Gary Passama

Gary Passama retired as president and CEO of NorthBay Healthcare on March 31, 2017. An active blogger since 2010, here’s a collection of his work.

Some Explaining To Do

July 28, 2015
 

I have purposely avoided discussing the Supreme Court decision last month regarding the Affordable Care Act (aka Obamacare). No matter which way the decision went it would not have affected California in any substantial way. Avoided it until now.

Obamacare will not become problematical in California until 2017-2018 when the full bill for its cost comes due and payable. That will be fun to watch. Politicians who are still in office will have some explaining to do.

In California, Obamacare was really just an expansion of the Medi-Cal program – a whopper of an expansion. Obamacare loosened eligibility requirements for this public program. The feds provided almost all the funding for the expansion. But when the feds shut off that funding stream in a couple years our state will inherit a huge new unfunded mandate.

More than 3.2 million people became new Medi-Cal beneficiaries – taxpayer supported health plan members – within the past year. Some 12 million people in this state now have healthcare coverage through this public program, or nearly one in three citizens. That is staggering.

Covered California, the Obamacare state exchange, enrolled 1.4 million people in various commercial plans. That's good, but remember: That doesn't mean these 1.4 million had no previous insurance. It now appears most of these Covered California participants previously had individual or commercial policies from other sources. There was no net increase in commercial insurance members due to Obamacare.

Estimates are that there remain three to four million Californians who for various reasons still have no insurance. From that perspective, there is still a problem.

Obamacare covered a lot of territory, but at its core it was simply an expansion of an existing public program. It would have been easier and certainly more honest to have acknowledged that during the discussions that gave rise to a 2,000-page piece of legislation that needlessly and deeply divided our country. 

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