“The California Democrats voting in favor of the measure were [Rep. Scott] Peters [(San Diego)] and Reps. Pete Aguilar (Redlands), Ami Bera (Elk Grove), Julia Brownley (Westlake Village), Jim Costa (Fresno), John Garamendi (Walnut Grove), Janice Hahn (Los Angeles) and Raul Ruiz (Palm Desert).”

Democrats divided

Already reeling from a string of losses under Obama at the state and federal level, nervous Democrats nationwide proved too hard to convince to go along with the president. “New Hampshire Gov. Maggie Hassan, who is challenging Sen. Kelly Ayotte (R-N.H.) in her bid for reelection, urged the federal government to stop accepting Syrian refugees until the process is reviewed. Nevada Senate candidate Catherine Cortez Masto wants U.S. intelligence officials to sign off on the vetting process before admitting more refugees. And former Ohio Gov. Ted Strickland, aiming to unseat GOP Sen. Rob Portman in Ohio, joined the chorus,” Politico observed, “calling for a ‘short-term pause’ in the resettlement program.”

But many California Democrats have sided firmly in favor of fast-tracking more Syrian refugees, many of which have already settled in Southland locales such as San Diego. And some lawmakers explicitly linked the plight of the current group of refugees with their families’ own. Rep. Norma Torres, D-Calif., of Pomona, visited the Islamic Center of Claremont “to meet with members of two Syrian families who arrived in Southern California this fall,” the Times reported separately. “The stories she heard from the Kanjou and Wawieh families, about fleeing the violence of Syria and journeying through Lebanon and Egypt before arriving in Pomona, were familiar. Torres came from war-torn Guatemala to live with an uncle in Los Angeles when she was five years old.”

A spiking problem

The comparison has turned out to be well-timed. Adding to the controversy and raising the stakes, border officials have suddenly seen a significant spike in unauthorized crossings, reminiscent of the surge into Texas last year of surprising numbers of women and children. But rather than the kinds of economically-motivated unlawful immigrants who have become poster figures in California’s border debate, the current wave of includes many “women and children fleeing vicious gangs and endemic sexual violence in Central America who are hoping for asylum in the United States. Rather than hiding from Border Patrol agents they often try to find them, to ask for protection and start the long legal battle to remain here,” according to the New York Times.

“In October, the United Nations High Commissioner for refugees, António Guterres, said uncontrolled violence by the gangs had become ‘pervasive’ in El Salvador, Guatemala and Honduras. He issued an ‘early warning’ of ‘a looming refugee crisis.’ A report by his agency found that women in particular ‘face a startling degree of violence that has a devastating impact on their daily lives.’ According to United Nations figures, this year El Salvador moved into first place in the world for the rate of murders of women and Guatemala ranked third, while Honduras had the highest murder rate over all.”

Politically, the situation could play into the hands of those Democrats still rallying around President Obama, who has castigated Republicans nationwide for opposing the increase in Syrian and Iraqi refugees he has targeted. “Apparently they are scared of widows and orphans coming into the United States of America,” he remarked, The Hill reported. “At first, they were too scared of the press being too tough on them in the debates. Now they are scared of three-year-old orphans. That doesn’t seem so tough to me.”

Pushing back amid the debate over the Congressional vote on Obama’s proposed policy, Rep. Trey Gowdy, R-S.C., used his opportunity during a recent hearing as chairman of the House Judiciary subpanel on immigration to say of Obama that “with all due respect to him, what I’m afraid of is a foreign policy that creates more widows and orphans,” The Hill noted.

As the last blanket deadline extension arrived, late signups slowed down on Covered California, the state’s Obamacare exchange.

Difficulties brought on by the website’s inability to process a wave of applicants gave officials an opportunity to push back the original March 31 deadline. That, in turn, caused exchange administrators to require applicants to work with a “certified enrollment counselor” to navigate the often ponderous process.

During the two-week delay that followed this month, politicians and activists favoring the health care law scrambled to drum up more support. But in contrast to the March surge of online activity, the Covered California exchange added only about 70,000 new enrollees over the past two weeks.

Peter Lee, executive director of the exchange, emphasized an increase in Latino signups during the final reprieve, calling the uptick “dramatic.” That’s relative, however, to California’s previous numbers for the group, which fell short of expectations set by lawmakers such as state Sen. Norma Torres, D-Pomona.

Proposed reform

The scope of the problem drove Torres to go public with a new reform plan in the San Jose Mercury News. She wrote that her proposed legislation, Senate Bill 972, “would allow leaders with expertise in marketing, customer service, information technology management and management information systems to serve on Covered California’s board of directors. It would also expand the board from five to seven members to provide additional oversight and to better assure the membership reflects the state’s diversity in terms of expertise and demographics.”

Torres assumed that Latinos are key because the health exchange needs their healthy young people to drive down costs. Yet many uninsured Latinos targeted for Obamacare outreach in California are still outside the system because they immigrated illegally. In one Santa Clara County clinic, an estimated one third of visitors lacked citizenship documentation, according to the California Health Report.

Under the terms of the Affordable Care Act, you must be a U.S. citizen to get insurance through the state exchanges set up in accordance with the law.

Loopholes remain

Aiming to add as many young and uninsured citizens as possible, Covered California stressed that this time there really wouldn’t be another chance to register. In a remark making the rounds in the media, exchange spokesman Larry Hicks said Californians “have had since October to enroll. These are the final hours. If they don’t sign up by Tuesday [April 15], they likely won’t have insurance for the rest of the year.”

