ON HEALTH WILL COME TO ORDER.
GOOD AFTERNOON IN RESPONSE TO
THE COVERT NINETEEN A MERCHANT
SEE AND TO PROTECT THE PUBLIC
LEGISLATORS AND EMPLOYEES WE
MUST LIMIT NONESSENTIAL
GATHERINGS AND IT HERE TO
SOCIAL DISTANCING AND FACE
COVERING GUIDELINES. IN
COMPLIANCE WITH THESE ORDERS
THE SENATE HAS MADE NECESSARY
ADJUSTMENTS TO NORMAL PRACTICES
IN ORDER TO ENSURE THAT PUBLIC
THAT THE PUBLIC CONTINUES TO
HAVE ACCESS TO THE LEGISLATIVE
PROCESS. WE ARE HOLDING OUR
INFORMATIONAL COMMITTEE
HEARINGS HERE IN THE CAPITAL
WHATSOEVER COMMITTEE MEMBERS
PARTICIPATING REMOTELY FOR THIS
HEARING. TODAY WE CAN EXPECT OF
THREE MEMBERS PARTICIPATING
REMOTELY CENTERS GONZALEZ.
CENTER HER TADO AND CENTER
LEYVA. AND IN THE SENATE
CHAMBER WITH ME ARE CENTER
MINING AND WE'RE EXPECTING
CENTER RUBIO. WE ALSO HAVE
WITNESSES AND REPRESENTATIVES
FROM THE DEPARTMENT JUSTICE
COVERED CALIFORNIA THE
DEPARTMENT HEALTH CARE
SERVICES. AND THE LEGISLATIVE
ANALYST'S OFFICE WHO ARE
PARTICIPATING REMOTELY. OUR
REMOTE PARTICIPANTS PLEASE MUTE
YOUR PHONES OR COMPUTERS THIS
WILL GREATLY AID AND
ELIMINATING ANY ACOUSTIC
FEEDBACK. I ASK THAT EVERY TIME
YOU WISH TO BE RECOGNIZED THAT
YOU USE THAT RAISE YOUR HAND
FEATURE IN THE PROGRAM. EACH
TIME YOU ARE RECOGNIZED TO
SPEAK A POP UP WINDOW WILL
APPEAR ASKING IF YOU WOULD LIKE
TO ON MUTE. THESE SELECT ON
MUTE BEFORE YOU BEGIN SPEAKING.
R. I. T. PERSONNEL WILL PUT YOU
BACK ON MUTE WHEN YOU ARE DONE.
ONCE RECOGNIZED TO SPEAK PLEASE
MAKE SURE YOU CAN BE SEEN ON
THE SCREEN STATE YOUR NAME AND
THEN YOU'RE READY TO ADDRESS
THE COMMITTEE. TO ALLOW PUBLIC
ACCESS WE'VE ADMITTED MEMBERS
OF THE PUBLIC TO TWO HEARING
ROOMS TO THE EXTENT THAT SOCIAL
DISTANCING REQUIREMENTS ALLOW.
WILL BE USING A TELECONFERENCE
SERVICE FOR THOSE INDIVIDUALS
WHO WISH TO TESTIFY TODAY. FOR
ALL INDIVIDUALS WISHING TO
PROVIDE PUBLIC COMMENT THE
PARTICIPANT TOLL FREE NUMBER
AND ACCESS CODE IS POSTED ON
OUR COMMITTEE WEBSITE. AND WILL
ALSO BE DISPLAYED ON THE SCREEN
AND I WILL ANNOUNCE IT NOW.
TODAY'S PARTICIPANT NUMBER IS
EIGHT FOUR FOUR. TWO NINE ONE
SIX THREE SIX FOUR. AGAIN.
844-291-6364 AND THE ACCESS
CODE IS. TWO TWO FIVE ONE ONE
NINE AGAIN THE ACCESS CODE IS.
TWO TWO FIVE ONE ONE NINE FOR
DETAILED INSTRUCTIONS ON HOW
THE TELECONFERENCE DIM WORKS
PLEASE REFER TO THE SENATE
LANDORE COMMITTEE WEBSITE. FOR
TODAY'S HEARING WILL BE HEARING
ALL THE PANELS OF WITNESSES ON
THE AGENDA PRIOR TO TAKING
PUBLIC COMMENT. ONCE WE HAVE
HEARD ALL THE WITNESSES WILL
HAVE A PUBLIC COMMENT PERIOD
FOR THOSE WHO WISH TO COMMENT
ON THE TOPICS ON TODAY'S AGENDA.
PLEASE NOTE THAT IN ORDER FOR
US TO HEAR YOU CLEARLY AND
AVOID ACOUSTIC FEEDBACK. YOU
MUST MEET THE DEVICE YOU'RE
WATCHING THE HEARING ON PRIOR
TO GIVING TESTIMONY OVER THE
PHONE. IT IS IMPORTANT THAT
WE'RE ABLE TO HEAR YOU AND HEAR
FROM YOU AND WE THANK YOU FOR
YOUR PATIENCE. I WILL MAINTAIN
DECORUM DURING THE HEARING AS
IS CUSTOMARY AND ANY INDIVIDUAL
WHO IS DESTRUCTIVE MAY BE
REMOVED FROM THE REMOTE MEETING
SERVICE OR HAVE THE CONNECTIONS
MUTED. WHILE EVERY EFFORT HAS
BEEN MADE TO STREAMLINED
HEARING PROCESS AND CONDUCTOR
HEARINGS AND THOSE CLOSE TO THE
SAME MANNER AS IS CUSTOMARY.
THERE MAY BE SOME LAG TIMES FOR
PARTICIPANTS WERE ADJUSTING TO
THE NEW USE OF ONLINE TOOLS OR
TECHNOLOGIES. PLEASE BE
RESPECTFUL AND PATIENT SO ALL
INTERESTED PARTIES CAN BE HEARD.
SO NOW WE'RE GOING TO OPEN THIS
INFORMATIONAL HEARING ON THE
AFFORDABLE CARE ACT IN JEOPARDY
WHAT DOES IT MEAN FOR
CALIFORNIA. AND I WANT TO
WELCOME AND THANK YOU ALL FOR
BEING HERE. IN THE DECADE AFTER
THE PASSAGE OF THE ACA.
CALIFORNIA HAS BEEN ABLE TO
REDUCE THE NUMBER UNDER. IN THE
STATE BY OVER HALF. ESTABLISH
CALIPHATES. COVERED CALIFORNIA
WHICH PROVIDES AFFORDABLE
HEALTH INSURANCE INDIVIDUALS
AND SMALL BUSINESSES. AND
ALLOWED MANY CALIFORNIANS TO
START THEIR OWN BUSINESSES.
PROVIDE VALUABLE PROTECTIONS TO
PEOPLE WITH PRE EXISTING
CONDITIONS INCLUDING
ELIMINATING LIFETIME LIMITS THE
COVERAGE ALLOWING CHILDREN TO
STAY ON THE PARENTS HEALTH
PLAN. AND SLOW THE RATE OF
GROWTH OF HEALTH INSURANCE
PREMIUMS PARTICULARLY IN THE
INDIVIDUAL MARKET. I THINK
IT'S- APPROPRIATE TO SAY A BIT
ABOUT WHAT IT WAS LIKE BEFORE
THE ACA SINCE IT'S BEEN OVER
TEN YEARS SINCE WE IMPLEMENTED
IT. BACK THEN WE HAD INSURANCE
PREMIUMS PARTICULARLY FOR
INDIVIDUALS SKYROCKETING. AS
MANY INDIVIDUALS THAT PIECE OF
THE CONDITIONS EITHER COULD NOT
PURCHASE HEALTH INSURANCE OR
ONLY AT EXORBITANT RATES. WE
SAW PEOPLE WHO HAD PAID FOR
INSURANCE FOR YEARS AND THEN
WHEN THEY FINALLY FELL ILL.
