Congressman Salud Carbajal hosts standing room only town hall meeting to discuss possible effects of House Republican's health care plan to repeal and replace the Affordable Care Act at the Santa Barbara Museum of Natural History's Fleischmann Auditorium.
S.B. Health-Care Experts Deliver Grim Trumpcare News
And Carbajal Drops Mic on Republican Repeal Bill
Thursday, March 16, 2017
The timing couldn’t have been much better. Or worse.
The very day Santa Barbara’s Congressmember Salud Carbajal had scheduled a mic-dropping town hall forum to denounce the Republican bill to repeal the Affordable Care Act, the Congressional Budget Office (CBO) issued its intensely anticipated report on the same subject. The findings were extremely damning. In 10 years, 24 million fewer Americans would have health insurance if the Republicans’ American Health Care Act — now dubbed Trumpcare — were enacted than if Obamacare were allowed to run its course. In just year one, 14 million Americans would fall off the insurance rolls. By 2026, 52 million would be without, worse even than during the Great Recession when a record 48 million went uncovered.
Info Courtesy of Kaiser Permanente
The fine print appeared even more devastating. The Republican plan, according to the CBO, would slash federal Medicaid spending by nearly a trillion dollars in 10 years, shedding from its roster nine million beneficiaries by 2020 and 14 million by 2026. Medicaid, part of President Lyndon Johnson’s War on Poverty, has traditionally funded health-care programs for the poorest of the poor — single women, their kids, and the elderly. Under the Affordable Care Act, Medicaid eligibility rules were expanded to allow low-income single adults to get covered. Income limits were likewise. Under Obamacare, someone earning as much as $16,400 a year — 138 percent the federal poverty level — could qualify. Before that, the cutoff was $12,000 a year.
The good news — at least to its Republican supporters — is that the CBO found the repeal bill would reduce federal spending by $377 billion over 10 years. It would have reduced it by even more, but the legislation includes about $800 billion in tax cuts. Those taxes — primarily on households earning more than $250,000 a year — had been imposed by the Affordable Care Act to pay for subsidies enacted to bring insurance premiums within financial reach for the 20 million customers who signed up over the past seven years. Under the Republican proposal, there will still be subsidies — tax rebates — but much less than under Obamacare. And according to the CBO, those Republican subsidies strongly favor the younger and the more affluent customers at the expense of older, low-income consumers.
Under Obamacare, subsidies were doled out based on income and geographic location. Under the repeal bill, subsidies — from $2,000-$4,000 — are parsed based on age instead. The Republicans took pains to maintain Obamacare’s protections for those with existing health-care conditions. But their bill allows insurance companies to compensate for the greater risk posed by older customers by charging them five times more than what they charge younger ones. Under Obamacare, the age differential charge was limited to three times.
Little wonder, then, that most of the 400-plus cramming into the Santa Barbara Museum of Natural History Monday night to attend Carbajal’s health-care town hall rant were sporting more than a dusting of snow at the temples. By then, the CBO report had been in general circulation several hours, and the disparate impact of the repeal bill on middle-income earners in their advanced middle ages was well known. Already, Facebook had blown up with the situation of a theoretical 64-year-old customer making $26,500 a year. Under Obamacare, this person could have secured a $15,000 health plan — with subsidies — for $1,700. Under the Republican plan, it would cost $14,600.
By Paul Wellman
Panel seated L to R Congressman Salud Carbajal, Dr. Charity Dean, Santa Barbara County Public Health Officer, Dr. Dodson, Samsun Clinic, Dr. Fenzi, Santa Barbara Neighborhood Clinics, Michael Harris, Director of Administration & Government Services at CenCal Health, and Jenna Tosh, Executive Director of Planned Parenthood Central Coast.
It was standing room only inside Fleischmann Auditorium, with the crowd pooling out into the courtyard. The enthusiasm was palpable and the clapping explosive enough to inflict eardrum discomfort. If anyone in attendance worried about Obamacare’s escalating premiums and long-term financial sustainability — or opposed the individual mandates so antithetical to the Republican virtue of economic choice — they kept such thoughts to themselves. Republican congressmembers in other districts have found themselves called on the carpet by large, spirited, angry anti-Trump crowds. But Carbajal, still finding his legs as an anti-Trump crusader, basked in unalloyed adulation. One member of the audience toasted him with a boisterous “Hip! Hip! Hooray!” Even Carbajal was taken briefly aback. “We didn’t set him up to do that,” he quipped.
As a firebrand, Carbajal didn’t pack much heat. He didn’t need to. He praised the crowd for its engagement. Keep writing letters and making phone calls, he told those assembled. The Republicans’ repeal bill, he said, was “ridiculous.” Mostly, he relied on the CBO report for talking points. “They’re basically trying to destroy our health-care system,” he charged, adding, “In other words, they want us to pay more for a lot less.” In his district, the percentage of the uninsured dropped from 16.5 to 9.4 under Obamacare.
By Paul Wellman
Congressman Salud Carbajal hosts standing room only town hall meeting to discuss possible effects of House Republican’s health care plan to repeal and replace the Affordable Care Act at the Santa Barbara Museum of Natural History’s Fleischmann Auditorium.
Carbajal let a heavyweight panel of area health-care experts do most of the talking. Together, they left few stones un-hurled when it came to the Republicans’ repeal legislation. Dr. Charity Dean, Santa Barbara County’s Public Health Officer, objected that the Republicans sought to eliminate outright Obamacare’s modestly funded Prevention and Public Health Fund. When four UCSB students turned up about four years ago with meningitis, an often deadly viral infection that frequently requires amputation of feet and hands, that fund covered the cost of 8,000 vaccines administered at UCSB for two years.
Likewise, Dean said, the same fund paid for the genetic detective work needed to link five cases of hepatitis C to a popular area medical practitioner offering an unorthodox blood transfusion-rejuvenation therapy. That’s nothing, however, compared to the massive question mark the repeal bill is casting over the 11,000 new patients enrolled at the eight Santa Barbara Health Clinics since Obamacare’s new Medicaid eligibility went into effect. Previously, Dean said, the county received $8 million in federal funds to treat the uninsured. Once insurance was provided — via the Affordable Care Act — that $8 million disappeared. But thus far, she said, she’s seen nothing in the repeal bill to suggest that $8 million is coming back.