The poll was based on 691 registered voters, as well as 517 voters likely to vote in the primary. The top two vote-getters in the primary, regardless of party affiliation, will advance to the Nov. 6 general election.

Newsom, the current lieutenant governor, received 21 percent of the vote, with former Los Angeles Mayor Antonio Villaraigosa and Republican businessman John Cox contending for second place with 11 percent and 10 percent of the vote, respectively; well within the margin of error of plus or minus 4 percentage points.

Of potential interest to the battle for second place could be President Trump’s recent decision to endorse Cox. While it could potentially mobilize Republican support, it could just as easily backfire and turn away moderates.

California Treasurer John Chiang, who was hoping to become the state’s first Asian-American governor, and Huntington Beach State Assemblyman Travis Allen, who has brashly courted Trump supporters, stand at 6 percent and 5 percent, respectively.

When it comes to issues that could swing voters in congressional races, the Trump administration’s tax overhaul and attempts to repeal the Affordable Care Act hold the most cache. Almost half of poll respondents opposed the December tax overhaul, with 52 percent being less likely to re-elect their representative if they supported the changes. And six out of 10 residents support the ACA; similarly, 54 percent would be less likely to vote for a representative trying to repeal Obamacare.

Will progressive lawmakers challenge Gov. Jerry Brown over his decision to dash their big dreams for the 2017-18 fiscal year? Or will they acquiesce as they mostly have in recent months of May after Brown released revised budgets without money for new or expanded government programs?

Despite the pleas of Assembly Speaker Anthony Rendon, D-Paramount, and Senate President Kevin de Leon, D-Los Angeles, that he take a break from his usual frugality, the governor’s revised 2017-18 $124 billion general fund budget released last week is far more concerned about helping public schools and beefing up the state’s rainy-day fund than any new liberal cause.

With a month until the June 15 deadline to adopt a state budget, that means Democratic lawmakers – especially those from liberal districts in the Bay Area and Los Angeles County – have a big decision to make: Do they accept a wipeout? Or do they put pressure on Brown by sending him bills popular with Trump-agitated grass-roots Democrats and making him veto them?

This is the dynamic created by the fact that Democratic legislative leaders entered the current session in January with ambitious hopes for bold new programs making college much cheaper, expanding state affordable housing efforts and providing health care for all.

Ambitious legislation not taken seriously

The governor doesn’t even think the ideas are worth discussing.

Brown’s budget rejects the basics of Assembly Bill 1356, by Assemblywoman Susan Talamantes Eggman, D-Stockton, which would have added a 1 percent surtax on California families earning $1 million or more to cover the cost of fees and tuition for in-state students at the University of California, California State University and the California Community College system. The governor also dismissed without comment Assembly Democrats’ push to help cover basic living expenses for 350,000-plus UC and CSU students from families which make less than $150,000 a year.

Brown’s budget makes no mention of SB562, a bill by Sens. Ricardo Lara, D-Bell Gardens, and Toni Atkins, D-San Diego, that would create a government-run single-payer health care system. It’s won some early committee victories, despite not having a fiscal analysis that explains how or who will pay for the program.

And a push supported by dozens of Democratic lawmakers to impose a fee on real-estate transactions to provide a steady stream of hundreds of millions of dollars in annual funding for subsidized affordable housing projects was flatly rejected by Brown as inadequate to addressing California’s housing crisis.

At a Thursday press conference, the governor said, “I don’t think we should throw money at the housing problem if we don’t adopt real changes that make housing production more efficient and less costly. We’ve got to do that first.”

For nearly two years, the governor has pushed for laws reforming the California Environmental Quality Act to give builders fewer obstacles to constructing new housing units. But legislative Democrats have heeded their union, trial lawyer and environmental allies who say CEQA shouldn’t be weakened.

Brown and top Democratic lawmakers pulled off a big win last month on an issue they agreed on: the urgent need to improve California’s decaying infrastructure, both for quality-of-life reasons and to help the economy by reducing the drag on the economy caused by bad, clogged roads. They pushed through gas tax hikes to pay for a 10-year, $52 billion infrastructure improvement and repair initiative.

But Brown’s pragmatism about government spending has been the calling card of his second stint as governor. Given his high approval ratings, the governor seems unlikely to believe he needs to make concessions if Democratic lawmakers send him spending bills he doesn’t like.