WE'RE UNABLE TO MAINTAIN YOUR
INSURANCE YOU ALSO HAD PEOPLE
WHO HAD CONDITIONS IN WHICH-
BECAUSE OF THE EXPENSE OF THE
TREATMENT. INSURANCE BECAUSE A
LIFETIME COVERAGE ESSENTIALLY
ENDED WHILE THEY WERE IN THE
MIDDLE THEIR TREATMENT. AND YOU
HAD FAMILIES WHOSE CHILDREN
WERE GOING OFF TO COLLEGE AND
YET BECAUSE THEY WERE NOT IN
THE WORK FORCE. WE'RE UNABLE TO
HAVE HEALTH INSURANCE. BECAUSE
THEY CANNOT STAY ON THEIR
PARENTS PLAN. SO THIS AND MANY
OTHER REASONS WERE WHAT DROVE
THE PASSAGE OF THE ACA. NOW AS
AFTER THE DEBATE THE PASSAGE OF
THE ACA. I THINK MANY PEOPLE
OVER TIME RECOGNIZE HOW
IMPORTANT IT IS IN FACT IN MANY
STATES. WHO DIDN'T INITIALLY
ADOPTED THE MEDICAID EXPANSIONS
IN THE ACA. EVEN DESPITE THE
RESISTANCE FROM THE
LEGISLATURE'S HE PEOPLE HAVE
ACTUALLY PASSED INITIATIVES IN
THOSE STATES TO IMPLEMENT.
EXPANSIONS OF THE MEDICAID
PROGRAM AND OTHER TYPES OF
CHANGES AS WELL. HOWEVER MORE
RECENTLY THERE'S A REPUBLICAN
LAWSUIT SUPPORT BY PRESIDENT
TRUMP THAT THREATENS TO
OVERTURN THE ACA. AND ELIMINATE
FEDERAL SUPPORT FOR ALL THE
GAINS THAT WERE DESCRIBED.
CALIFORNIA'S ATTORNEY GENERAL
AND OTHERS HAVE APPEALED TO THE
US SUPREME COURT WHICH IS
SCHEDULED TO HEAR THE CASE ON
NOVEMBER TENTH. SO WHAT WILL
HAPPEN IF TRUMP SUPREME COURT
RULES IN FAVOR OF THE
REPUBLICAN LAWSUIT DURING THE
WORST PANDEMIC IN THE CENTURY.
THE SENATE COMMITTEE ON HEALTH
WILL HEAR FROM EXPERTS AS- AND
WHAT AN ADVERSE RULING BY THE
SUPREME COURT MEANS FOR
CALIFORNIA. AND WITH THAT I'D
LIKE TO BEGIN WITH OUR FIRST
PANEL. SO OUR FIRST SPEAKER IN
THE FIRST PANEL. OF SPEAKERS IN
OUR FIRST PANEL ART DEBRA READY
COACH. AND MELANIE FONTES
RAINER WHO IS SPECIAL ASSISTANT
TO THE ATTORNEY GENERAL AND
DEPARTMENT JUSTICE. OF LET'S
FIRST BEGIN WITH- DEBRA
CULTURES IN INVENTING CONSULT
AND AN EX. ON THE PORTABLE CARE
ACT. THE WRECKAGE. THANK YOU
SENATOR- I HOPE YOU CAN SEE THE
SLIDES. YOU HAVING ME HERE
TODAY. I'M A RETIRED
INDEPENDENT CONSULTANT AND
FORMER LEGISLATIVE STAFFERS AND
I JUST APPRECIATE THAT THIS
HEARING IS HAPPENING HELLO KIM
HM MINE HE. IT'S NOT LETTING ME.
WORK THE SCIENCE. I MEAN IT. IT
WORKED I DON'T KNOW WHAT'S
HAPPENING. IS THERE ANYBODY
THAT CAN HELP BECAUSE I'M I'M
JUST UNABLE TO PAGE DOWN AS IT
WAS WORKING JUST FINE THIS
MORNING. THE AREA OKAY OKAY IT
LOOKS LIKE THAT OKAY THANK YOU
YEAH SORRY SO I JUST WANTED TO
START BY SAYING THAT- THE
STRAINS OF THE ACA- AS YOU SAID
SENATOR IS THAT IT'S REALLY
COMPREHENSIVE SO IT'S NOT JUST.
A COUPLE OF COVERAGE PROGRAMS
IT'S THAT PLUS- YOU KNOW
SUPPORT FOR LOW AND MODERATE
INCOME INDIVIDUALS TO PURCHASE
COVERAGE. INSURANCE MARKET
REFORMS THAT GO ACROSS MARKETS
INDIVIDUAL SMALL GROUP AND
LARGE GROUP ALSO AFFORDABILITY
ACCESSIBILITY TRANSPARENCY EASE
OF USE FOR CONSUMERS.
PROHIBITING DISCRIMINATION
PROMOTING PREVENTION WELLNESS
AND QUALITY IMPROVEMENT SO IT'S
SO MUCH THAT IS AT STAKE. THE
FEDERAL ACA. STRUCTURE INCLUDES
THE COVERAGE- ISSUES THAT WE
TALKED ABOUT THE CONSUMER
INSURANCE PROTECTIONS AND ALSO
HEALTH WORKFORCE DEVELOPMENT
QUALITY AND SYSTEM PERFORMANCE
AND IT MADE VERY SUBSTANTIAL
CHANGES TO MEDICARE INCLUDING
PAYMENT REFORMS AND CLOSING.
THE GAP IN THE MEDICARE PART D.
PRESCRIPTION DRUG PROGRAM ALL
THESE AT POTENTIAL RISK THE
COVERAGE FRAMEWORK ITSELF IS-
REVOLVES AROUND MEDICAID
EXPANSION AS YOU SAID MEDIC CAL
IN CALIFORNIA MARKET REFORMS
EXCHANGES FINANCIAL ASSISTANCE.
AND INDIVIDUAL RESPONSIBILITIES
BOTH FOR INDIVIDUALS AND
EMPLOYERS THIS CHART REALLY
SHOWS THE EXTENT OF THE PROOF
THE INSURANCE MARKET REFORMS
AND ALSO SHOWS THAT IT DOES
APPLY- TO ALL MARKETS NOT MANY
OF THEM DO APPLY- NOTABLY
COVERAGE FOR PREVENTIVE
SERVICES WITH NO COST SHARING
AS YOU MENTIONED CENTER THOUGH
THE ANNUAL AND LIFETIME LIMITS.
BEING PROHIBITED AND SO BEFORE
THE ACA WE HAD IT ON AND RATE
OF UNINSURED AROUND 20% FOR
DECADES- I THINK WE HAD A
MEDICARE PROGRAM THAT ONLY
SERVES CERTAIN POPULATIONS AND
WAS PARTICULARLY COMPLEX IN
TERMS OF ENROLLMENT. WE HAVE
THIS VERY DYSFUNCTIONAL
INDIVIDUAL HEALTH INSURANCE
MARKET THAT WAS YOU
EUPHEMISTICALLY DUBBED THE WILD
WILD WEST WITH VERY FEW ROLES
AND MINIMAL STATE OVERSIGHT.
CALIFORNIANS COULD EXPERIENCE
DISCRIMINATION JOB LUCK JOB
LOCK AND DISRUPTIONS IN THEIR
HEALTH CARE IF THEY CHANGE JOBS
OR EXPERIENCE OTHER LIFE
CHANGES CALIFORNIA WENT ALL IN
AND WE NOT ONLY EMBRACED ALL
ASPECTS OF THE ACA BUT WE ALSO
PRESERVED AND BUILT ON OUR OWN
TREATS- PREVIOUS CONSUMER
PROTECTIONS. AND EXPANDED
COVERAGE. WE HAD THEM CAL. WITH
THE WENT ON TO. ON THAT WITH M.
STATE FUNDED COMPREHENSIVE
MEDICARE UP TO LOW INCOME
UNDOCUMENTED CHILDREN AND
SENIORS WE'LL HEAR ABOUT COVER
CALIFORNIA FROM MR LEE- WE ALSO
INVESTED HEAVILY AND WROTE OUT
REGION WRONG THEN AND MAKING IT
POSSIBLE FOR PEOPLE TO GET
SIGNED UP. AND THEN WE WENT
BEYOND THE ACA WITH THINGS LIKE
STANDARDIZED BENEFITS THAT HELP
INDIVIDUALS. SEARCH AFFECTIVELY
AND COMPARED THEIR- POTENTIAL
COVERAGE OFTEN OPTIONS. THIS IS
A LITTLE BIT ABOUT THAT A PRE
ACA INDIVIDUAL MARKET I THINK
OF IT AS- THE POTENTIAL FOR.
