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GOP Health Plan Could Be Bitter Pill For California

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By Chad Terhune, California Healthline

Republicans are touting their health plan as the right medicine for ailing insurance markets across the country, from Arizona to Tennessee.

But California never landed in sick bay. Its insurance exchange, Covered California, features the healthiest mix of customers nationwide, federal data show. That’s been instrumental in holding down rates and boosting enrollment to 1.5 million.

Now state and insurance industry officials fear the replacement plan for the Affordable Care Act, introduced by GOP leaders this week, would threaten those gains. They warn that the proposal, which would cut subsidies to lower-income consumers, could undermine the broader market, driving up premiums for the wide range of Californians who purchase their own coverage.

Republicans and some industry analysts say those fears are overblown and that the GOP replacement plan would strengthen the individual insurance market by lowering premiums for young, healthy people and offering more latitude on covered benefits. In any case, the Trump administration said the plan was not final, describing it as a “work in progress.”

Nearly 90 percent of Covered California enrollees rely on federal premium subsidies and many could drop coverage if they lose thousands of dollars in government assistance. And the ones who do stay insured are likely to be the sickest and costliest patients, according to some experts.

In response, health insurers would be forced to significantly raise rates in the individual market, both on and off the exchange. It could mark a return to the double-digit rate hikes routinely seen before the 2010 health law.

“The worst possible thing is a market that tends to just have sick people,” California Insurance Commissioner Dave Jones said. “That is exactly where the Republican proposal is taking us. It’s a recipe for disaster.”

Peter Lee, executive director of Covered California, predicts a downward spiral if only the sickest customers hang onto coverage. The net effect of the Republican proposal “would be to increase the costs for everyone in the individual market since the lower-income people that do enroll are likely to be sicker and costlier — raising the premiums paid by everyone covered.”

Under Obamacare, premium subsidies are tied to income and the local cost of coverage. The less people earn, the more financial assistance they receive. The Republican plan pegs premium tax credits only to age, starting out at $2,000 a year for people under 30 and increasing to $4,000 for those over 60.

Those credits begin to phase out for people making $75,000 a year or more.

The chief executive of Molina Healthcare, an insurer in Covered California and other exchanges, said the GOP’s age-based tax credits are inadequate for people to maintain insurance. Dr. J. Mario Molina said premium rate hikes could reach 30 percent next year in California and other states if Congress and the Trump administration don’t do more to stabilize the marketplaces. This year’s increase in California was an average of 13.2 percent.

“This bill is not making me more optimistic about the future of the marketplaces,” Molina said. “There is nothing here providing any comfort or relief.”

The Blue Cross Blue Shield Association, which represents California’s Anthem Blue Cross and other big insurers, expressed similar concerns in a letter this week to House Republicans.

“The flat tax credit which is adjusted by age, but not by income or premium, does not give healthy people enough incentive to stay in the market, especially in absence of an individual mandate,” the group wrote.

For more information go to Kaiser Health News.

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Civil Rights Before the Loving Decision

Loving v. Virginia was a landmark civil rights case in 1967 that recognized marriage as a fundamental right guaranteed by the Fourteenth Amendment of the U.S. Constitution, which includes the Due Process Clause and the Equal Protection Clause.

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Not so recently in the United States, same sex marriages were illegal. In the last century, there were laws on the books that prohibited folks from different races marrying.  

Loving v. Virginia was a landmark civil rights case in 1967 that recognized marriage as a fundamental right guaranteed by the Fourteenth Amendment of the U.S. Constitution, which includes the Due Process Clause and the Equal Protection Clause.

In 1958, Mildred Loving, a Black woman, and Richard Loving, a white man, were convicted and sentenced to a year in prison for violating the state of Virginia’s laws prohibiting their marriage.

That conviction was overturned by the Supreme Court in 1968, ending discrimination in marriage based on race.

The Loving decision was a catalyst in 2015 to help abolish discrimination in marriage in same-sex marriages, which allowed for equality in the LGBTQ communities of all races including this author.

Before the Loving decision, Joan Steinau, a white woman, married Julius Lester, who at the time was a singer and a photographer for the Student Nonviolent Coordinating Committee (SNCC).  Julius later became a writer.  

Joan and Julius were divorced in 1970.

Next month, Joan’s memoir, “Loving before Loving:  A Marriage in Black and White,” will be released. In the book, she recounts her marriage to Julius Lester before the Loving decision in the midst of the civil rights era as a wife, mother, and activist. 

