Oakland residents, community activists catch up on healthcare reform

As the 2010 midterm elections approach, Obama supporters are trying to get Oaklanders to think positively about the healthcare reform bill signed into law this past March. Organizing for America, the grassroots network that helped elect President Barack Obama, held a healthcare teach-in for Oakland residents and community organizers at their downtown office on Tuesday evening, July 20.

“People are out there trying to change or repeal the healthcare reform bill,” Linda Leu, an analyst with the statewide healthcare advocacy group, Health Access, told the standing-room only crowd of some 80 people. “We need to be out there letting people know what’s good about it,” she said.

The hard-fought Patient Protection and Affordable Care Act—the country’s first major healthcare reform in nearly 100 years—continues to take hits from both sides of the political spectrum. Conservatives have called for a repeal, saying the law amounts to socialized health care, and will eliminate patients’ right to choose providers and services. On the left, some have criticized the law for failing to ensure healthcare for all Americans through a single-payer system, and for not doing enough to curb skyrocketing health care costs.

At the teach-in on Tuesday, healthcare reform advocates said the law wasn’t perfect, but a step in the right direction. “We’re expanding coverage, we will have better benefits, we’ll begin to control costs,” said Ellen Schaffer, co-director of the Center for Policy Analysis on Trade and Health, a San Francisco-based, public health advocacy group. “We’re not going to do all of that this month.”

Leu and Schaffer explained key points of the healthcare reform law to the crowd assembled in the Organizing for America office, which included a mix of Obama supporters and Oakland residents hoping to understand how the reform will affect their families. Attendees sat in rows of folding chairs, and stood against walls tacked with campaign maps, activity calendars

and a large, pixilated sketch of a smiling President Obama.

Schaffer explained how and when different interest groups will be affected by the new law. As of January, small businesses that provide health benefits to their workers have been eligible for tax credits worth up to 35 percent of the employer’s contribution to employees’ insurance plan.

As of June, seniors who are covered under Medicare will receive a one-time, tax-free check for $250 to help close the so-called “donut hole”—a coverage gap that forces many seniors to pay full-cost for some prescription drugs—for the rest of this year. Next year, Medicare recipients facing the donut hole will receive 50 percent off their brand name drugs.

In late September (for healthcare plans and policies that begin on or after the 23^rd of that month), young adults will have the option of staying on their parents’ healthcare plan until they turn 26 years old. Currently, young adults represent one of every five uninsured people in the United States, according to HealthCare.gov, a government website that provides information about the reform.

Also starting September 23, insurance companies will no longer be allowed to deny coverage for children age 18 and under because of a pre-existing condition. This rule will expand to all age groups by 2014.

Until then, California will cover residents who are unable to get insurance in the private

market under its newly expanded Major Risk Medical Insurance Program. Under the program, participants pay premiums that are subsidized by the state. California has offered this coverage since 1991, but limited funding has led to a long waiting list for eligible patients. New federal funding will help quadruple the number of high-risk Californians covered under the program from the current 7,000, according to Health Access. The state plans to begin taking applications for the program in August, with coverage beginning in September, according to Leu.

Also for health plans beginning in September, insurance providers can no longer rescind coverage if they determine a patient failed to reveal a preexisting condition, except in cases of outright fraud or when an insurance applicant intentionally misstates the facts on his or her application. Plus, all new health plans must cover preventive services without charging a deductible or co-pay, although the list of covered preventive services has yet to be finalized.

Addressing one of the main concerns of health reform opponents, Leu said Tuesday night that people who are happy with their existing healthcare plans will not be forced to make changes. “The president said over and over and over again, if you like it, you can keep it,” she said.

Nevertheless, when a woman in the audience later asked Leu and Schaffer if the law would guarantee she could keep her doctor, Schaffer was less conclusive. “Managed care was tried in the 1990s and I don’t think people will put up with that,” she said.

In fact, insurance companies are already piloting plans that provide reduced premiums in exchange for a more limited selection of doctors and hospitals, according to a recent article in the New York Times. Under these plans, patients who wish to see doctors outside of established networks may pay more or all of the cost. Whether or not these plans will catch on is yet to be seen.

Participants at the teach-in shared their healthcare nightmares.

Audience member Quenby Morrow brought up a second, longstanding debate about healthcare reform—how much can the law actually do to cap insurance costs to consumers? Morrow said she’s currently covered under COBRA (Consolidated Omnibus Budget Reconciliation Act), a government program that extends health benefits for workers who lose their jobs and accompanying health benefits. Her COBRA benefits are set to expire in November. If she can’t find a job with health benefits before then, Morrow wondered how she would get health insurance for herself, her 11-year old daughter, and her husband, who was recently diagnosed with a heart condition.

“Is there anything?” asked Morrow, who lives in Montclair. Her insurance provider can’t drop coverage for the family after her COBRA benefits expire, explained Leu and Schaffer, but there are no limits on how much it can charge for continued coverage.

Still, several bills currently in the California legislature would put limits on rate hikes. One, AB 2578, would make insurance companies get state approval before raising premiums, deductibles and co-payments. Another, AB 2042, would limit rate hikes to one a year for individual insurance companies and other benefit providers.

After Leu and Schaffer concluded their presentations and took a series of questions, meeting attendees broke into groups by neighborhood to share their own healthcare woes, and to strategize regarding how to talk to others about the reform act. Conversations were loud and animated—a testament to the passion sparked by the issue.

Gerhart Kneisse, who lives in Hiller Highlands, in the North Oakland hills, said he came to the event for both political and personal reasons. “These discussions come up [about the healthcare reform act], and I want to be able to combat all the false rumors out there,” said Kneisse.

Kneisse said his wife was diagnosed with breast cancer 14 years ago, and was subsequently refused long-term healthcare three times because of her pre-existing condition. She has since recovered, and has health benefits through her employer, Apple. But Kneisse said his wife, who’s 63, can’t afford to retire because her health care costs would be too high.

“I hoped she could retire before 65 so we could do things together,” said Kneisse, who’s 75 and retired. “We’ll have to wait for Medicare,” he said resignedly.

—

For government information on the Patient Protection and Affordable Care Act, visit http://www.healthcare.gov

For information on healthcare bills in the California legislature, and how the federal healthcare reform affects Californians, visit http://www.health-access.org

For information on the Major Risk Medical Insurance Program for high-risk Californians, visit http://www.mrmib.ca.gov

Connect with Oakland North on Facebook, or follow us on Twitter.