Inland concerns about the future of health care costs

March 20--Many of the 2.5 million Southern California residents insured by President Obama's Affordable Care Act could lose coverage under the Republican replacement plan, local health experts say.

Riverside University Health System staff worry many of the 500,000 people getting outpatient primary care and specialty care at its medical center in Moreno Valley and 10 community clinics may lose their insurance, leaving them to decide between buying medicine or putting food on the table.

Most of them are "working, productive citizens," said Dr. Geoffrey Leung, chief medical officer for the federally qualified clinical services.

"There's nothing worse than to be worried about your health and being worried about not being able to pay for your healthcare," he said. "When they have health insurance, it alleviates that worry and allows them to thrive."

The uninsured rate in California has reached a record low of 7 percent since the passage of the Affordable Care Act, or Obamacare.

In Riverside, San Bernardino, Los Angeles and Orange counties, about 674,025 people have subsidized plans through Covered California, the state private health insurance exchange, and 1.8 million through expanded Medi-Cal, California's Medicaid program.

The Congressional Budget Office last week released estimates the number of people without health insurance could reach 24 million by 2026 through reduced subsidies and cuts to Medicaid, the insurance program for the poor.

That projection has not been extrapolated regionally, but health policy experts say that coverage would be in jeopardy for many of the roughly 5 million Californians whose plans are funded by the ACA.

"We are confident, sadly, that it would be millions," said Peter Lee, executive director of Covered California. "Exactly how many, and where, is going to take further analysis."

Comparing subsidies

According to the state's exchange, last year 1,484,537 Californians received $4.2 billion in tax subsidies to help pay for their coverage. The GOP proposal would offer a flat tax credit based on age, while the Affordable Care Act also considers income, family size and local insurance costs when calculating the amount of assistance.

For the four-county region, younger adults and higher earners would fare best under the Republican tax credit proposal.

A 25-year-old earning $75,000 would not qualify for a subsidy under Obamacare but would receive $2,000 a year in tax credits from the GOP plan. A 60-year-old making $75,000 would get a $4,000 tax credit but nothing under the ACA.

The toughest squeeze would be on older, low-wage earners. Under the Republican plan, a 60-year-old making $20,000 a year would receive a $4,000 tax credit. But the ACA subsidies are much larger, ranging from $6,800 in Los Angeles and San Bernardino counties to $7,080 in Riverside County and $8,030 in Orange County, according to a Kaiser Family Foundation analysis.

Dr. J. Mario Molina, chief executive officer of Long Beach-based Molina Healthcare, which offers Covered California plans in the four-county region, said without adequate subsidies, most of their members won't be able to afford coverage.

Digital & Driveway Delivery -- 50% Off

"Before the ACA passed, the biggest reason for personal bankruptcies was medical bills," Molina said. "That's almost died. After this bill is passed, it's going to come right back."

Expanded healthcare access

Chris Winter, 60, of Big Bear City in the San Bernardino Mountains, bought private insurance through Covered California. Even with a $5,000 deductible, Winter said he saved more than $150,000 and avoided bankruptcy after having an appendectomy and a heart attack that required an airlift, emergency room visit and heart-related surgery.

Town hall meetings supporting SB 562, state legislation introduced in February to establish a universal, single-payer health coverage program and healthcare cost control, were held over the weekend in Riverside, Fullerton, Pomona and Covina. Sponsored by the California Nurses Association and other organizations, a march and rally will be held Sunday, March 26, in Los Angeles.

With California's expansion of Medi-Cal through Obamacare, single residents qualify if they earn $16,395 a year or less. The coverage is free.

About 45,000 Riverside County health system patients got coverage under expanded Medi-Cal.

After going without regular care, their health problems had progressed to multiple serious conditions such as high blood pressure, diabetes, heart disease and chronic stress. There were some who hadn't seen a doctor in 10 or 20 years.

"In many cases, we were the first people to take care of them in a long time," Leung said. "That was a life-changing event for them."

Deteriorating health strains all parts of people's lives, including work, self-confidence, family and other relationships, Leung added.

"We've seen many cases in the past where, if you can help someone with their physical health, then other parts of their life start to get better as well," he said.

Before the Affordable Care Act, Riverside County's health system charged income-based sliding scale fees for Inland residents without insurance.

Leung urged people to continue seeking the care they need to stay healthy and said the county medical system will help them, despite changes to the Affordable Care Act.

"Our doctors and nurses, hospital and clinics are always there for our community," he said.

Digital & Driveway Delivery -- 50% Off

___

(c)2017 The Press-Enterprise (Riverside, Calif.)

Visit The Press-Enterprise (Riverside, Calif.) at www.PE.com

Distributed by Tribune Content Agency, LLC.