CALIFORNIANS TO GET STYMIED
ALONG THE WAY EITHER AS THEY
WERE APPLYING FOR COVERAGE AND
BEING DENIED BECAUSE OF THEIR
HEALTH STATUS AND THIS IS
IMPORTANT YOU KNOW WE THINK OF
CANCER DIABETES HEART DISEASE-
BUT PREGNANCY WAS A PRE
EXISTING CONDITION AND ALSO-
INDIVIDUALS WHO HAD PAST
ILLNESSES EVEN THOUGH THEY WERE
RESOLVED THAT COULD BE A CAUSE
FOR THEM GETTING TONIGHT AND OF
COURSE WE THINK. AS WE ARE
LOOKING AT IT THAT CO THAT
EVENTUALLY WILL BE A HIGH A PRE
EXISTING CONDITION- THEY CAN
ALSO BE STYMIED AS THEY SOUGHT
COVERAGE YOU MIGHT BE GET
COVERAGE BUT THEN THE RATES
COULD SKYROCKET. IF THEY HAD
ANY KIND OF- HEALTH ISSUE AND
THEN ONCE THEY SECURED COVERAGE
THE BENEFITS MIGHT BE LIMITED
FOR EXAMPLE EXCLUDING MENTAL
HEALTH OR ADDICTION TREATMENT
OR EXCLUDING THOSE VERY
SPECIFIC THING THEY NEEDED
BECAUSE- IT WAS A REFLECTION OF
SOMETHING THAT HAPPENED
EARLIER. SO SALUTING THEIR FOOT
ANYTHING. TO DO WITH THEIR FOOT
AS AN EXAMPLE THE POSTINGS END
OF THE MARKET ADDRESSED ALL
THREE OF THESE AREAS. THE
REQUIRING EVERYONE TO GET
COVERAGE- ELIMINATING THE
ABILITY OF HEALTH PLANS TO RATE
UP BASED ON HEALTH STATUS AND
ENSURING THAT EVERYONE HAS
COMPREHENSIVE BENEFITS
INCLUDING ELIMINATING THE
ANNUAL AND LIFETIME DOLLAR
LIMITS. SO AGAIN THIS IS JUST
ME SAYING AND IT'S SORT OF
BECOME KIND OF A ONE LINER
COVER PEOPLE WITH PRE EXISTING
CONDITIONS BUT IT'S NOT A ONE
LINER IS A COMPREHENSIVE
PROGRAM THAT STARTS WHEN YOU
APPLY AND GOES ALL THE WAY
UNTIL YOU RECEIVE BENEFITS.
HEALTH STATUS IS NO LONGER A
FACTOR. SO AS YOU MENTIONED
CENTER WE SUCCESSFULLY DROPPED
OUR UNINSURED RATE IN HALF. AND
I WOULD JUST LIKE TO SAY THAT.
THE OVERALL RESULT IS THAT THE
ACA MORE CALIFORNIANS CAN STAY
COVERED WHEN THEY CHANGE JOBS
HAVE A CHANGE IN CIRCUMSTANCES
OR OTHERWISE LOSE COVERAGE AND
MANY. CAN GET FINANCIAL HELP IF
THEY QUALIFY JUST A NOTE- ON
THE STE THE IMPACTS ON EQUITY
THAT- WE CAN SEE FROM THE ACA
SO ALL. RACIAL AND ETHNIC
GROUPS- FOUND IMPROVED HEALTH
INSURANCE RATES WITH THE LATINO
IS EXPERIENCING THE LARGEST
REDUCTION AND LOW INCOME
CALIFORNIANS AS WELL AS THE
SENATE SAN JOAQUIN VALLEY
REGION SAW SIGNIFICANT DECLINES
THAT WE HAVE TO MENTION MUST
MENTION THAT DESPITE THESE
IMPROVEMENTS. THERE ARE STILL
SOME VERY SERIOUS HEALTH
DISPARITIES IN THE RATE OF AN
INSURANCE. AMONG NON WHITE POP.
COMPARED TO WHITE POPULATIONS
SO ASKING THE QUESTION WHAT'S
AT STAKE IS WHAT WE CAN SEE IS
THAT THE ACA MADE VERY DRAMATIC
CHANGES IN VIRTUALLY ALL AREAS
OF PUBLIC AND PRIVATE COVERAGE.
THE UC BERKELEY LABORCENTER
ESTIMATES THAT CALIFORNIA COULD
END ONLY ANNUALLY LOSE TWENTY
SEVEN BILLION AND THEY JUST
CAME OUT WITH. INTENSELY TWO
HUNDRED NINETY NINE THOUSAND
JOBS IF THE ACA WAS REPEALED
ARE STRUCK DOWN. AND SO REALLY
SIGNIFICANTLY CALIFORNIA STANDS
TO LOSE MATCH OF THE HISTORIC
GAINS IT MADE IN THINKING ABOUT
IT YOU KNOW REALLY IN LESS THAN
A DECADE REALLY QUITE
ASTONISHING GIVING OUR HISTORY
PRIOR TO THE ACA. IMPROVING
ACCESS AFFORDABILITY AND
QUALITY OF HEALTHCARE. AND WITH
THAT I'D BE HAPPY TO ANSWER ANY
QUESTIONS THAT YOU MIGHT HAVE
FOR ME. OKAY THANK YOU I THINK
WHAT WE'LL DO IS WE'LL THEN
MOVE ON TO OUR SECOND SPEAKER-
AND THEN WE'LL TAKE QUESTIONS
FROM THE COMMITTEE. SO NEXT- WE
HAVE ON THE LEGAL STATUS OF THE
ACA MELANIE FOSTER RAINER- WITH
A SPECIAL ASSISTANT TO THE
ATTORNEY GENERAL AND THE
DEPARTMENT OF JUSTICE. WELCOME
HI THANK YOU DR HANNAH NUMBERS
THE COMMITTEE FOR HAVING US
HAVING ME HERE TODAY. AND MY
NAME IS MELANIE FONTANA RAINER
I'M A SPECIAL ASSISTANT HERE ON
BEHALF OF ATTORNEY GENERAL.
ETCETERA AND JUST A QUICK
UPDATE ON SORT OF WHERE WE ARE
THE LEGAL LEGAL MATTERS BEHIND
THIS CASE- IN TWENTY EIGHTEEN
SEVERAL OTHER AND STATES RED
STATES TEXAS. INTO INDIVIDUAL
PLAINTIFFS FILED A LAWSUIT
DECLARE THE AFFORDABLE CARE ACT
UNCONSTITUTIONAL AND INVALID-
THEY ASSERTED THAT WITH THE
TWENTY SEVENTEEN PASSAGE OF THE
REPUBLICAN TAX LAW- ALSO KNOWN
AS THE TAX CUTS AND JOBS ACT.
OF WHICH STYLE DOWN THE
INDIVIDUAL MANDATE PENALTY TO
ZERO DOLLARS THAT THE
INDIVIDUAL MANDATE WAS NO
LONGER CONSTITUTIONAL AND AS A
RESULT SINCE THE OTHER
PROVISIONS OF THE LAW ARE TIED
TO THE INDIVIDUAL MANDATE. THAT
ALL THE OTHER PROVISIONS
INCLUDING THOSE PROTECTIONS FOR
PEOPLE WITH PRE EXISTING
CONDITIONS MUST FALL- THE
ARGUMENT RELIES- SOLELY ON THE
SUPREME COURT'S TWENTY TWELVE
DECISION IN THE NATIONAL
FEDERATION OF INDEPENDENT
BUSINESS VERSUS A BILIOUS R.
