CVIndependent

Sat08172019

Last updateTue, 18 Sep 2018 1pm

California’s Democratic legislators want to extend health benefits to undocumented young adults, the continuation of an effort that ushered children without legal status into the state’s publicly funded health care system last year.

It is unclear when the program would start or how much the state would spend if the proposal, which could cost up to $85 million a year, is approved by Gov. Jerry Brown. Lawmakers are working out details ahead of their June 15 deadline for passing a new budget.

The plan would provide full-scope coverage for 19-to-26-year-olds who qualify for Medi-Cal, the state’s name for Medicaid. Currently, the federally funded program covers only emergency visits and prenatal care for undocumented residents. Under the proposal, revenue from taxes on tobacco products would absorb expenses for all other coverage.

Democratic Sen. Ricardo Lara of Bell Gardens has been one of the strongest voices for expanded care. In 2015, he pushed for coverage for all adults. That proposal was changed to admit only undocumented children; it took effect last year. This year, he said in a recent video message to supporters, “We are going to make the final push to ensure we capture our young adults.”

Supporters’ ultimate goal is to include all undocumented adults, said Anthony Wright, executive director of Health Access California, a health care consumer group backing the proposal.

“We believe without coverage, people are sicker, die younger and are one emergency away from financial ruin. It has consequences for their families and their communities—both health and financial consequences,” he said.

The plan would mean that undocumented children currently in the program would not age out at 19, putting low-income undocumented immigrants on par with those allowed to stay on their parents’ insurance under the Affordable Care Act (often called Obamacare) until they are 26.

Republican Sen. John Moorlach of Costa Mesa opposes an extension of benefits. One reason is financial: California doesn’t have “a balance sheet we can brag about,” he said, citing the state’s debt load, among other reasons.

Secondly, he disapproves of illegal immigration. Moorlach migrated to the U.S. legally as a child with his family from the Netherlands.

“I’m kind of offended that we feel an obligation to pay for expenses for those who did not come through the front door,” he said. “I certainly have compassion and want to help people in need, but I’m having difficulty, as a legal immigrant, because we are already in such bad fiscal shape.”

Advocates argue that undocumented immigrants help propel California’s economy with their labor and the taxes they pay, and that they cost the state money when they don’t work because of illness or when they end up in the emergency room.

“Health care is a right,” said Ronald Coleman, director of government affairs for the California Immigrant Policy Center, an advocacy organization and supporter of the proposal. “These are folks we are investing in through the California Dream Act and through other programs our state offers, and it makes sense to invest in our future, which our young adults will be.”

Estimates vary for how many people this expansion of Medi-Cal would serve and what the costs would be. Each house of the Legislature has passed its own version of the proposal, with differing figures attached.

The Assembly allocated $54 million a year to cover an unspecified number of additional enrollees, with a July 2017 start date. The Senate proposed $63.1 million in the first year, beginning in 2018, and $85 million annually thereafter, also without specific population numbers.

Coleman’s center, which is working closely with lawmakers on the issue, estimates about 80,000 new people would be eligible, and the cost would be around $54 million a year. That assumes the federal Deferred Action for Childhood Arrivals program continues, because it provides access to Medi-Cal. If DACA were eliminated, the figures would increase to about 100,000 eligible people and about $84 million in annual costs, Coleman said.

The governor’s proposed budget does not include the proposed expansion or any money for it.

Kevin, a 19-year-old Angeleno who asked that only his first name be used, because he lives in California illegally, wants the proposal to succeed. He has been working for more than a year to distribute information about Medi-Cal children’s coverage to immigrant families.

He meets all but one of the requirements for DACA: He was not in the country before June 15, 2007. He arrived in the U.S. in 2011 at age 14 from Guatemala, on a visa that later expired. He graduated high school, has no criminal record and is now majoring in business administration at California State University, Los Angeles.

“There’s this misunderstanding that young people are healthy,” said Kevin, who suffers from eczema. He worries about the chronic condition flaring up. “When it gets worse, it doesn’t let me do anything with my hands.”