Ironically, however, another legal loophole led analysts to expect yet another round of late signups. According to the Covered California website, if Californians experience a “qualifying life event,” they can sign up through the exchange up to 60 days after the event takes place, whenever it happens.

The criteria for qualifying events are very broad. They range from rare occurrences like marriage, adoption and release from prison to more common ones like loss of coverage and change in income. Covered California even promises to grant special enrollment “on a case-by-case basis.”

Californians may now face the last official deadline for Obamacare signups. But the slow and cumbersome process of enrollment has only just begun.

Responding to a state senator’s call for an investigation into the marketing budget of California’s Obamacare exchange, the agency says it is in great financial shape and even received high marks for an audit conducted last year.

“By 2015/16, we project a reserve of over $184 million,” Covered California spokesperson Anne Gonzales told CalWatchdog.com. “We are putting aside a healthy amount of federal grant money and plan to draw on our reserves until our enrollment starts generating income.”

But GOP state Sen. Ted Gaines, R-El Dorado Hills, who is vice chairman of the Senate Standing Committee on Insurance, said the agency will be $78 million in the red during the next fiscal year. He was incensed to learn that Covered California spent $1.37 million on an advertising campaign featuring a lurid Richard Simmons web stream that is now on YouTube.

Gaines learned about how much the “Tell a Friend, Get Covered” campaign cost from a Jan. 30 CalWatchdog.com article and then demanded an audit of Covered California on same day. He had initially asked for the financial information in a letter to Covered California Director Peter Lee, but it had gone unanswered when the article appeared.

Democratic bill

Covered California’s detractors aren’t limited to the Republicans. Late Monday, state Sen. Norma J. Torres, D-Chino, introduced Senate Bill 972, aimed at fixing “problems experienced by consumers” – lackluster customer service, a low Latino sign-up rate and inaccuracies in the provider directory, a press release stated.

“Accountability starts at the top,” Torres tweeted Tuesday. “Covered CA customers deserve better.”

To remedy the situation, Torres’ bill increases the number of Covered California directors from five to seven and broadens the types of expertise for board eligibility to include marketing and information technology. It has bi-partisan support.

Torres’ spokesperson, Alex Barrios, said in an interview that Covered California’s poor performance “is the responsibility of the board.”

However, on paper, Covered California is doing a stellar job.

To date, it has had three audits:

• The state of California, which labeled it a high risk entity, yet praised its transparency and marketing plans as “more than adequate” and “logical and deliberate.”
• A self-review that was submitted to the state Department of Finance on Dec. 30 that says it has “adopted and operates with an adequate system of internal control and … monitoring processes” with on-going reviews and personnel tasked with ferreting out waste, fraud and abuse.
• A federal compliance audit that is scheduled to be completed in a few months.

Budget

Covered California’s current budget is $399.7 million. Since 2010, the federal government has awarded $910 million in grants and no further funding will be received after Jan. 2015. The agency has been saving money for reserves, which will fund its budget after the grants end. Unlike other state agencies, it is prohibited from drawing on the state’s general fund.

In the 2015/16 fiscal year, the deficit will be $78.4 million, decreasing to $34.5 million in 2016/17. The deficit should shrink in succeeding years as more insureds are signed up in the system, Covered California says.

“We are a startup enterprise, and it would not be fiscally conservative to imagine we will make money as soon as we open our doors,” said spokesperson Anne Gonzales. “We are being frugal, setting aside reserves until our revenues ramp up. In addition, Covered California is currently helping the state’s fiscal situation. We are operating exclusively with federal funds, and many of those dollars go to create jobs for people who buy goods and pay taxes. We are an economic engine in that respect.”

This doesn’t mollify Gaines, who wants to know more.

He received a response to his letter to Director Peter Lee a day after CalWatchdog.com’s story appeared.

“From our early data, Tell a Friend – Get Covered has been a success and has surpassed expectations,” Lee wrote. “[W]e have measured a reach of over 202 million impressions throughout the campaign; a significant milestone amplified by over 60 media personalities who … have encouraged their own followers to learn more.”

The 8-hour web stream that featured Simmons also included spots by actress Olivia Wilde and comic Billy Eichner. Other celebrities blogged or tweeted for the campaign: President Obama, Adam Levine, Fran Drescher, George Lopez, Lisa Leslie and Kerry Washington.

Gaines said in an interview that Lee’s letter didn’t give specific details about how many people signed up during the campaign and a breakdown of dollars spent.

“They have these high-priced consultants for all this so-called great marketing advice,” Gaines said. “The millennials are not signing up at the rate that they should be and there are problems with the Latino outreach. I’m not convinced that the financial structure is going to bring us to the point of break even or profitability.

“I would like to ask these probing questions and have someone provide an account of how dollars are being spent,” Gaines said.

Marketing plan

However, the state audit said Covered California’s “outreach plans appear more than adequate” and it “appears to have engaged in a logical and deliberate process when developing its marketing plan.”

Torres also asked Covered California for an accountability on how dollars were being spent and details about its Latino enrollment.

“We didn’t get specific answers,” said Barrios, Torres’ spokesperson. “We believe in accountability. We asked in mid-December for this.”

Director Lee was invited to speak before the Latino Legislative Caucus and he provided some answers to questions, but not all of them, Barrios said.

“As a Democrat, Norma Torres wants to see Covered California do better,” Barrios said.