Guest Column: Obamacare versus Trumpcare

Reymundo Espinoza

Despite the Senate’s latest misguided attempt to repeal the Affordable Care Act (ACA/Obamacare), it survived. Republicans tried and failed more than 50 times to eliminate basic and essential health care services for everyone, especially our most vulnerable communities. Although Senate Majority Leader Mitch McConnell and House Speaker Paul Ryan suggested that they might finally move on to other issues, our health care safety net remains vulnerable with opponents vowing to “kill it with a thousand cuts.” We cannot let that happen.
Since implementing the ACA, California’s uninsured rate fell from 17.2 percent in 2013 to a historic low of 7.4 percent in 2016, an increase of more than 5 million enrollees. In 2015, Governor Brown built on the ACA’s early success by signing Health for All Kids, granting Medi-Cal coverage, regardless of immigration status, to hundreds of thousands of low-income children.
If Obamacare had been replaced by Trumpcare, California’s Medi-Cal program, covering almost 14 million low-income residents, would have faced an initial $3 billion annual reduction in 2020 followed by $30.3 billion in annual reductions by 2027, forcing California to limit eligibility and reduce benefits for everyone, including children, seniors, veterans, the disabled and the poor. Under a repeal, the uninsured rate for non-elderly patients would have exploded from the current rate of 9 percent to 21.4 percent by 2022.
The ACA remains essential to the physical and financial well-being of Californians. Last year, under Covered California, 60 percent of consumers receiving tax credits qualified for coverage costing less than $10 per month; this included free preventive care and protection from high-cost medical events. Currently, 3.7 million Californians, or 1/3 of our population, are enrolled in Medi-Cal under the ACA expansion, with safety-net clinics serving 1.3 million of these patients. In Santa Clara County, 136,179 patients are enrolled in Medi-Cal under the ACA and without a comparable plan, those already struggling to make ends meet face chaos and financial ruin.
Under Trumpcare and its many iterations, even the employed and insured would have been hit hard. Insurance rates would have risen for all but the young and healthy. Pre-existing conditions or common age-related ailments would have pushed people out of coverage. Basic health care for women would no longer be covered. Hospitalization might not be considered essential. Everyone in America would be affected or know someone who could no longer obtain health coverage.
For decades, Gardner Family Health Network has been at the front lines of the healthcare battlefield, providing essential health care regardless of pre-existing conditions or ability to pay. Located in some of our most vulnerable communities, Gardner operates seven clinics spanning two counties, providing primary care and behavioral health services to a broad range of patients at all income levels. Today, Gardner serves roughly 39,600 patients, of which over 7,200 were ineligible for coverage prior to the ACA. Locally, Gardner’s Gilroy clinic treats extremely low income individuals and families who would fall through the cracks if not for the Obamacare.
After seven years of extraordinary improvements in access to care and the health of our communities, Republicans are still bent on dismantling a system that has enhanced health outcomes, cut costs, and served as an important component of California’s thriving economy. Instead of fixing the flaws, they have fought to repeal the ACA without even having a replacement. That makes no sense.
Here in Gilroy, our friends, neighbors, and families have benefited from a system of care that is open to everyone. Whether you call it the Affordable Care Act or Obamacare, it has served our nation well.
Reymundo Espinosa, Chief Executive Officer
Gardner Family Health Services
Gilroy, California

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