AND F. ID. IN THAT DECISION A
FIVE JUSTICE MAJORITY OF THE
SUPREME COURT HELD THE ACA'S
INDIVIDUAL MANDATE WHICH
REQUIRED PEOPLE TO BUY HEALTH
INSURANCE OR MAKE A PAYMENT TO
THE IRS. BEFORE REACHING THAT
CONCLUSION THE COURT REASONED
THAT IF THE MANDATE WERE READ
AS A COMMANDS. IT WOULD BE
UNCONSTITUTIONAL BUT THE COURT
FOR THE REASON THAT THE
INDIVIDUAL MANDATE COULD BE
INTERPRETED AS A TAX. THAT IS
NEARLY TAX OF THOSE WHO CHOOSE
NOT TO HAVE HEALTH INSURANCE
COVERAGE AND IT WAS
CONSTITUTIONAL. IN TWENTY
SEVENTEEN WHEN CONGRESS REDUCE
THE AMOUNT OF THAT TAX ZERO
DOLLARS BUT LACKS THE ACTUAL
TAX AND LANGUAGE OF THE
INDIVIDUAL MANDATE- ON THE
BOOKS. WHICH PROVIDES THE
INDIVIDUALS SHALL MAINTAIN
HEALTH INSURANCE COVERAGE ON
THE TRUMP ADMINISTRATION AND
REPUBLICAN LED STATES EMBRACE
THIS IDEA THAT. THE AC WAS
INVALID- AN ACTION THAT WAS SO
OUT OF THE ORDINARY ATTORNEYS
AT U. S. DOJ RESIGNED AND TOOK
THEIR. NAMES OFF OF THE LEGAL
BRIEFS. CALIFORNIA'S LEAD COLOR
OF TO ONE STAY THAT. VERY EARLY
IN THIS CASE IN ORDER TO ENSURE
THAT THERE WAS A PARTY
DEFENDING THE AFFORDABLE CARE
ACT. AND HEALTH CARE IN TWENTY
NINETEEN THE HOUSE
REPRESENTATIVES INTERVENE IN
THE CASE FOR THE SAME REASON.
THE DISTRICT COURT ACCEPTED THE
PLAINTIFFS ARGUMENTS. AND THE
COURT OF APPEAL ACCEPTED THE
ARGUMENT THAT THE MANDATE IS
NOW UNCONSTITUTIONAL BUT DID
NOT DECIDE AS TO WHETHER THE
REST OF THE ACA SHOULD FALL IN
WAS INVALID. OUR COALITION
ASKED THE SUPREME COURT TO HEAR
THE CASE IN JANUARY. AND THE
COURT GRANTED OUR REQUEST. ON
AND I'M A MEMBER TENTH
CALIFORNIA SOLICITOR GENERAL
MICHAEL MUNGAN WILL BE ARGUING
THE CASE ON OUR BEHALF.
CALIFORNIA HAS PRESENTED THREE
ARGUMENTS WHY I BELIEVE WE
SHOULD WHEN THIS CASE FIRST WE
ARGUE THAT NO PLAINTIFF IN THIS
CASE HAS STANDING TO FILE THIS
LAWSUIT. STANDING AS MANY OF
YOU KNOW IS THE BASIC IDEA THAT
A PERSON CAN CHALLENGE A LOT IN
COURTS. AND MUST SHOW THAT THE
LAW CAUSES HIM OR HER SOME
INJURY. HERE THAT YOU
INDIVIDUAL PLAINTIFFS HAVE NO.
HARM BECAUSE THERE IS NO
PENALTY FOR NOT HAVING HEALTH
INSURANCE- SO A PENALTY OF ZERO
DOLLARS NO HARM THERE'S NO
NEGATIVE CONSEQUENCE. FURTHER
ON THE STATES THAT HAVE SUED.
ARE NOW NOT BURDEN AND ALSO NOT
HARMS BY ZERO DOLLAR INDIVIDUAL
MANDATE- SECOND WE ARGUE THAT
WHAT IS LEFT OF THE INDIVIDUAL
MANDATE REMAINS CONSTANT
CONGRESS HAS THE POWER TO DIAL
UP AND DIAL DOWN. ON TAXES AND
THEY DO THAT OFTEN AND SO IN
THE SAME WAY THAT THEY DIAL
DOWN THE MEDICAL DEVICE TAX AT
ONE POINT. THEY HAVE THE
AUTHORITY TO DIAL DOWN THE
INDIVIDUAL MANDATE PENALTY TAX-
AND THAT IS CONSTITUTIONAL NOT
AS WITHIN THEIR PURVIEW- AND
LAST EVEN IF THE COURT DECIDES
NOW THAT THE TOOTHLESS
INDIVIDUAL MANDATE ZERO DOLLAR
PENALTY IS. UNCONSTITUTIONAL
BUT IT SEVERABLE FROM THE REST
OF THE ECA. THIS LEGAL DOCTRINE
ASKED WHETHER IF ONE
PROVISIONAL LAW IS
UNCONSTITUTIONAL OTHER
PROVISIONS OF THE LAW MUST ALSO
BE HELD BALLOT. THIS BOILS DOWN
TO A QUESTION OF CONGRESSIONAL
INTENT. WHETHER IF CONGRESS HAD
KNOWN THAT ONE PROVISION OF THE
LOT IT DOC DID WAS
UNCONSTITUTIONAL. IT WOULD HAVE
PREFERRED TO KEEP THE REST OF
THE LAW OR SCRAP IT ENTIRELY.
HERE WE ARGUE THAT THE INTENT
OF THE CONGRESS- IN TWENTY
SEVENTEEN WAS ABSOLUTELY CLEAR.
BY GETTING RID OF THE ONLY
NEGATIVE LEGAL CONSEQUENCES FOR
HAVING HEALTH INSURANCE.
CONGRESS VERY INTENSELY KNEW
WHAT IT WAS DOING AND LEFT THE
REST OF THE LAW ON THE BOOKS-
AND THERE ARE MANY STATEMENTS
BY MEMBERS OF THE UNITED STATES
SENATE- WHERE IT'S VERY CLEAR
THIS ISN'T. EXPANSION THIS
ISN'T THE PRE EXISTING
CONDITION PROTECTIONS
ASSISTANCE- SUBSIDIES ECCENTRIC
SATCHER- AT THE SAME TIME
CONGRESS PRESERVED EVERY OTHER
FEATURE OF THE ACA CAPTAIN IN
TAX- AND- WE ARGUE THAT
CONGRESS IS INTACT ACTIONS IN
THIS CASE ARE CONCLUSIVE PROOF.
THAT IF THE INDIVIDUAL MANDATE
IN ITS PRESENT FORM IS
UNCONSTITUTIONAL. CONGRESS
WANTED THE REST OF THE ACA TO
REMAIN IN PLACE. AND THISCASE
IS LEGALLY. DANGEROUS AND IT'S
IRRESPONSIBLE TAKING WITH
PROTECTIONS REPEAT OF PRAISE
CONDITIONS MATTER X. COVER SUCH.
WERE FOR. COVERAGE FOR ADULTS
UP TO AGE TWENTY SIX PUBLIC
HEALTH INVESTMENTS THAT HELP
THE BUILDING LACKED CAPACITY.
AN EPIDEMIOLOGY EFFORTS AND
MORE DURING A PANDEMIC EVER
PURCHASED NOW IS WRONG- WE'VE
SEEN THIS TIME AND TIME AGAIN
BY THIS PRESIDENT WHO AND WHOSE
OWN WORDS WANTS TO EXPLODE THE
ECA. AND WE'VE DONE EVERYTHING
IN OUR POWER TO FIGHT HIS
SABOTAGE OF THE AFFORDABLE CARE
ACT- WE WILL CONTINUE TO. DO
THAT I'M A MEMBER TENANTS-
BECAUSE WE DON'T THINK THAT
HEALTH ARE SHOULD JUST BE FOR
THOSE WHO ARE HEALTHY OR RICH.
AND BECAUSE A MATTER WHERE YOU
LIVE WHAT YOUR HEALTH CARE
CONDITION IS HOW MUCH MONEY
MAKER WHO LOVES. HEALTH CARE
EMPOWERS US AND SHOULD BE
AVAILABLE TO ALL OF US- THE
CONTRAST HERE COULD NOT BE
STARKER WE ARE SUPPORTED BY A
BIPARTISAN COALITION OF
ECONOMISTS. LEGAL SCHOLARS
ATTORNEYS GENERAL MAJOR MEDICAL
ASSOCIATION ADVOCATES UNIONS
REPRODUCTIVE RIGHTS GROUPS L.
G. B. T. Q. I. A. AND CIVIL
RIGHTS GROUPS AND OTHERS.
HEALTH CARE IS ON THE LINE AND
WE WILL CONTINUE EVERYTHING. WE
CAN TO PROTECT IT THANK YOU.