He is enrolled in a county health insurance program for low-income residents, but he can’t afford a dermatologist. He can barely pay for the prescription lotion he uses for the eczema, and sometimes goes without it.

“We are trying to have a better economic standard, and we are like the building blocks of this society,” he said. “Having health insurance will allow us to focus more on school and do our regular day-to-day activities. A healthier society works better for everyone.”

If lawmakers can now agree on details, a consensus proposal will go to the full Legislature for approval. The deadline for that is June 12.

CALmatters.org is a nonprofit journalism venture dedicated to exploring state policies and politics.

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If you live in the Coachella Valley, you may receive a phone call sometime early next year from a nonprofit called HARC—Health Assessment and Research for Communities.

HARC’s new board president, Bruce Purdy, says it’s vital for you to take that call, and answer all of the survey questions that follow—even if the questioning is lengthy and a bit tedious.

“The data we’ll collect will ultimately support and improve the health and well-being of the residents of the Coachella Valley,” he said. “It will provide an objective picture of the health of citizens in this community, and help create programs and policies that will help improve health of a whole lot of residents.”

It’s HARC’s job to conduct this survey of residents every three years, and then compile and release the results.

So, why’s it so important to have this data?

“We believe that in the last five years, grants have provided roughly $12.8 million in support to local nonprofits that used HARC data to justify their requests,” Purdy said.

It’s Purdy’s experience with one of those nonprofits, the Desert AIDS Project, that led Purdy—a semi-retired development economist—to get involved with HARC. Purdy sits on the Desert AIDS Project’s board, and saw how helpful HARC’s data was to DAP.

“We’ve gotten so many grants because (we) have really good, analytical data (from HARC),” he said.

David Brinkman, the CEO of DAP, encouraged Purdy to join the HARC board, Purdy said. Dr. Glen Grayman, the chief population health officer and regional medical director of Borrego Health, had been the president of HARC’s board since it was founded in 2006, and oversaw the first three HARC surveys. When Grayman decided it was time to hand over the reins to someone else, Purdy was tasked with becoming that someone else. Purdy became the HARC board president in October.

The last HARC survey, conducted in 2013, showed the Coachella Valley’s collective health badly needed improvement. It showed a third of local adults between the ages of 18 and 64 didn’t have insurance. The data also showed high rates of hypertension, high cholesterol and binge-drinking, and that cancer rates and the number of children living in poverty were on the rise.

Of course, a lot has changed in the last three years. The economy has improved, and the Affordable Care Act has given more adults access to reasonably priced insurance plans. Purdy said he’s curious what the 2016 numbers will show.

“I’m really interested to see if the increase in people covered by Obamacare has helped, hurt or not changed at all the health and wellness of people in the valley,” he said.

Purdy said HARC is “inundated” with requests from nonprofits for various questions to be included in the survey. He said the 2016 survey will include deeper questions regarding two matters on different ends of the age spectrum: childhood obesity/early-onset diabetes; and the various health issues the valley’s older snowbird population is facing.

Purdy said the survey includes about 160 questions, and that he hopes to get more responses than the 2,000-plus received during the 2013 survey. Kent State University will again conduct the survey.

“We are very proud of and excited about the work we do,” Purdy said.

For more information, visit www.harcdata.org.

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Many Republicans predicted that the Affordable Care Act, aka “Obamacare,” would send this country into utter chaos.

Of course, this didn’t happen. Nonetheless, there is murmuring among a few 2016 Republican presidential candidates that repealing the ACA would be one of the first things they’d do if elected. But in reality, the plan is working so well that it would be political suicide to try to repeal it at this point—and I am one of the millions of Americans who have benefited from the plan.

