Will the new GOP health-care bill be devastating to San Joaquin Valley residents?

Sept. 25--The Graham-Cassidy plan to reform health care could destroy California's individual insurance market and be devastating to hundreds of thousands of San Joaquin Valley residents who rely on Medi-Cal to pay for their health care, according to two studies.

Nearly 872,600 people in the San Joaquin Valley could lose health coverage, according to an analysis by the University of California at Berkeley Labor Center. The biggest hit would be to residents on Medi-Cal. According the study released on Friday, 764,200 children, adults, seniors and people with disabilities would lose Medi-Cal coverage in the region.

"We see a regression back to the days when we had 25 to 35 percent of our patients uninsured," said Stephen Schilling, executive director of Clinica Sierra Vista, which operates health centers in Fresno and Bakersfield.

Republicans are racing against a Saturday deadline to act on the bill before special rules would require more than 50 votes, plus a tie-breaking vote from the vice president, for passage. Debate began in the Senate Finance Committee on Monday amid protests by angry demonstrators. Approval appeared in jeopardy with reports that Sens. John McCain, R-Arizona, Susan Collins, R-Maine, and Rand Paul, R-Kentucky, were opposed and that Lisa Murkowski, R-Alaska, and Ted Cruz, R-Texas, had reservations about the bill.

The legislation by Lindsay Graham, R-South Carolina, and Bill Cassidy, R-Louisiana, would cap the amount of federal money states receive for Medicaid. The Republicans say the legislation gives states more flexibility. Critics say it would effectively eliminate a Medicaid expansion that allowed millions of low-income people to be enrolled in the state-federal program. Medi-Cal is California's version of Medicaid.

Diana Dooley, secretary of the California Health and Human Services Agency, said "no amount of state 'flexibility' can make up for the havoc this bill would wreak on California's health care system." California has added nearly 4 million people to Medi-Cal under the expansion provided by the Affordable Care Act. In Fresno County, 125,900 people were enrolled.

Gary Herbst, CEO of the Kaweah Delta Health Care District in Visalia, said 42 percent of patients are on Medi-Cal and a loss in revenue could cost the hospital millions, affecting all patients, including those with private insurance and employer-sponsored insurance. "It would affect our ability to reinvest in technology and new types of procedures and drugs, and supplies." he said.

It would affect our ability to reinvest in technology and new types of procedures and drugs, and supplies.

Gary Herbst, CEO Kaweah Delta Health Care District

Covered California on Monday released an analysis saying Graham-Cassidy could trigger a near-collapse of California's individual health insurance market. Covered California is the state's insurance exchange established for the Affordable Care Act. About 7.5 million Californians would lose their health insurance by 2027, Covered California said.

The bill would end federally funded subsidies for lower-income people who buy insurance on exchanges. The UC Berkeley study, released Friday, shows 106,500 Valley residents would lose subsidies. Statewide, more than 1.2 million people would lose the help to pay for plans purchased through Covered California, the state's insurance exchange established for the Affordable Care Act.

The Graham-Cassidy bill also would end the requirement that everyone must have health insurance or pay a penalty. And it would allow states to give insurers more flexibility in the insurance market, which some people fear would allow insurance companies to charge more to people with pre-existing conditions.

Esmeralda Hurtado, of Sanger, pays $150-a-month for a health plan through Covered California. It's all she can afford. She had to switch to an individual plan when she turned 19 earlier this year and no longer was eligible for Medi-Cal. Health insurance is essential for the college student: She has one kidney. Since doctors made the diagnosis 10 years ago, she's been in and out of hospitals. "And I still have to go to doctors and specialists," she said.

Hurtado, who is going to community college and works part-time as an after-school tutor, said her health is stable. All that could change if she were unable to afford insurance, she said. "Everything can collapse."

Barbara Anderson: 559-441-6310, @beehealthwriter

Graham-Cassidy's insurance impact

UC Berkeley's Labor Center estimates 6.7 million Californians could lose their health insurance by 2027 under the Graham-Cassidy bill, the latest attempt to undo the Affordable Care Act. Here's how the Valley would be affected.

County

Subsidized Covered California enrollees

Medi-Cal Expansion Adults

Medi-Cal Children

Medi-Cal Seniors

Medi-Cal Disabled

Total

Fresno

22,600

125,900

62,300

2,300

2,400

215,500

Kern

16,700

105,400

51,100

1,900

2,000

177,100

Kings

2,300

14,600

6,900

300

300

24,400

Madera

4,100

16,400

8,600

300

300

29,700

Merced

9,100

35,100

16,800

700

700

62,400

San Joaquin

22,900

77,900

33,700

1,700

1,700

137,900

Stanislaus

17,500

69,800

28,400

1,200

1,300

118,200

Tulare

10,600

59,200

32,400

1,200

1,200

104,600

Valley total

105,800

504,300

240,200

9,600

9,900

869,800

California

1,252,800

3,961,500

1,341,100

76,200

77,000

6,708,600

Source: University of California, Berkeley, Labor Center

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