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Bay Area perspectives on the Affordable Care Act

Cari Spivack
Medical students at Zuckerberg SF General Hospital show their support for the Affordable Care Act

Doctors, nurses, and medical students stood outside of Zuckerberg San Francisco General Hospital this week in their lab coats and scrubs, holding signs that said “Protect our patients” and “Keep America covered.” They joined with healthcare providers across the country to demonstrate their support for the Affordable Care Act - also known as “Obamacare.” The Senate has begun the process of repealing the historic law. Republicans are trying to make good on President-Elect Trump’s promise to do away the Affordable Care Act on “day one” of his presidency.

Five million Californians gained health care coverage under the Affordable Care Act. More than a million people signed up for coverage through the Covered California marketplace. Another four million people became eligible for Medi-Cal, the state's version of Medicaid, the health insurance program for low-income people.

Under the ACA, young adults are able to stay on their parents insurance until the age of 26. And people who had previously been blocked from signing up for insurance due to a pre-existing condition are able to get insured.

Bay Area residents share their experiences

Many Bay Area residents are deeply concerned that they will lose their health insurance if the Affordable Care Act is repealed. Nicole, a 27 year old from San Francisco, was able to enroll in Medi-Cal, the state's version of Medicaid, after the Affordable Care Act expanded Medicaid. Nicole declined to give her last name because of her past history with drug use. She was addicted to opiates and now relies on Medi-Cal to cover her Suboxone treatment, an opiate replacement drug.

Before the Affordable Care Act, only parents, seniors, children, and people on disability were eligible for Medi-Cal. Individual adults like Nicole wouldn't have been able to sign up. “I truly believe I would not be sober today,” she says, “if it weren’t for Medi-Cal.”

Laila Mehta, from Oakland, was able to sign up for health insurance through Covered California. As an independent contractor, she doesn’t get insurance through an employer, so she’s glad to have the option. However, getting treatment as a Covered California customer has been frustrating. She had to wait two months in severe back pain to get a steroid injection because the one doctor who took her Covered California insurance wasn’t available. She also has to constantly call Covered California to report her income changes and has racked up hours on the phone with insurance agents. Despite her frustrations, she doesn’t want to see the Affordable Care Act repealed. “We might have complaints but it’s an awful thought that it could go away without an alternative,” she says.

Danny Turner, on the other hand, is happy to see the Affordable Care Act repealed. He’s a Republican in Livermore and just wrapped up a run for Congress earlier this year. He opposes the Affordable Care Act on principle but admits he’s actually benefited from it as well. He was able to stay on his parents insurance until he was 26 years old, which helped cover his medical bills when he was diagnosed with bipolar disorder. Now he’s able to get health insurance through Covered California despite his pre-existing condition.

“I’m in this very interesting situation where I’m taking advantage of something that I don’t particularly agree with,” Danny says. “But at the end of the day, I’m in a position where I need to make sure I have that coverage because of my condition. It’s just the reality that I have to live with.”

Repeal and… replace?

People like Danny and Laila may see their insurance on the chopping block - whether they like it or not. Republicans took the first steps to repeal the Affordable Care Act this week. They’re doing it through a somewhat obscure process called budget reconciliation. It allows them to pass changes to the budget with only a simple majority - 51 votes. There are 53 Republicans in the Senate. Reconciliation bills also can’t be blocked by a filibuster.

Republican Senator Mitch McConnell says he wants to repeal the law immediately, perhaps as soon as this week. He promises that a replacement will soon follow. But how quickly that would take place, no one knows. Most Democrats and a few Republican Senators, including Senator Tom Cotton of Arkansas, are urging lawmakers not to repeal the Affordable Act without an immediate replacement plan. They say that asking hospitals, insurance companies, and patients to live in a state of limbo is irresponsible and reckless.

Many Republicans are calling for “repeal and delay” meaning that the Senate can vote down the law now, but the actual repeal will be delayed until a replacement plan is in place.

Any new replacement plans will have to be voted in with 60 votes, meaning Republicans will have to convince some Democrats to get on board. This could take time.

Meanwhile, Covered California is still open for business and Californians can be fined if they do not have insurance. The enrollment period ends January 31, 2016. You can enroll in Medi-Cal at any time

If you’d like to share your story about the Affordable Care Act, please email us at health@kalw.org 

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