The budget showed a $2 billion deficit — modest by historical standards, but worthy of the lawmakers’ attention — caused by an increase in government programs over the last few years and lagging revenues.

Brown said he didn’t want to “repeat mistakes of the past,” recalling the days of the state’s budget crisis. The proposed budget showed approximately $8 billion in the Rainy Day Fund by the end of 2017-18, which is 63 percent of the constitutional target, which Brown said was bigger than it seemed as he called for greater savings now. 

Independent analysts, as well as Brown’s budget experts, have cautioned against the state’s over-dependence on the wealthiest residents to fund the government. Brown lauded the state’s “progressive” tax system, where people with the most pay the most. But he said it also requires prudence.

“It doesn’t make sense to pretend we have money when we really don’t,” Brown said. 

Trump 

Recently, many prominent Democrats staked out positions as Trump antagonists, in interviews and even with the Legislature’s hiring of former U.S. Attorney General Eric Holder. Brown took a more measured approach by saying money wasn’t moved around to certain areas in anticipation of Trump, but left the door open for the May budget revision.

Brown seemed confident that the Affordable Care Act, which has expanded coverage to millions of Californians, wouldn’t go anywhere, noting that any repeal-and-replace proposal would have to get Democratic support in the Senate and that cutting health care for millions of people would be political suicide for Trump. 

Transportation and housing 

In response to the ongoing infrastructure funding woes, Brown proposed a “road improvement charge” of $65 per vehicle. In other car-related news, the gas tax will increase 2.1 cents per gallon automatically. 

As for housing, one of the other major unresolved issues facing the state, Brown proposed to re-appropriate an unused $400 million in funding for housing that was set aside in the last budget.

The budget does send $3.2 billion to local municipalities for affordable housing projects, but Brown said more needed to be done to spur housing development by cutting red tape, cutting delays and cutting “whatever expenses we can do without.”

“We have to bring down the cost structure of housing, not just subsidize,” Brown said.  

Short-term pain with ACA repeal

Good morning! TGIT. Republicans in Washington appear poised to repeal the Affordable Care Act, better known as Obamacare, some time after Donald Trump is sworn in as president.

With premiums on the rise and consistently poor polling, repeal is music to the ears of many, as evidenced by every federal election since the measure was passed in 2010. But California would suffer major economic consequences if Congress repeals the ACA without an adequate replacement, according to a new study by the UC Berkeley Labor Center. 

A partial repeal (as a full repeal still seems out of reach) would cause Californians to lose hundreds of thousands of jobs, billions of dollars in annual federal funding and kick millions out of coverage. Some of the losses would be offset by gains elsewhere, but it’s impossible to give a complete analysis of the offsetting effects without Republicans’ replacement plan.

CalWatchdog has more. 

In other news:

• Budget: “California’s state auditors recently released an unflattering look at the state’s finances, part of their annual report. Issued several years in arrears, the assessment showed nearly $2 billion in deficit spending for the 2011-2012 fiscal year, piling more borrowed money onto what Gov. Jerry Brown has called a figurative ‘wall of debt.’” CalWatchdog has more. 

• CPUC: “Gov. Jerry Brown has chosen two of his closest advisors on environmental and climate change issues to fill positions on the California Public Utilities Commission, the powerful state agency that regulates energy companies and the telecommunications industry.” The Los Angeles Times has more. 

• Trump Transition: “Abel Maldonado, California’s former lieutenant governor, the Central Coast’s former assemblymember and state senator, and Santa Maria’s former mayor, was in Florida on Wednesday, reportedly interviewing with President-elect Donald Trump to discuss a possible appointment as Secretary of Agriculture.” Santa Barbara Independent has more. 

• Lobbying: The Sacramento Bee looks at how a top Democratic donor pushed a major environmental bill through the Legislature. 

Legislature:

• Gone till January. 

Gov. Brown:

• No public events announced. 

Tips: matt@calwatchdog.com

Follow us: @calwatchdog @mflemingterp

New follower: @LGullyborn

Republicans in Washington appear poised to repeal the ACA, better known as Obamacare, some time after Donald Trump is sworn in as president. With premiums on the rise and consistently poor polling, repeal is music to the ears of many, as evidenced by every federal election since the measure was passed in 2010.

However, a partial repeal would cause Californians to lose hundreds of thousands of jobs, billions of dollars in annual federal funding and kick millions of people out of coverage. Some of the losses would be offset by gains elsewhere, but it’s impossible to give a complete analysis of the offsetting effects without Republicans’ replacement plan.

