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The Affordable Care Act under Trump

2/27/2017

2 Comments

 
The Trump Administration continues to make repeal of the Affordable Care Act (ACA) or Obamacare a key policy, so it is obvious that healthcare will be a major political battleground.  Members of Congress home at recess are finding town halls and an electorate reflective of the same engaged and energetic citizens who participated in the Women’s March and other public outpourings of views.  While the Affordable Care Act was not perfect, it was a significant improvement on what proceeded it.  Now that there is a prospect of losing actual coverage under the ACA, recent polls have been showing the ACA gaining in popularity. 

The ACA has provided almost twenty million Americans with health insurance who didn’t have it before, lowering the uncovered population from 14.4 percent to 8 percent.   It is probably  no accident that Senate Democratic Leader Senator Chuck Schumer and House Minority Leader Nancy Pelosi tapped former Kentucky Governor Steven Beshear to give the Democratic response to President Trump’s address to a Joint Session of Congress this Tuesday.  Governor Beshear’s work in implementing healthcare and the Kynect exchange brought the percentage of uninsured Kentuckians from 20.4 percent in 2013 to 7.5 percent in 2015, and gained him national recognition in Democratic circles. 

In California, under the ACA the number of uninsured residents has fallen to 7.1% of the population in 2016 from 17% in 2013.  Our state system relies on $22 billion in Federal funds to cover insurance subsidies linked to plans purchased through the state health insurance exchange.  This means that, in the health care arena as in so many others, we do not carry out a California policy model in complete isolation from the Federal Government.  Governor Brown, our legislature, and our new Attorney General, Xavier Becerra, who has twelve terms of Washington Congressional experience, are involved in defending our California model.  The state legislature is active in discussing legislation, and has retained former U.S. Attorney General Eric Holder to advise on how to defend California legal frameworks from the initiatives of a Trump Administration. 

Here in Ventura County, the ACA has already had an important effect on health care treatment.  Some 226,000 residents now participate in Medi-Cal, up from 112,658 in 2013.  Medi-Cal now serves more than one-quarter of Ventura County’s residents.  44,000 residents have obtained an insurance plan through Covered California.   Congresswoman Julia Brownley held a lively town hall meeting last week about health care at the Camarillo Library for a standing-room-only crowd, and people had a lot to say.

It was easy for the Republicans to take potshots at an imperfect ACA while it was being implemented and avoid working to perfect it.  Reform of the health care sector, involving 17 percent of our GDP, is incredibly complex.  Despite the fact that Americans spend more per capita and as a percentage of our GDP, we have not achieved a better outcome than other developed countries (many with single-payer systems).  For the Obama Administration, working on health care reform through an unusually partisan and fractious national legislative process, even when based on a largely Republican framework, has not been a smooth process.  It now seems a long time ago, when Governor Mitt Romney and Senator Ted Kennedy were able to come together in Boston on April 26, 2006, for the Governor’s signing of the Massachusetts health care legislation that came to be called “Romneycare,” and ultimately covered 97 percent of Massachusetts’ population.   Now the new Administration wants to “repeal and replace,” but we do not yet have much sense of what the plans for “replacement” are.  I fear we will begin to know very soon.

Whatever the Trump Administration wants to do in terms of health care reform should recognize the importance of the sector to the average citizen and the economy.  If the Administration and Congress want to make changes that affect such a large portion of the public and the economy, they owe it to the American people to explain clearly their replacement proposals, hold careful, deliberative and constructive hearings, that are open to give and take with the public’s views.  The public should insist on this. It is also fervently to be desired that people who currently have health care coverage don’t lose it, that citizens don’t suffer from lack of access to it, and that what comes out at the end does not leave medical bankruptcy as the leading cause of personal bankruptcy in the U.S.  The American people are wise, and will be well able to judge the result of the process underway and who is responsible on their merits.
2 Comments
Barbara Hensley
2/28/2017 02:58:23 am

Tuesday, February 28, 2017

With all due respect, it is time to stop talking and start acting. Not all, but most Republicans or conservatives do not have the empathy gene. They understand their own well-being but not that of others and so they cannot see beyond tomorrow. They do however understand strength.

For the past twenty years, I have watched the Democrats cave in and be walked on. How is that working out for you?

My disenchantment started with Bill Clinton….the best Republican money could buy. Those who are now in the White House are no longer, what we call Republicans or conservatives. They euphemistically call themselves “alt-right” and by the time the people of this country figure out what that really is (fascism), just like WWII Germany, it will be too late to stop them.