On July 3, 2014, I was diagnosed with a detached retina. A blow to the back of the head a week earlier and two subsequent airplane rides caused the injury. I was in South Bend, Ind., meeting my partner’s family for the first time, when I got the news. I was given a choice: I could have surgery in Indiana, and be forbidden to fly for six weeks (not an option), or fly home to Palm Springs as soon as possible and have surgery there. A detached retina is a serious situation, and time is of the essence, but since my retina was already completely detached, the doctor said a few days would not make much of a difference.

I was barely absorbing this information, since I was pretty much hysterical. Thank God for my partner, Eric, who calmly took control of the situation. It was after 5 p.m. on Thursday, July 3, the day before a major holiday. The office was closing up, and the janitor was vacuuming the carpet. Luckily, the ophthalmologist I had seen was kind enough to stay until we could make the arrangements. I will never forget the sight of Eric sitting on the floor, urgently trying to get through to someone in the Inland Empire Health Plan office in Palm Springs to set up an appointment ASAP. Fortunately, he got through.

We flew back to the desert on Saturday night, saw the IEHP folks on Sunday, and met with the surgeon on Monday; I had the surgery on Thursday, July 10. A series of miracles, to be sure.

My surgery—a vitrectomy—involved removing the liquid from the eye and inserting a gas bubble in the eyeball, which then pressed the retina back into place. The rehab is ghastly—six weeks of sleeping face-down on a special cut-out pillow—and keeping your head down at all times. Yes, at all times. That includes sitting, standing, walking, showering—everything, so that gravity can do its work.

I was a dutiful patient, and followed directions to the letter. Thankfully, the outcome was good: The vision in my left eye is at 99.9 percent, and will likely keep improving. Another miracle.

None of this would have happened if Eric and I had not received health insurance coverage from the Affordable Care Act, just two months before all this occurred. Eric and I are both professional performers, but we also have “job jobs” to pay the bills. He had just been hired to sell Steinways for SoCal Pianos in San Marcos, and I work part-time as the activities assistant at a local senior health care facility. Neither of us could afford health insurance before the advent of “Obamacare.”

In addition to my surgery, I had to fill five or six different prescriptions for eye drops (some of which I am still using more than a year later); go through cataract surgery the following January; and endure many, many follow-up appointments. My total out-of-pocket expense has been $30—to rush some lab work. Had I not had “Obamacare,” there is no question I would now be blind in my left eye. A friend of mine has a cousin who suffered a detached retina and did not have insurance. He lost his sight.

Of course, there are thousands of people like me who made it through catastrophic injury or illness because of the Affordable Care Act. Like 58-year-old Kathy Bentzoni of Slatington, Pa., who got a life-saving transfusion after being diagnosed with a rare blood disorder. Her previous insurance company called it a pre-existing condition and denied her coverage. Or 41-year-old Mike O’Dell of Kansas, who received a new heart after his heart developed an infection. His old health plan would not cover the $4,000 a month for anti-rejection medicine following the transplant.

Those who still disparage the ACA are ignoring the facts. According to a 2014 article in the Los Angeles Times, nearly 10 million previously uninsured people now have health care coverage because of the ACA. The nonprofit Rand Corp. indicates that fewer than a million people who had health plans in 2013 are now uninsured—and that’s because their plans were canceled for not meeting new standards set by the law. Fox News personality Juan Williams says half of those people can get better coverage for a lower price, and some will even get subsidies to help them pay for it. What the ACA basically did was put in place consumer protection so that health insurance companies could no longer take advantage of people by giving them crappy coverage.

It’s important to remember what insurance companies can no longer do because of the ACA: They can no longer cancel your policy if you get sick, deny you coverage or charge you more for a pre-existing condition, or impose lifelong caps on your health coverage. The ACA also mandates that your insurance company must pay for the ambulance ride if you are rushed to the hospital. Those are long-overdue, positive changes—so what’s all the fuss about?

So the next time you hear someone railing against “Obamacare,” think about the millions of people who now have access to healthcare who once did not. Think about Kathy Bentzoni and Mike O’Dell.

I will. And I will be filled with gratitude that I can today see a beautiful desert sunrise—with both eyes.

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