What we know

Even with Republican majorities in Congress and a Republican president, a full repeal of the ACA is unlikely, due to a 60-vote threshold in the Senate that would require at least a handful of Democratic votes.

UC Berkeley Labor Center analysts used a 2015 partial-repeal bill that was ultimately vetoed by President Barack Obama to estimate the effects. Under that bill, California would lose $20.5 billion annually in federal funding for low-income subsidies and expanded Medi-Cal coverage.

As a result of that lost funding, 3.7 million Californians would lose Medi-Cal coverage, while another 1.2 million would lose subsidies, which may or may not make coverage unaffordable. 

Offsets

The billions in lost federal funds would be offset by smaller gains elsewhere, like $6.3 billion in tax cuts to California insurers and high-income earners. A repeal could also remove the requirement to have coverage, saving $1.3 billion in penalties for the uninsured. 

The study estimates approximately 250,000 jobs would be lost from repeal. However, approximately 41,000 jobs would be created through tax cuts, as well as through eliminating fees on insurers, penalties to companies for not providing coverage and penalties for the uninsured.

Popularity

Polling and electoral results have repeatedly shown the law to be unpopular with the public nationally, and Californians are facing an expected average increase in premiums by 13.2 percent next year. 

Nationally, the public is divided on the law. In November, 45 percent of adults had an unfavorable impression of the law, compared to the 43 percent who had a favorable impression, according to a Kaiser Family Foundation tracking poll.

Republicans have incrementally seized power in Washington on a repeal platform ever since Democrats passed the ACA in 2010 with their own congressional majorities and president, Barack Obama. In 2010, Democrats lost the House. In 2014, they lost the Senate. And in 2016, they failed to regain the Senate and lost the White House.

How Obamacare repeals would affect some Californians

Good morning. Happy Monday. It seems like both the country and state are in a holding pattern until January when Trump will be sworn in, a new Congress starts and the California legislative session begins. 

Democrats in the Legislature have made it clear in recent weeks that everyone should expect fights with the feds over immigration, while Republicans in D.C. are prioritizing an Obamacare repeal. But details are sketchy. 

One thing is for sure: Even though Republicans have taken control of D.C. on an anti-Obamacare platform, there could still be many upset people, depending on how the replacement system is structured. 

In fact, Bakersfield.com/Kaiser Health News talked to some of those upset people in the Bakersfield district of House Majority Leader Kevin McCarthy. But no matter what happens, there will be people both upset and pleased. 

In other news:

• Fate of the CA GOP: “Many say the party needs to soften its posture on undocumented immigrants and social issues in order to attract more Latino, Asian and young voters. Others, particularly in the GOP’s traditional voter base, counter that Trump’s victory nationwide is proof that a stronger stance is called for. At stake is the very relevance of the Republican Party in California.” The Orange County Register has more. 

• Mismanagement of a gov’t program?: “The Metropolitan Water District’s massive $340-million turf rebate program — which helped thousands of Southern Californians rip out their lawns in favor of drought-tolerant landscaping — was plagued by poor planning and oversight by the agency, a new audit found.” The Los Angeles Times has more. 

• Racial profiling: “Police officers in California will soon track the race of those they pull over for traffic stops or encounter in the street, according to proposed guidelines released Friday by Atty. Gen. Kamala Harris,” reports the Los Angeles Times. 

• Drought: “October was wet, November dry. And December? The soft but steady rains this weekend were enough to push the Sacramento region to 155 percent of normal precipitation for the season. … And there’s more to come. … So what does that mean for California’s drought, now entering a sixth year? While Northern California has seen a wet start to winter, the situation is more complicated across the state. Central and Southern California continue to experience unusually dry conditions. And even in the north state, it’s not clear how the rest of the rainy season will shape up.” The Sacramento Bee has more. 

Legislature:

• Gone till January. 

Gov. Brown:

• No public events announced. 

Tips: matt@calwatchdog.com

Follow us: @calwatchdog @mflemingterp

New followers: @SpokeAna

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.”

Obamacare has largely been in effect for more than two years, but it wasn’t until Jan. 1 that employers with 50 to 99 employees were required to provide insurance. In 2015, the cutoff was 100 employees. This hits both farm labor contractors and smaller farmers who do their own hiring, who tend to have much less financial reserves than large agribusiness farms to fall back on to deal with additional costs and often smaller profit margins.