In an interview with the Post, she said,   “Given both the erasure and distortion of Black lives as presented in the white-led media, the existence of a robust Black press . . .has been essential to the survival and thriving of Black community.”

Quoting the Chicago Daily Defender in her memoir, she said, “When one of its reporters asked President Truman, after he said school integration might lead to intermarriage, ‘Would you want your daughter to marry a Black man if she loved him?’ The president responded with a typical segregationist attitude of the time, ‘She won’t love anybody that’s not her color.’   It was important for the Black reporter to be there, because of course he assumed the possibility that naturally she could love anyone and pointed that out with his question.”

She added,  “That’s just one example of a long history of significant advocacy and reportage by hundreds of Black newspapers over the last 150 years. The Post News Group has jumped into the gap regionally to fill this important space, and I’m grateful for it. Until we have true representation of all experiences/perspectives at major media outlets, we will continue to need media targeted to excluded groups.

“My own history with Oakland/Berkeley dates to the 1980s when I began to visit from the East Coast and plot a way to move here. In 1991, my wife and I did settle in Berkeley. We immediately joined a predominantly Black church in Oakland and began creating a friendship circle. The diverse culture here was high on our list of reasons to move from our predominantly white area in New England. And it has been everything we hoped for.”

Joan Lester dedicates this memoir to her wife, Carole.  In addition to this memoir, she is a commentator, columnist and book author.

“Loving before Loving A Marriage in Black and White” by Joan Steinau Lester is available for pre-order now and on sale on May 18 on Amazon and at local bookstores.

For more information log onto JoanLester.com.

Wikipedia was a source for this story.

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Bay Area

At Least 4 Bay Area Counties Pause Use Of J&J Vaccines Amid Blood Clot Concerns

Public health officials in Alameda, Contra Costa, San Mateo and Marin counties announced that they would temporarily halt use of the vaccine, which was developed by J&J’s pharmaceutical subsidiary Janssen.

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     At least four Bay Area counties paused administrations Tuesday of the Johnson & Johnson COVID-19 vaccine after a handful of people across the country developed blood clots less than two weeks after the shot.

     Public health officials in Alameda, Contra Costa, San Mateo, and Marin counties announced that they would temporarily halt the use of the vaccine, which was developed by J&J’s pharmaceutical subsidiary Janssen.
The state’s Department of Public Health also issued a statement Tuesday urging a temporary pause on the vaccine’s administration while state and federal officials determine whether the clotting incidents are significant.

    More than 6.8 million doses of the vaccine have been administered across the country.
Health officials have confirmed cases of rare and severe blood clots in just six women between the ages of 18 and 48 who received the J&J vaccine, with symptoms appearing between six and 13 days post-vaccination.

   Both the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration have also advised states to pause administration of the Janssen vaccine to allow for an investigation of the clots and whether a causal link with the vaccine can even be established.

     In a joint statement, FDA Center for Biologics Evaluation and Research Dr. Peter Marks and CDC Principal Deputy Director Dr. Anne Schuchat said the two agencies will review the cases of clotting this week to determine whether they are statistically significant. “Until that process is complete, we are recommending a pause in the use of this vaccine out of an abundance of caution,” Marks and Schuchat said. “This is important, in part, to ensure that the health care provider community is aware of the potential for these adverse events and can plan for proper recognition and management due to the unique treatment required with this type of blood clot.”

     State epidemiologist Dr. Erica Pan said the state will also follow the recommendation by the FDA and CDC and order a statewide pause of administrations of the Janssen vaccine.
“Additionally, the state will convene the Western States Scientific Safety Review Workgroup to review the information provided by the federal government on this issue,” Pan said.

     California joined the states of Nevada, Oregon, and Washington to establish the workgroup last year to conduct independent review and analysis of each vaccine as they are approved for emergency use by the FDA.
Officials in the four Bay Area counties noted that Janssen vaccines represent 4 percent or less of the doses administered in each county to date, with the majority being the two-dose Pfizer and Moderna vaccines.
Health officials have lauded the Janssen vaccine’s utility in reaching demographics like unhoused residents and people who are homebound, who may have difficulty returning for a second vaccine dose.

     Officials in the four counties said they did not expect the Janssen vaccine pause to force the widespread cancellation of vaccination appointments or significantly affect their ability to continue vaccinating their respective populations.

    Janssen vaccine recipients who got vaccinated more than a month ago are not deemed at risk for developing blood clots, according to local, state, and federal health officials.

   People who received the vaccine more recently are encouraged to contact a health care provider if they begin noticing symptoms like severe headaches, leg pain, and shortness of breath, which may be associated with clotting.

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