THANK YOU SIR I MUCH. SO NOW
WILL TAKE ITS QUESTIONS FROM
MEMBERS FOR THEIR MEMBERS
PARTISAN REMOTELY USAID RAISE
YOUR HAND FEATURES I KNOW THAT
YOU WISH TO SPEAK I DO SEE
CENTER MONEY HAVING MICROPHONE
UP CEREMONY. ONE THANK YOU MR
CHIU AND- I DO WANT TO THANK.
THE CHIU THE COMMITTEE FOR
ORGANIZING THIS TIMELY AND
IMPORTANT HEARING. AND MY
QUESTION TO. EITHER OF THE
PANEL MEMBERS I WANT TO THANK
THEM FOR THEIR- ADDITIONS TO
THIS HEARING TODAY AND
ESPECIALLY THINK THE ATTORNEY
GENERAL SO FOR THEIR PURSUIT.
OF. BEING HEARD IN THIS COURT.
TO CHALLENGE THOSE WHO SEEK TO
INVALIDATE THE ACA. IN THE
NATIONAL DEBATE THERE'S BEEN
MUCH FOCUS ON. THE ISSUE A PRE
EXISTING CONDITION. AND I THINK.
BOTH OF YOU HELPED OUTLINE A
LITTLE FURTHE FROM WHAT WHAT
COULD BE LOST OR WHAT COULD BE
CONSIDERED A PRE EXISTING
CONDITION COVERT NINETEEN
PREGNANCY AT SETRA. ONE OF THE
ELEMENTS OF THE ACA THAT I
THINK DOESN'T GET ENOUGH. FOCUS
AND I WOULD LIKE YOUR FURTHER
COMMENTS. THE IMPORTANCE OF THE
ACA IN REMOVING LIFETIME CAPS.
ON INSURANCE COMPANIES
OBLIGATION TO PROVIDE INSURANCE
SOMEBODY SUFFERING FROM A
SERIOUS ILLNESS OR DISEASE OR
SERIOUS. ACCIDENT INJURIES
WOULD EITHER OF CARE TO COMMENT
TO LITTLE FURTHER. THE
IMPORTANCE OF HOW THE ACA HAS
REMOVED A LIFETIME CAPS IN WHAT
WOULD BE THE CONSEQUENCE NOT
JUST FROM A HEALTH PERSPECTIVE
BUT IN ECONOMIC PERSPECTIVE IF
THE LIFETIME CAP REMOVAL WERE
TO BE REVERSED. THANK YOU. OKAY
THE CENTER I'M BE HAPPY TO TAKE
A STAB AND MAYBE MELANIE ALSO
HONORED. YOU RAISE A REALLY
IMPORTANT- QUESTION- AND I
THINK GENERALLY I WAS TRYING
AND- TO REINFORCE WHAT YOU'RE
SAYING THAT YOU SEE IS THAT ONE
PROVISIONS AROUND PRE EXISTING
CONDITION IS A COMPREHENSIVE
FRAMEWORKS THAT MAKE SURE
PEOPLE WHO. EITHER HAVE HEALTH
ISSUES OR NEED HEALTH SERVICES
ARE NOT DISCRIMINATED AGAINST
RIGHT SO THE ANNUAL AND
LIFETIME LIMITS ESSENTIALLY
SAID. YOU ARE COVERED. BUT YOU
MAY ONLY USE- THIS MANY DOLLARS
WORTH OF SERVICES IN A YEAR.
AND MOREOVER IT COULD BE A
LIMIT OF A COUPLE HUNDRED
THOUSAND DOLLARS AND FOR PEOPLE
WITH THE MOST SERIOUS
CONDITIONS WHETHER IT'S CANCER.
OR WELL CANCERS THE BIG WHEN I
SUPPOSE BUT THERE ARE LOTS OF
CONDITIONS ARE YOU CAN EVEN
HAVE A MAJOR ACCIDENT- AND HAVE
THESE HIGH MEDICAL BILLS LONG
TERM NEED FOR ONGOING CARE. AND
SO AS I WAS SAYING I THINK AT
EVERY TURN IN THE PRE ACA
MARKET INDIVIDUALS COULD
EXPERIENCE DISCRIMINATION BASED
ON WHAT IS GOING ON WITH THEM
WHAT SERVICES THEY NEED OR
WHERE THEY'VE BEEN AND SO I
THINK IT IT'S DEFINITELY A
MAJOR ISSUE. AND AS I SAID IT'S
NOT JUST AN ISSUE FOR PEOPLE
BUYING INDIVIDUAL COVERAGE IT
IS LAYS ACROSS THE BOARD IN
TERMS OF EMPLOYER BASED
COVERAGE. AND SO A LOT MORE
PEOPLE ARE GOING TO BE AFFECTED
BY THINGS LIKE THE PROHIBITION
ON PRE EXISTING CONDITIONS. AND
THE ANNUAL AND LIFETIME LIMITS-
THEN MIGHT HAVE BEFORE- I HOPE
THAT ANSWERS YOUR QUESTION. YES
THANK YOU THAT IS HELPFUL IN
MAY BE ON THE LEGAL FRONT FROM
MISS RAINER WOULD HAVE A
COMMENT ON THE SEVERABILITY
ISSUE. THE SUPREME COURT COULD.
THE HELP WALK US THROUGH THIS
THAT COULD INVALIDATE SOME.
MANDATE WHICH THEY ALREADY DID
THE PENALTY MANDATE BUT RULED
THAT THE REST OF IT. IT
MAINTAINS AND IN THESE FOR.
PROTECTIONS THAT ARE STILL PART
OF EXISTING LAW. YEAH I MEAN I
THINK THAT SENATOR TO YOUR
QUESTION AND VERY INSIGHTFUL
POINT- THERE THERE ARE A NUMBER
OF THINGS THE SUPREME COURT
COULD DO HERE- AND YOU KNOW I.
DON'T WANT TO SPECULATE ON THAT
I DO THINK THEY ARE OF CAN
INSTEAD THROUGH ONE LIKE YOU
SAID THEY THEY COULD DECIDE
THAT THE INDIVIDUAL MANDATE IS
UNCONSTITUTIONAL LEAVE IT AT
THAT- THEY COULD ALSO DECIDE
INDIVIDUAL MANDATE IS
UNCONSTITUTIONAL AND THEN NOT
SEVERABLE FROM THE REST OF THE
LAW AND TAKE DOWN THE REST OF
THE LOT- ONE OF THE THINGS
THEY'RE RELYING ON IN THE
SEVERABILITY ARGUMENT BASED ON
THE NFIB DECISION- ARE SOME
LEGISLATIVE FINDINGS THAT
ACCOMPANIED THE AFFORDABLE CARE
ACT IN TWO THOUSAND TEN. AND
THOSE LEGISLATIVE FINDINGS-
WE'RE DYING TO SHOW THE
CONNECTION BETWEEN THE
INDIVIDUAL MANDATE AND SOME OF
THE OTHER PROVISIONS INCLUDING
GUARANTEED ISSUE IN SOME OF THE
PRE EXISTING CONDITION
PROTECTIONS AND SO I DO THINK
THERE ARE SOME WHO THINK IF
DECIDE TO MANDATE AND- THEY
MAKE. TO SEVER OFF THOSE
pBECAUSE THEY'RE TIED TOGETHER
AND USE LEGISLATIVE FINDINGS-
THAT BEING SAID THERE WOULD
STILL BE A GREAT AMOUNT OF HARM
AND IMPACTED TEAM STATES AND
PEOPLE ACROSS THE COUNTRY FOR A
DECISION LIKE THAT AND SO IN NO
WAY IS IT A MORE MODERATE
pYOU KNOW MANY MILLIONS OF
PEOPLE THAT WOULD BE IMPACTED
BY THAT AND WOULD BE- HARMS AND
SO- YOU KNOW I THINK WE ARE
CAUTIOUSLY OPTIMISTIC THAT-
TIME AND TIME AGAIN THE
AFFORDABLE CARE ACT HAS
SURVIVED AT THE SUPREME COURT.