KQED looked at the issue last week:

Farm labor contractors who must now offer their workers health insurance are complaining loudly about the cost in their already low-margin business.

 

Some are also concerned that the forms they must file with the federal government under the Affordable Care Act will bring immigration problems to the fore: about half of the farm labor workforce in the U.S. is undocumented.

 

“There’s definitely going to be some repercussions to it,” says Jesse Sandoval, a farm labor contractor based in Stockton. “I think there’s going to be some things that cannot be ignored.”

 

Sandoval has about 100 workers on his payroll. When farmers need a crew to pick cherries or pumpkins or asparagus, they call him to send the workers. He needs to offer insurance this year, and he’s smarting at the price tag. At $300 a month per employee, he’s looking at a $30,000 monthly bill. …  “The numbers aren’t there. My margin is 10 percent. And I have to increase expenses 10 percent? Well, that doesn’t work.”

Workers struggle with their share of cost

But under Obamacare, the cost of health insurance isn’t entirely borne by employers. The 2010 federal law allows requiring workers to pay up to 9.5 percent of their income to cover the coast of health premiums.

As with small farmers, that’s a cut on the margins that makes life rough for low-paid agricultural workers. As KQED notes …

… for farmworkers who pick oranges or peaches for $10 an hour, [the premium cost is] still too much.

 

Agostin Garcia says the two contractors he works for near Fresno offered him insurance directly. But when he saw the price tag, he turned them both down.

 

“For me, I’m the only one in my house who works. There’s five of us in the family,” he says in Spanish. “It just wouldn’t work. Either I pay for health insurance, or I pay the rent and utilities.”

Grim quality of life for farmworkers

And that rent is often for housing that is in awful condition, according to a 2014 report by the California Rural Legal Assistance group. In These Times offered this summary:

Even today, however, surveys and field reports have revealed that a large portion of workers are squeezed into essentially unlivable spaces. Some dilapidated apartments and trailer parks lack plumbing or kitchen facilities, much less any modicum of privacy; others are exposed to toxic pesticide contamination or fetid waste dumps.

 

Workers can “live in a single-family dwelling with perhaps a dozen to 20 [people] crowding in,” [report author Don] Villarejo says. In some residences, “mattresses are lined up against the wall because during the daylight hours you could not be able to walk through the rooms owing to all the mattresses on the floor at that time.”

Though premium costs may strain the budget of impoverished farmworkers’ families, the Affordable Care Act retains the passionate support of the United Farmworkers Union as a huge improvement over previous health insurance programs for agriculture workers.

Former UFW Vice President Dolores Huerta has used 2016 Republican presidential candidates’ opposition to Obamacare to argue this shows they hate Latinos — to the annoyance of one of California’s most prominent Latino journalists, Carlsbad-based Ruben Navarrette Jr., an unpredictable moderate whose syndicated column is carried by the Washington Post Writers Group.

Two years later, the Kaiser Family Foundation has issued a report that suggests these warnings were more accurate than the upbeat predictions of Covered California Executive Director Peter Lee. A key finding:

“Among adults who say that they pay a monthly premium for their health coverage, nearly half of newly insured adults (47 percent) say it is somewhat or very difficult to afford this cost, compared to just 27 percent of adults who were insured before 2014. When looking specifically by type of coverage, 44 percent of Covered California enrollees (not all of whom are newly insured) report difficulty paying their monthly premium, versus a quarter of adults with other types of private coverage. Medi-Cal enrollees do not pay monthly premiums for their coverage.”

Cost, not glitches, slowing CA sign-ups

The Kaiser report, which was based on interviews with 4,555 Californians, says the cost factor is the biggest barrier to higher enrollments, not online technical snafus:

“Cost continues to prevent many uninsured adults from seeking coverage. While many people focused on website glitches and administrative barriers during 2014, uninsured adults say that the reason they still lack coverage is because it’s too expensive, with most not even trying to get ACA coverage, and many who did still saying they are ineligible or believe the coverage is too costly.”

The cost of premiums is also prompting Californians to quit Covered California, KCRA TV in Sacramento reported, citing documents showing that 150,000 people dropped their state coverage in 2014.

