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Local families worried new healthcare plan could jeopardize coverage

Posted at 7:53 PM, Mar 07, 2017
and last updated 2017-03-07 22:53:25-05
SAN DIEGO - Local families are worried that the new healthcare plan could jeopardize their coverage.
 
Under the GOP plan unveiled Monday, the Medicaid expansion implemented under the Affordable Care Act would be phased out by 2020. 
 
Ellen Montanari has a 14-year-old daughter with disabilities. She relies on Medi-Cal to pay for her daughter's care. 
 
"So what that looks like over time is the cost, of course, continues to go up, the amount of money that the feds send to the states stays same or gets less so states have to cover more more so the states have a choice, either they're  paying out of their pocket which is the rest of the taxpayers or starting to cut services and typically what states do is cut services," said Montanari. 
 
Galen Moore relies on Medi-Cal to cover his expensive HIV medications. 
 
"Thanks to the health care I get now, the medications I take now, some of the medications are upwards of 5,6 thousand dollars," said Moore. 
 
Insurance Agent Craig Gussin said it's too early to tell how the proposal will affect Medi-Cal recipients. 
 
"Unfortunately, a lot of this is politics and I don't think any politician is gonna get re-elected if all the people on Medicaid are losing coverage," said Gussin. 
 
Gussin is concerned about the elimination of the individual mandate or the part of President Obama's plan that required people to buy insurance or pay a penalty. Instead, people who have gone 63 days without insurance would pay a 30% higher premium. Gussin thinks that's a mistake.
 
" I look at that and I go, I'll drop my insurance tomorrow if I need to get hip surgery, I'll pay $390 for 3,4,5 months and I'll drop it," said Gussin who added both sides need to find a way to get young people to enroll.
 
"So that you're not having people walk in, use the system and then drop it. If that happened, you're going to see every insurance company leave the market because they can't buy health insurance and if you think about it, why would they?"
 
Gussin said California is at an advantage because there are several insurance companies competing. Other states only have a couple companies; but that's not the only factor driving price.
 
"Health insurance is expensive because health care is expensive, until we get to a point where we figure out how to reduce the cost of health care, health insurance premiums cannot go down," said Gussin.
 
San Diegans for Healthcare Coverage is also worried about the proposal. 
 
"The plan as written would result in many working adults losing health coverage that they simply cannot afford on their own.  The lack of advance premium tax credits and no consideration for income and family size, while giving tax credits to individuals at higher incomes, seems counter to actual needs. Eliminating the expansion of Medi-Cal to adults is heartless. These low-income adults simply cannot afford the healthcare they need to stay healthy or to address health issues before they become emergencies," said Jan C. Spencley, Executive Director. 
 
Spencley is especially concerned about the impact to Medicaid. 
 
"There are between 235,000 and 340,000 Medi-Cal beneficiaries and 150,000 Covered California enrollees in San Diego that are at immediate risk.  
 
Other adults who lose their job will not have a health coverage safety net to fall back on. Block granting Medi-Cal will essentially limit both coverage and health services to over 800,000 San Diegans over time, including senior Block grants will not keep up with medical inflation nor will they keep up with those turning 65 every day," said Spencley.