AND YOU KNOW WE THINK WE HAVE A
STRONG CASE ANYTHING WERE
BACKED BY A BUNCH OF
BIPARTISAN- COALITION STATES
GROUPS AND SO WE'RE WE'RE
HOPEFUL THAT. THE COURT WILL
SEE IT THAT WAY TOO. THANK YOU
MUCH YOU MISTER CHAIR PRESHEAF
THE UPPER. THANK YOU SIR MINING
AND I'D A MOVE ON TO THAT
BEFORE I JUST WANTED KNOWLEDGE
YOUR LONG SERVICE IN THE
LEGISLATURE AND YOUR LEADERSHIP
AND HEALTH CARE- I DON'T KNOW
WHETHER YOU'LL BE AT ANY
ADDITIONAL HEARINGS BEFORE- YOU
YOUR TERM ACTUALLY FORMALLY
ENDS BUT- I DO WANT TO
ACKNOWLEDGE AND THANK YOU SO
MUCH FOR YOUR LEADERSHIP AND
JUST ONLY BE MISSED OUT HERE
STATE SENATE. THANK YOU MAY
CHAIR SPENT ON HONOR AND A
PRIVILEGE THANK YOU THANK YOU-
NEXT UP I DO HAVE CENTER LEYVA
FOLLOWED BY SENATOR RUBIO SIR
LEYVA. TWENTY THIRD LEYVA. OKAY
I THINK I'M GOOD CAN YOU HEAR
ME WE CAN HEAR YOU EXCELLENT
THANK YOU MISTER CHAIR OF MY
QUESTION IS FOR MELANIE I THINK
YOU LAID OUT A GREAT CASE AS
SOMEONE WHO SPENT MOST OF THEIR
ADULT LIFE FIGHTING FOR HEALTH
CARE AND WOOD BEFORE I WAS IN
MY ROLE AS SENATOR- BECAME A
NAVIGATOR FOR THE- ACA OR THE
COVER CALIFORNIA AND WAS ABLE
TO SIGN UP FIVE HUNDRED PEOPLE
WHO DID NOT PREVIOUSLY HAVE
HEALTH CARE TO THE ACA WAS
ENACTED. IF I IF I WROTE THIS
DOWN BECAUSE THE THREE THINGS
THAT YOU THINK THAT WE HAVE
THAT ARE REALLY MAKE OUR CASES
THAT THE PLAINTIFFS- DO NOT
HAVE ANY STANDING IN THIS CASE
BECAUSE THEY HAVE NOT BEEN
HARMED- WHAT IS LEFT OF THE
INDIVIDUAL MANDATE IS
CONSTITUTIONAL AND CONGRESS CAN
DIAL IT UP OR DOWN IF THIS
PROVISION IS UNCONSTITUTIONAL
IT DOESN'T MEAN THAT THE REST
OF THE LAW IS UNCONSTITUTIONAL
WELL THAT MAKES PERFECT SENSE
TO ME- AND WITHOUT MAKING THE
OTHER SIDE'S CASE WHAT WOULD
THEY ARGUE- THAT WOULD
INVALIDATE THE- AFFORDABLE CARE
ACT. YES SIR SIR AND THANK YOU
SON OF THE LATE GAS. FOR YOUR
SERVICE AND- BEING NAVIGATOR
THAT'S REALLY WONDERFUL AND-
YEAH I THINK THE OTHER SIDE IS
COMPLETELY RELYING ON A COUPLE
OF THINGS HERE- THAT THEY'VE
YOU KNOW CONSISTENTLY HAVE. PUT
OUT IN THEIR PAPERS AND
FILIGS- BASED OFF OF THE NFIB
DECISION- THAT THAT MANDY WAS
NO LONGER CONSTITUTIONAL AND SO
EVERYTHING ELSE NOT SEPARABLE
AND WHAT THEY'RE USING AS A
JUSTIFICATION FOR THAT ARE
THESE LEGISLATIVE FINDINGS.
FROM THE ACA ITSELF THERE'S
ACTUALLY- A COUPLE OF FINDINGS
IN THE LAW AS IT WAS PASSED
THAT WERE DONE FOR COMMERCE
CLAUSE AND OTHER SORT OF
CONSIDERATIONS. AND THOSE
FINDINGS TIED TO GATHER
EVERYTHING AND SO THAT THAT IS
THE BASIS OF THEIR ARGUMENT
THAT- YOU DON'T NEED TO LOOK TO
WHAT MITCH MCCONNELL OR SUSAN
COLLINS SAID ON THE UNITED
STATES SENATE FLOOR TO FIGURE
OUT WHAT. DAIS TWENTY SEVENTEEN
CONGRESS MEN YOU SHOULD LOOK TO
THE LEGISLATIVE FINDINGS FROM
TWO THOUSAND AND TEN A CONGRESS
THAT HAD NO INSIGHT INTO OR
PURVIEW INTO WHAT THE TWENTY
SEVENTEEN CONGRESS WAS. DOING
AND YOU KNOW SEPARABILITY
DOCTRINE AS A AS A FLUID DOCTOR
OF LAW BUT I THINK YOU KNOW
GIVEN THE BODY OF STATEMENTS
AND ALSO THE CASE FIVE. I THINK
WE FEEL STRONGLY THAT. THAT
SHOULDN'T BE THE CASE THAT A
CONGRESS SEVEN YEARS AGO
SHOULDN'T BE IN THE CITING
FACTOR FOR WHETHER OR NOT THE-
BACKBONE OF OUR HEALTH CARE
SYSTEM EXIST. THEY YOU VERY
MUCH AND PLEASE KEEP UP THE
FIGHT WE APPRECIATE YOU. THANK
YOU SIR LABOR CENTER RUBIO.
THANK YOU MISTER CHAIR- I ALSO
WANT TO THINK OTHER PRESENTERS
SITES A LOT OF GREAT
INFORMATION BUT UP FOR ME
PERSONALLY WHEN I HEAR THINGS
OUT LIKE THE PRE EXISTING
CONDITIONS SUCH AS PREGNANCY
AND NOW WE KNOW THE PUBLIC
NINETEEN HAS COST A LOT MORE
YOU KNOW CAN CONCERNED I JUST
WANT TO ASK AND ANSWER TO PUT
IN A SITUATION WE DON'T HAVE
THE ANSWER BUT- WE DO KNOW THAT
AFTER NINE ELEVEN. IT TOOK
APPROXIMATELY TEN YEARS FIFTEEN
YEARS TO SEE THAT THE AFTER
EFFECTS OF WHAT THE FIRST
RESPONDERS HAD DEALT WITH
ANYTHING AS THE TRAGEDY WAS
UNFOLDING AND A LOT OF THEM
PERISHED YEARS LATER- ARE WE IS
THERE DATA ON CLUB IN NINETEEN
IN THE AFTER EFFECTS CURRENTLY
THAT WE HAVE AND IS IT USING
BEING USED AS PART OF THE
ARGUMENT. IN PARTICULAR I KNOW
PER A PERSONAL FRIEND WHO'S
DEALING WITH READING ISSUES AND
LONG ISSUES I MEAN IS THERE
DATA THAT WE ARE USING ACTUAL
RESEARCH. TO PROVIDE A SUPPORT
EVIDENCE. DESPITE SIR SENATOR
CAN UPON SORRY I HAPPY TO START
A TALK TALK A LITTLE BIT ABOUT
THAT SUIT AND CENTER IN OUR IN
OUR BIGGEST FREAKS WHICH WERE
HAPPY TO PROVIDE YOU AND YOUR
STAFF AND WE HAD MANY MANY
GROUPS PUBLIC HEALTH
ASSOCIATIONS- ECONOMISTS TALK
ABOUT SOME OF WHAT YOU'RE
GETTING AT THAT SORT OF WE
DON'T KNOW THE LONG TERM
IMPLICATIONS OF THIS- AND TALK
ABOUT SORT OF THE ECONOMIC
IMPACT OF THAT AND HEALTH
IMPACTS SO WE'RE HAPPY TO SEND
THOSE OVER THE ONLY THING I
WOULD FLAG IS MY MOM HAD CODED
THIS SUMMER SHE WAS IN THE
HOSPITAL SHE WAS ON A BREATHING
MACHINE. SHE WAS VERY VERY
SICK- AND LIKE YOU'RE SAYING
YOUR FRIEND IT'S NOT JUST CODED
SHE HAS JOINT PAIN NOW SHE HAS
BEEN MUSEUM ISSUES SHE GETS
VERY TIRED SHE HAS FOGGY BRAIN
AND SO I THINK YOU'RE RIGHT IN
THAT WE DON'T REALLY KNOW THE
TRUE IMPACT OF THAT WOULD SO
YOU KNOW PUTTING THE PRE
EXISTING CONDITION PROTECTIONS
ON THE LINE AT THIS POINT IT IS
SORT OF NONSENSICAL AND I THINK
SOMETHING THAT WILL HURT A LOT
OF PEOPLE IN CERTAINLY. AS WE
DON'T AS WE KNOW MORE MORE MORE
WE JUST DON'T KNOW WE DON'T
KNOW RIGHT NOW. YEAH OKAY.