These developments come in a pivotal year for Covered California — the last year in which federal subsidies will help cover the subsidies provided by the state agency. By law, beginning in 2016, the agency cannot seek state subsidies and must rely only on revenue it generates from premiums. Its goal was to have 1.7 million residents enrolled by Feb. 15, but it fell far short, with 1.4 million signups.

More criticism from national media

Meanwhile, Covered California is again provoking comment from outside of California. A May 31 Columbia Journalism Review essay by Trudy Lieberman criticized coverage of the agency as misleading:

It’s not easy to figure out how to monitor the progress of Covered California, the country’s largest state-run health insurance exchange.

 

Is it the total number of people who have signed up for an insurance plan on the exchange during open enrollment? The rate at which people renew? The number of new sign-ups in a given year? The number of Latino sign-ups? The number of “covered lives”? The number of Californians who have had coverage through the exchange at any point? Or, simply, the overall rate of uninsured adults across the state?

 

“In recent months, Covered California has cited each of these measures to tout its success. And though outside analysts have raised some notes of caution, press coverage has largely followed the lead set by the exchange. The result is coverage that has too often been reactive, short on enterprise, and with missed opportunities to ask some necessary questions. Covered California may ultimately have a success story to tell — but it will need to face some sharper skepticism before we can be sure.”

Lieberman wrote that California journalists should spend more time talking to affected state residents about their experiences with the agency and be less inclined to accept Covered California’s characterizations of its record.

“Today, more than 12 million Californians, nearly one-third of the state’s total population, are enrolled in the government’s health insurance plan for low-income, disabled and disadvantaged residents,” U-T San Diego reported.

Wrangling reimbursements

The sharply increased burden has driven stark divides into statewide politics. The dispute has centered around reimbursement rates, which have fallen low enough to discourage many doctors from accepting Medi-Cal.

Even for those who do, low caps on Medi-Cal patients have become the norm. “According to the California Medical Association, Medi-Cal pays an average of $41.48 for an office visit, less than half the $102.45 that Medicare pays for the same service,” according to U-T San Diego.

Part of the problem traced back to 2011, when the state Legislature, deep in the red, passed Assembly Bill 97 — a bill cutting Medi-Cal reimbursements by 10 percent. As the San Jose Mercury News reported, a court injunction forestalled the cut until this fiscal year, but did not prevent it from staying in effect each year after that. In opposing the cut, Medi-Cal providers have been joined by the California Hospital Association and representatives in California’s rural counties, where doctors accepting Medi-Cal can be especially difficult to find without traveling long distances.

Gov. Brown’s administration has anticipated that the reimbursement cut will yield a first-year savings of over $214 million. But as state coffers have swelled with a big taxation windfall, Sacramento Democrats have pushed Brown to take a more liberal approach to budgeting.

For now, with the state deadline for budgeting looming, the governor’s office has refused to budge. Finance Department spokesman H.D. Palmer told the Mercury News that more specifics are needed on how reimbursement increases will expand access to care before the old rates are restored. Meanwhile, finance officials “have pointed out that the $91.3 billion Medi-Cal budget for 2015-16 is almost $10 billion more than the current fiscal year. More than half of the cost comes from the federal government, but the state increased its contribution from the general fund by $700 million for the next fiscal year, up to $18.2 billion.”

Competing priorities

Adding to the sense of chaos, activists have begun a new push to increase health care access for unlawful immigrants. That effort has come at an awkward time. As the Los Angeles Times observed, “reductions made in county health program funding to help finance Obamacare have made it more difficult for some local officials to add — and in some cases maintain — medical care for the poor and residents living here illegally.” California pulled about $900 million in funding for local health programs “to help pay for expanded insurance coverage for those eligible to receive Medi-Cal,” according to the Times.

Lawmakers have also targeted another way Gov. Brown has clawed back some health care outlays. In a unanimous vote, the state Senate sent legislation to the Assembly that would crack down on California’s so-called Medi-Cal recovery program. That regulatory approach that allows the state to reclaim Medi-Cal money from the estates of deceased beneficiaries, even going after the value of their homes. Under the law governing Medicaid, the federal government has been authorized to recover funds in a more narrow way.

For many Californians affected by the rules, the takings come as an shock. As Emily Bazar noted at the Sacramento Bee, beneficiaries can be targeted even if they never went to a doctor. In a particularly counter-intuitive twist, Obamacare enrollees placed into Medi-Cal based on their low income will be required to pay back their health subsidies — while higher-income Covered California enrollees will not have to repay the ones they receive.