Californians Contemplate 'Unthinkable Choices' if GOP Health Plan Becomes Law

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Healthcare activists in San Francisco staged a "die-in" on June 21, after the release of the Senate Republican health bill. The Congressional Budget Office estimates the bill will increase the ranks of the uninsured by 22 million.  (Justin Sullivan/Getty Images)

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.

“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 California Health Care Foundation.

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 Covered California, but that’s a smaller group, about 1.7 million residents, compared to the 13.5 million residents covered by Medi-Cal.

“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.

“States, communities, and families will be forced to make unthinkable choices about providing necessary care for their loved ones," she added.


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 analysis by the Kaiser Family Foundation.

But a 27-year-old in San Francisco making $40,000 a year would see premiums decrease by 12 percent.

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.

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 coalition of health clinics in northern California.

“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.”

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.