SENATOR THIS IS- DEBRA. I WOULD
LIKE TO ADD THAT WE DO KNOW A
FEW THINGS AND I THINK IT'S
IMPORTANT TO SET THAT CONTEXT
WE KNOW THAT THE DECISION
BEFORE THE ACA THE DECISION ON
WHAT WOULD BE A PRE EXISTING
CONDITION HOW FAR BACK IT WOULD
GO WHAT WOULD COUNT WITH THE
RATIONALE ALL OF THOSE
DECISIONS WERE MADE BY THE
HEALTH PLANS WITH ZERO
GOVERNMENTAL OVERSIGHT. AND
THERE WAS NO LIMIT ON WHAT THEY
COULD SAY AND THEY DIDN'T HAVE
YOU KNOW THERE ARE LOTS OF
EXAMPLES ONE EXAMPLE THAT COMES
TO MY MIND IS THAT YOU COULD BE
DENIED COVERAGE BECAUSE YOU
WERE A BAD WEATHER BEYOND
NORMAL POTTY TRAINING YEARS AND
YOU COULD BE NOW S. FORTY YEAR
OLD PERSON AND YOU COULD BE
DENIED COVERAGE BASED ON THAT.
BASED ON ALLERGIES BASED ON
LOTS OF THINGS THAT WERE NOT
EITHER EVEN PRESENT IN YOUR
CURRENT HEALTH STATUS OR THAT
WERE NOT WHAT WE THINK OF AS
REALLY SERIOUS CONDITIONS SO
AND IT'S CERTAINLY LIKELY MORE
THAN LIKELY REALLY THAT THE
HEALTH PLANS WOULD JUST SAY
BECAUSE IT WAS A PRE EXISTING
CONDITION AND THEY DON'T REALLY
NEED TO MAKE A CASE TO ANYONE-
THAT THERE'S GOOD EVIDENCE FOR
THAT AND SO THAT'S REALLY WHY
IT'S SUCH A- FRIGHTENING
PROSPECT BECAUSE WE GO BACK TO
A TIME. AND THEY DIDN'T EVEN
AGREE WITH EACH OTHER YOU KNOW
DEPENDING ON THE HEALTH PLAN
THEY WOULD HAVE DIFFERENT
CRITERIA. AND STANDARDS FOR
THAT. THANK YOU SIR RUBIO- I
DID ALSO HAVE A QUESTION
PARTICULARLY FOR. DIFFICULT SIR
FALLING APART CENTER RUBIO SAID
CAN CAN YOU- PER DO YOU HAVE AN
ESTIMATE FOR THE NUMBER OF
PERCENTAGE OF AMERICANS PRIOR
TO THE ACA WHO HAD A PRE
EXISTING CONDITION SO WE TALK
ABOUT PRE EXISTING CONDITIONS
HOW MANY PEOPLE ARE YOU TALKING
ABOUT WHO MIGHT BE EITHER
DENIED HEALTH CARE COVERAGE OR-
HAVE TO PAY MUCH HIGHER RATES
FOR THEIR HEALTHCARE COVERAGE
BECAUSE OF PRE EXISTING
CONDITION HOW MANY. PEOPLE OR
WHAT PERCENTAGE OF PEOPLE HAD A
PRE EXISTING CONDITION I WANTED
HIM TO INSURANCE. PRIOR TO THE
EIGHT MONTHS YEAH THAT'S A GOOD
QUESTION CENTER I. A QUESTION I
SHOULD HAVE DEFINITELY LOOKED
UP BEFORE THE HEARING BUT MY
RECOLLECTION IS THAT- IN THE
TIME PERIOD. BEFORE THE ACA WE
CAN EXPECT THAT 2230% OF PEOPLE
WITH BUDGET BE DENIED HEALTH
INSURANCE. AT A MINIMUM THOSE
WHERE THE LOW ESTIMATES. AND
REMEMBER THERE WAS LOTS AND
LOTS OF PEOPLE WHO UNDERSTOOD
THE WORLD AND DIDN'T EVEN
APPLY- WHEN THEY HAD HEALTH
CONDITIONS AND WE HAD A VERY.
INSUFFICIENT PROGRAM FOR PEOPLE
WHO HAD BEEN AND DENY COVERAGE
THEY THEY HAD TO DENY ALL FROM
TWO DIFFERENT COMPANIES THEY
COULD BE IN OUR HIGH RISK POOL
AT THE TIME AND- IT WAS A
QUITE. A QUITE A DIVERSE ARRAY
OF REASONS BUT SO I THINK.
PROBABLY SOMEWHERE IN THAT
RANGE IS THE NUMBER 2230% OF
AMERICANS HAVE DEPENDING ON HOW
YOU THINK ABOUT IT. AND I THINK
THOSE ESTIMATES ARE ALWAYS LOW
BECAUSE I DO THINK PEOPLE GO TO
THESE BROADER HEALTH CONDITIONS
THAT YOU WOULD EXPECT MIGHT BE
A PREVIOUS LIKE HEART DISEASE
LIKE CANCER LIKE AIDS HIV.
THOSE KINDS OF OBVIOUS LAW-
EXPENSIVE CONDITIONS BUT I
DON'T THINK THEY REALLY TAKE
INTO ACCOUNT HOW BROAD THE
CRITERIA THE HEALTH PLANS FOR
USING AT THE TIME. AND THAT
JUST WOULD ADD EVEN TO THE
NUMBER OF PEOPLE WHO WOULD NOT
BE ELIGIBLE. THANK YOU AFTER
THAT- WHAT THE MIRACLE OF- THE
INTERNET I WAS ABLE TO LOOK UP
A QUICKLY. YEAH DEPARTMENT
HEALTH AND HUMAN SERVICES OF
THE FEDERAL GOVERNMENT THE
CENTERS FOR MEDICARE MEDICAID
SERVICES SAID I THINK IT DOES
SPEAK TO SEE SOME VARIABILITY
IN TERMS OF HOW THE MEASURE
THAT- NINETEEN TO FIFTY
PERCENT. ONE IN TWO AMERICANS.
AT AT EIGHT PREVIOUS IN
CONDITION WHEN IT CAME TO
HEALTH CARE COVERAGE. SO I
THINK WE NED TO THINK ABOUT
THAT WHEN WE TALK ABOUT
OVERTURNING THE ACA WE'RE
TALKING ABOUT SOMETHING THAT
COULD AFFECT HALF OF ALL
AMERICANS- IN TERMS OF
DURABILITY GET HEALTHCARE
OVERAGE AT. AT AFFORDABLE
RATES AND FAIR RATES SO. I
APPRECIATE THAT. SO I WOULD DO
IF THERE ARE ANY OTHER
QUESTIONS. COMMITTEE MEMBERS
OKAY SEE NO HANDS UP. SO I JUST
WANT THAT AGAIN THANK BOTH
DEBRA COACH AND MELANIE. RAYNER
FUND IS RAINER SO MUCH FOR YOUR
EXCELLENT PRESENTATIONS AND
THAT TELLING US GIVING US THIS
OVERVIEW AND ALSO THE LEGAL
STATUS AND SOME OF THE LEGAL
ARGUMENTS- CERTAINLY I THINK
WERE- HERE TO TRY TO UNDERSTAND
WHAT WOULD HAPPEN IS. THE
SUPREME COURT UNFORTUNATELY.
RULES IN A WAY- AT AND THIS IS
A- COURT CASE THAT IS BEEN
BROUGHT FORTH. BY A-
FORTUNATELY- SOME REPUBLICAN-
ATTORNEY GENERAL THEY BELIEVED
AND SUPPORTED STRONGLY BY
SUPPORT PRESIDENT TRUMP AND HIS
DEPARTMENT JUSTICE TO STRIP
AWAY COVERAGE FROM- POTENTIALLY
HALF OF ALL AMERICANS- SO.