We have to be smarter and faster. We have history on our side and this “thing” has to be fought now, and wrestled into submission. Any healer will tell you that an aggressive cancer must be cut from the body or the body will perish. Passivity and a wait and see approach in the face of this regime will mean the death knell for this nation.

Life has always been a struggle. We struggle to be born, we struggle to live, and most times, we struggle not to die. United we have an opportunity to struggle together for our future and the future of this planet. The time is now.

I was writing about the ACA two years ago, but then what do I know.

Barbara Hensley

http://www.thecamarilloacorn.com/news/2015-01-30/Letters/Supports_healthcare_for_all.html


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Barbara Hensley
3/5/2017 06:21:23 am

RE: March 7th at 11:30 am - You Are Needed at a Board of Supervisors Meeting to Protect Our Water

Hello dear Democrats! For reasons I will not go into there are times (most) that I am physically unable to attend your meetings and these functions. However, the dissemination of accurate and critical information is pertinent for a democratic society. In other words, to have the best outcome there must a well informed and educated electorate who will make these decisions on how our society will function. Either we live in the light or we will be destine to surviving in the darkness.

Water is a human right and I am in opposition to “privatizing” our water supplies. What is it that people do not understand about what happened in the City of Flint and its water crises? For one most people in this nation are not paying attention. That in its self is a travesty. All across this land of ours we are finding out our water systems are at risk. Now is the time for WE the people to take command and not give away our human and rights to a private business. Now if you will bear with me:

Here from Wikipedia is the definition or “Privatization.” Use it wisely.

PRIVATIZATION

Wikipedia:

Opposition[edit]

Opponents of certain privatizations believe that certain public goods and services should remain primarily in the hands of government in order to ensure that everyone in society has access to them (such as law enforcement, basic health care, and basic education). There is a positive externality when the government provides society at large with public goods and services such as defense and disease control. Some national constitutions in effect define their governments' "core businesses" as being the provision of such things as justice, tranquility, defense, and general welfare. These governments' direct provision of security, stability, and safety, is intended to be done for the common good (in the public interest) with a long-term (for posterity) perspective. As for natural monopolies, opponents of privatization claim that they aren't subject to fair competition, and better administrated by the state.
Although private companies will provide a similar good or service alongside the government, opponents of privatization are careful about completely transferring the provision of public goods, services and assets into private hands for the following reasons:

• Performance. A democratically elected government is accountable to the people through a legislature, Congress or Parliament, and is motivated to safeguarding the assets of the nation. The profit motive may be subordinated to social objectives.
• Improvements. the government is motivated to performance improvements as well run businesses contribute to the State's revenues.
• Corruption. Government ministers and civil servants are bound to uphold the highest ethical standards, and standards of probity are guaranteed through codes of conduct and declarations of interest. However, the selling process could lack transparency, allowing the purchaser and civil servants controlling the sale to gain personally.
• Accountability. The public has less control and oversight of private companies.
• Civil-liberty concerns. A democratically elected government is accountable to the people through a parliament, and can intervene when civil liberties are threatened.
• Goals. The government may seek to use state companies as instruments to further social goals for the benefit of the nation as a whole.
• Capital. Governments can raise money in the financial markets most cheaply to re-lend to state-owned enterprises.
• Cuts in essential services. If a government-owned company providing an essential service (such as the water supply) to all citizens is privatized, its new owner(s) could lead to the abandoning of the social obligation to those who are less able to pay, or to regions where this service is unprofitable.
• Natural monopolies. Privatization will not result in true competition if a natural monopoly exists.
• Concentration of wealth. Profits from successful enterprises end up in private, often foreign, hands instead of being available for the common good.
• Political influence. Governments may more easily exert pressure on state-owned firms to help implementing government policy.
• Profit. Private companies do not have any goal other than to maximize profits. A private company will serve the needs of those who are most willing (and able) to pay, as opposed to the needs of the majority, and are thus anti-democratic. The more necessary a good is, the lower the price elasticity of demand, as people will attempt to buy it no matter the price. In the case of a price elasticity of demand of zero (perfectly inelastic good), the demand part of supply and demand theories does not work.
• Privatization and poverty. It is acknowledged by many studies that there are winners and losers with privatiza

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    Ariana King is the President of the Democratic Club of Camarillo.  Look for her blog every month.

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