An event hosted by Antioch University on Monday night featured California State Insurance Commissioner Dave Jones, who spoke about the Affordable Care Act, aka Obamacare. Following his speech, he was questioned by a panel of heavy hitters from the Santa Barbara health-care industry, including Dr. Cynder Sinclair, executive director of Santa Barbara Neighborhood Clinics; Dr. Takashi Wada, director of Santa Barbara County Public Health Department; Dr. Kurt Ransohoff, CEO of Sansum Clinic; and Ron Werft, CEO of Cottage Health System.
Jones outlined the immediate impact of Obamacare in California, as well as the provisions of the law that will take effect in 2014. He explained, among other things, a provision of the law that requires insurance providers and HMOs to spend at least 80 percent of their revenue from premiums and co-payments to pay for actual health care rather than keep as profit. Jones cited the example of Anthem Blue Cross, which in 2010 spent only 60 percent of its revenue and pocketed the rest.
Jones said, “There is a lot of misinformation about what’s in the act; a lot of folks are not aware of the benefits that we enjoy now. Were we to lose them, it would be a tremendous step back.” However, more than just educating the audience, he boasted that “California was leading other states” in implementing the law. He noted that California had already created what are known as health-care exchanges even though they are not required until 2014.
Health-care exchanges are online markets that compare standardized health plans by price so individuals and businesses don’t have to trudge through complicated fine print of insurance policies in order to find the right one. Jones also mentioned that he would prefer that the state insurance commissioner have “direct authority to reject excessive health insurance and HMO prices.”
Senator Dianne Feinstein lobbied hard for this provision to be included in Obamacare, but it was defeated; the same idea was also defeated in the California State Legislature. Jones announced his intention to collect signatures and put a measure on the ballot in 2014 that would give him this power.
Sansum CEO Ransohoff was concerned about the overall cost of health care, which continues to rise year after year whether or not insurance providers are prohibited from gouging customers or not. Jones assured him that that under Obamacare, “health insurers and providers … are rewarded to the extent that they keep the patient healthy.
Dr. Takashi Wadda asked about the “residually uninsured,” those who will remain uninsured despite the Obamacare’s individual mandate, which taxes people who do not buy health insurance. Wadda was concerned that the cost of ensuring these people would be passed on to city and county budgets. Jones leveled with Wadda, saying, “I don’t see the state creating a new program to help counties and cities with the cost of the residually uninsured.”
Toward the end of the meeting, Cottage CEO Werft asked a question about end-of-life care: “Every time we get into this, we’re talking about death panels. Is there hope for having a rational social conversation about this topic?”
Jones responded simply, “I think it’s really hard.”