CA Democrats target health care costs, seek Obamacare coverage for undocumented immigrants

On several fronts, California Democrats have used the tail end of this political season to push for advances on their health care agenda — with mixed results. 

In Sacramento, they succeeded in passing legislation targeting health care cost sticker-shock after several recent misfires. “The unexpected charges come when patients are treated by an out-of-network provider at an in-network facility,” NPR explained. “After several failed attempts in recent years, the California legislature last week passed Assembly Bill 72, which aims to protect patients’ pocketbooks when they’re hit by these surprise bills. Gov. Jerry Brown has until the end of September to sign or veto the legislation. He is expected to sign it into law.”

“A 2015 Consumers Union survey suggests the surprise bill phenomenon is fairly common,” the station added. “It found nearly 1 in 4 Californians who’d had hospital visits or surgery in the prior two years reported receiving an unexpected bill from an out-of-network provider.”

Waiver wanted

In Washington, D.C., meanwhile, a who’s who of members of Congress hailing from California tried to flex their muscle around California’s unlikely request that the federal government allow unlawful and undocumented immigrants in state to access health benefits under Obamacare. “In a letter announced Wednesday, 37 members of California’s congressional delegation asked Treasury Secretary Jack Lew and Health and Human Services Secretary Sylvia Burwell to accept California’s request for a waiver that would allow the state to offer health care to an estimated 50,000 undocumented immigrants,” TPM reported. 

“The letter is just the latest in the fight to expand health care coverage to California’s undocumented population. In June, California Gov. Jerry Brown signed a bill passed by the state’s Legislature that allowed California’s undocumented population to buy their own health insurance on the state’s exchange, Covered California. However, a special federal waiver — a 1332 waiver — is needed before the state is allowed to enact its law.”

It hasn’t been clear whether President Obama could be moved to take action before the end of his term in office. He has already wound up under immense personal pressure to convince insurers to remain committed to the Affordable Care Act’s health care exchanges, despite a growing sense in industry that doing so will be harmful.

Unaffordable care

“With no lifeline coming from the divided Congress, Obama and his administration are redoubling their pleas for insurers to shore up the federal health care law and pushing uninsured Americans — especially younger ones — to sign up for coverage,” Politico observed. “The administration is nervously preparing for its final Obamacare open-enrollment season just a week before Election Day, amid a cascade of headlines about rising premiums, fleeing insurers and narrowing insurance options.”

“But six years after passage of Obama’s signature domestic achievement, the litany of woes afflicting the Obamacare marketplaces is formidable. Enrollment has plateaued at half of what was projected. Three major insurers have largely quit, citing big losses. Double-digit rate hikes are the norm for plans across the country. And roughly one in five Americans may find just one insurer selling plans in their area when they shop for 2017 coverage.”

At the same time, although California’s exchange program has been one of the biggest relative success stories for the ACA, the state’s health cost burden has continued to rise over time. A new study released by the University of California Los Angeles Center for Health Policy Research revealed that “spending is projected to total more than $367.5 billion in 2016, with about 71 percent covered by public funds when additional resources such as the Affordable Care Act subsidies and county spending are included,” according to U-T San Diego.

Indeed, California Democrats pushing the White House used the problem as ammunition for their own waiver goal, arguing before the press “that denying undocumented immigrants health care was only driving up the long-term costs of health care,” as TPM recalled. “Without insurance coverage, many immigrants have been forced to depend on emergency services to be treated.”