for abortions; this is money the organization uses for breast exams, contraception and testing for sexually transmitted diseases.\u003c/p>\n\u003cp>\u003cstrong>5. The Senate Bill Still Ignores Health Care’s Real Problem: Cost\u003c/strong>\u003c/p>\n\u003cp>The frustrations that many voters have with the Affordable Care Act are understandable. Very little in that law reduced health care spending, or got at the root causes of excessive charges -- though the ACA did slow down the growth rate compared to previous years.\u003c/p>\n\u003cp>It’s a valid criticism to point out that premiums continued to rise under the ACA, and quite sharply in some places. If you don’t qualify for any of the ACA assistance to shield you from those price increases, you -- or your employer -- are paying those increases out-of-pocket. It’s a difficult and chronic pre-existing condition of American health care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If you are interested in learning more about \u003cem>how\u003c/em> the U.S. health care system became so expensive for patients, I recommend \u003ca href=\"http://www.npr.org/books/titles/523005656/an-american-sickness-how-healthcare-became-big-business-and-how-you-can-take-it-\" target=\"_blank\" rel=\"noopener noreferrer\">this book\u003c/a>.\u003c/p>\n\n",
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"excerpt": "Five takeaways from the new draft bill, and why it's not really 'repeal and replace.'",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>At last, Republican senators have \u003ca href=\"https://ww2.kqed.org/news/2017/06/22/senate-republicans-reveal-obamacare-repeal-bill/\" target=\"_blank\" rel=\"noopener noreferrer\">unveiled their crafted-in-secret health bill\u003c/a>, and everyone, including other Republican senators, are scrambling to understand the 142-page \"\u003ca href=\"https://www.budget.senate.gov/imo/media/doc/SENATEHEALTHCARE.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Better Care Reconciliation Act of 2017\u003c/a>.\"\u003c/p>\n\u003cp>To know whether it's truly \"better care,\" and for which patients, if any, we still need the Congressional Budget Office to weigh in. But some California advocates say the “discussion draft” is clear enough to conclude that the bill would be “disproportionately devastating” for California’s health care system.\u003c/p>\n\u003cp>“If the House bill was mean, as the President termed it, the Senate bill was actually meaner and crueler,” said Anthony Wright, executive director of Health Access California. “It has harsher cuts, especially to the Medicaid program that covers 14 million Californians.\"\u003c/p>\n\u003cp>In the meantime, here are my five takeaways from the bill:\u003c/p>\n\u003cp>\u003cstrong>1. 'Repeal and Replace' Rhetoric Should Be … Repealed\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At this point, it’s inaccurate and misleading. The Republican bill doesn’t repeal all of President Obama's health care law known as the Affordable Care Act, or Obamacare. Nor does it replace it with anything. The bill maintains the basic mechanics of the ACA but rolls back the financial assistance and some of the consumer protections. In addition, a huge part of this bill has nothing to do with Obamacare: It proposes a radical dismemberment of Medicaid as we know it.\u003c/p>\n\u003cp>Let’s describe what the bill actually does: It’s an Obamacare \u003cem>rollback\u003c/em> and a Medicaid \u003cem>cutback\u003c/em>.\u003c/p>\n\u003cp>\u003cstrong>2. Much Less Aid for Medicaid\u003c/strong>\u003c/p>\n\u003cp>The Senate bill will phase out one of the ACA’s most visible accomplishments: the \u003cem>expansion\u003c/em> of Medicaid (Medi-Cal in California) to poor, uninsured adults. That means 3.7 million Californians who got Medi-Cal since 2014 will eventually lose it.\u003c/p>\n\u003cp>But there's more. The Senate plan will also cut funding for \u003cem>traditional\u003c/em> Medi-Cal, and the cuts will be deeper, over time, than even the House Republicans proposed.\u003c/p>\n\u003cp>In California, Medi-Cal covers one-third of all residents, half of all children, and two-thirds of seniors in nursing homes.\u003c/p>\n\u003cp>Who pays for their care if the feds pay less? The short answer is no one -- or state taxpayers.\u003c/p>\n\u003cp>\u003cstrong>3. What About Covered California? Could It help?\u003c/strong>\u003c/p>\n\u003cp>Not really. The Senate version tries to assuage pre-Medicare seniors (below age 65) who were alarmed that the House bill would have given them only a maximum tax credit of $4,000 to buy a plan, no matter the plan’s price. The Senate bill reverts to the ACA mechanism of offering tax credits based on income, not age. But, insurers can still charge older people five times what they charge younger people.\u003c/p>\n\u003cp>And tax credits would only be offered to people with incomes below 350 percent of the federal poverty level, down from the ACA’s 400 percent. Do you make $42,000-$48,000 a year? You would no longer qualify for any subsidies on Covered California.\u003c/p>\n\u003cp>That’s not all. Other complicated changes to the exchanges mean premiums and deductibles would go up, and special ACA grants that help reduce those deductibles disappear.\u003c/p>\n\u003cp>\u003cstrong>4. Winners? Or Just Losers: Pre-existing conditions vs. Planned Parenthood\u003c/strong>\u003c/p>\n\u003cp>The Senate bill appears to drop a wildly unpopular provision that is still in the House bill -- the possibility that your state might allow insurers to refuse to cover people with pre-existing conditions, or charge them much more. That seems like good news for cancer survivors and millions of others with chronic illnesses. They can't be denied coverage, or charged more up front.\u003c/p>\n\u003cp>But experts who have read the bill closely say there are loopholes that would allow individual states to loosen regulations on insurers -- enabling those insurers to carve away coverage that people with pre-existing conditions need. As Kaiser Health News \u003ca href=\"http://khn.org/news/promises-made-to-protect-preexisting-conditions-prove-hollow/\" target=\"_blank\">reports\u003c/a>: \u003c/p>\n\u003cblockquote>\u003cp>Somebody with cancer might be able to buy insurance but find it doesn’t cover expensive chemotherapy. A plan might pay for opioids to control pain but not recovery if a patient became addicted. People planning families might find it hard to get childbirth coverage.\u003c/p>\u003c/blockquote>\n\u003cp>The Senate bill also retains a proposal to eliminate all federal funding for Planned Parenthood, for one year. The feds never paid for abortions; this is money the organization uses for breast exams, contraception and testing for sexually transmitted diseases.\u003c/p>\n\u003cp>\u003cstrong>5. The Senate Bill Still Ignores Health Care’s Real Problem: Cost\u003c/strong>\u003c/p>\n\u003cp>The frustrations that many voters have with the Affordable Care Act are understandable. Very little in that law reduced health care spending, or got at the root causes of excessive charges -- though the ACA did slow down the growth rate compared to previous years.\u003c/p>\n\u003cp>It’s a valid criticism to point out that premiums continued to rise under the ACA, and quite sharply in some places. If you don’t qualify for any of the ACA assistance to shield you from those price increases, you -- or your employer -- are paying those increases out-of-pocket. It’s a difficult and chronic pre-existing condition of American health care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If you are interested in learning more about \u003cem>how\u003c/em> the U.S. health care system became so expensive for patients, I recommend \u003ca href=\"http://www.npr.org/books/titles/523005656/an-american-sickness-how-healthcare-became-big-business-and-how-you-can-take-it-\" target=\"_blank\" rel=\"noopener noreferrer\">this book\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"soldout": {
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