LET'S NOW FOCUS MORE ON
CALIFORNIA IMPACTS SO AGAIN
THANK YOU SO MUCH FOR PEACE
PANEL AND- FOR THIS PANEL WE
HAVE. PETER LEAVES I GIVE
DIRECTOR OF COVERED CALIFORNIA
WILL LATE BORN- IS DIRECTOR OF
THE PART OF HEALTH CARE
SERVICES WITH JC COOPER'S ARE
STATE MEDICAID DIRECTOR. AND
THEN- FINALLY BEN JOHNSON WHO
IS THE PRINCIPAL FISCAL POLICY
ANALYST AT THE LEGISLATIVE
ANALYST'S OFFICE SO WE'RE-
GOING TO START WITH THAT PETER
LEAVE. WITH A COVERED
CALIFORNIA WELCOME. DR PAM THEN
MEMBERS OF THE COMMITTEE ON
PETERLEE AND I'M THE EXECUTIVE
DIRECTOR OF COVERED CALIFORNIA
CALIFORNIA STATE BASED
MARKETPLACE OF THE AFFORDABLE
CARE ACT. I THANK YOU FOR THE
OPPORTUNITY TESTIFIED TODAY IS
REALLY IMPORTANT HERE AND- THEN
I'M GOING TO PROVIDE MORE
DETAIL IN MY WRITTEN TESTIMONY.
SO MORE THAN TEN YEARS AFTER
ITS PASSAGE MANY OF THE
TRANSFORMATIVE POLICY
AFFORDABLE CARE ACT. ARE NOW
GENERATING PROGRESS. YOU'VE
TALKED A LOT ALREADY ABOUT THE
POLICIES PROTECTING CONSUMERS
WITH PRE EXISTING CONDITIONS.
BUT ANOTHER POLICIES THAT
REQUIRE INSURERS TO MEET
MINIMUM COVERAGE STANDARDS AND
PLAY BY A NEW SET OF RULES
DESIGNED TO PROTECT CONSUMERS.
FREE PREVENTIVE SERVICES ARE
NOW THE LAW WITH THE OF
EMPLOYER COVERAGE WE'RE IN A
MARKET PLACE OR MEDICAL. NO
ANNUAL LIFETIME CAP ON MEDICAL
EXPENSES. MAKING COVERAGE
AFFORDABLE FOR MILLIONS BY
EXPANDING MEDICAID AND
PROVIDING FINANCIAL HELP
THROUGH MARKETPLACES LIKE
COVERED CALIFORNIA. THESE KEY
PILLARS OF THE LAW HAD BECOME
ALMOST UNIVERSALLY ACCEPTED BY
AMERICANS ACROSS THE POLITICAL
SPECTRUM. THEY INSURE MILLIONS
OF CONSUMERS HAVE ACCESS TO
MEANINGFUL COVERAGE THEY GIVE
THEM CRITICALLY IMPORTANT
HEALTH AND FINANCIAL
PROJECTIONS. OF THE NATION
ESPECIALLY THE TIME ABOUT
ECONOMIC AND HEALTH CARE CRISIS
WE SHOULD NOT BE LOOKING TO.
BUT UNDER CUT OR INVALIDATE THE
AFFORDABLE CARE ACT WE SHOULD
BE LOOKING TO BUILD ON IT. SO
CALIFORNIA HAS EMBRACED THE
AFFORDABLE CARE ACT AND COVERED
CALIFORNIA HAS USED ALL THE
TOOLS OF THE LAW AS WELL AS
ADDITIONS ENACTED BY THIS
LEGISLATURE AND GOVERNOR'S TO
BUILD A STRONG AND SUSTAINABLE
INDIVIDUAL MARKET. THAT NOT
ONLY PROVIDE SUBSIDIES TO MANY
CALIFORNIANS BUT WE'VE ALSO
HELP KEEP HEALTHCARE PREMIUMS
DOWN. BENEFITING THOSE WHO DO
NOT GET SUBSIDIES. TAKEN
TOGETHER CALIFORNIA'S EFFORTS
TO MAKE A SIGNIFICANT
DIFFERENCE FOR CONSUMERS.
YOU'LL HEAR A MOMENT FROM WILL
I BORN AND J. C. COOPER ABOUT
THE MILLIONS OF CALIFORNIANS
WHO HAVE BENEFITTED FROM
EXPANDED MEDICAID ELIGIBILITY.
THE INDIVIDUAL MARKET
CALIFORNIA HAS SEEN PREMIUM
INCREASES OVER THE PAST SIX
YEARS BETTER THAN HALF OF THOSE
OF FEDERALLY FACILITATED
MARKETPLACE STATES. IN THE
CONTEXT OF THE COLD NINETEEN
PANDEMIC. LEVERAGING AND
BUILDING ON THE AFFORDABLE CARE
ACT IS MORE IMPORTANT THAN EVER
AND WE IN CALIFORNIA HAVE
RESPONDED. ACTIVELY TO THE
DIRECT BENEFIT OF HUNDREDS OF
THOUSANDS OF CALIFORNIANS
INSURED TODAY BECAUSE OF WHAT
WE'VE DONE AND MORE PEOPLE THAN
WE EVER INJURED BEFORE. WE'RE
NOW HEADING INTO OPEN
ENROLLMENT. FOR TWENTY TWENTY
ONE WITH A ALL TIME HIGH OF
OVER ONE POINT FIVE MILLION
RENEWING ENROLLEES. AT ALL TIME
LOW OF A ZERO POINT 5% PREMIUM
INCREASE FOR NEXT YEAR.
REVERSING THE GAINS WE HAVE
MADE OVER THE PAST TEN YEARS
WOULD BE CATASTROPHIC. FOR
MILLIONS A RELIABLE LAW FOR THE
FINANCIAL HELP IN CRITICAL
CONSUMER PROTECTIONS THAT EMIT
HEALTH COVERAGE ACCESSIBLE FOR
SO MANY. ABOUT A CRITICAL POINT
IS AT THE CORE PROVISIONS OF
THE AFFORDABLE CARE ACT OR
WALDRON TIGHTLY TOGETHER. MAKE
IT IMPOSSIBLE TO REMOVE SOME
SECTIONS WITHOUT CAUSING GRAVE
HARM TO MILLIONS OF AMERICANS.
IT ACTUALLY HEARD RECENTLY A
LOT OF FEDERAL PROPOSALS TO
POTENTIALLY PROTECT PEOPLE WITH
PRE EXISTING CONDITIONS. BUT
NOT ADDRESS OTHER PROVISIONAL
LAW. NOT SAYING YOU HAVE A
POLICY THAT CAN PRESERVE
PREEXISTING CONDITION
PROTECTIONS OF THE ACA WITHOUT
ADDRESSING THE OTHER ELEMENTS
IS LIKE SAYING WE WILL KEEP A
PLANE IN THE AIR BY PROTECTING
ITS WINGS. BUT NOT MAKING SURE
THE PLAN AS AN ENGINE A RUNNER
OR LANDING GEAR. ONE AIRPLANE-NEEDS WINGS TO FLY IT ALSO
NEEDS OTHER CORE ELEMENTS TO
GET PASSENGERS SAFELY TO WHERE
THEY'RE TRYING TO GET. TO SAY
YOU CAN SEPARATE OUT PRE
EXISTING CONDITION PROTECTIONS
FROM THE OTHER CORE ELEMENTS OF
THE ACA SUCH AS SUBSIDIES AND
THE CHANGES TO OTHER INSURANCE
ROLES IS BOTH ECONOMIC AND
HEALTH CARE FALLACY.
ADDITIONALLY THE COMMITTEE
SHOULD BE AWARE THAT THE
AFFORDABLE CARE ACT PROVIDES
APPROXIMATELY SEVEN BILLION
DOLLARS TO CALIFORNIANS IN THE
FORM OF THE FEDERAL PREMIUM
SUBSIDIES TO MAKE COVERAGE.
MORE AFFORDABLE THROUGH COVER
CALIFORNIA. NINE OUT OF TEN OF
OUR ENROLLEES GET THOSE
SUBSIDIES. THIS FEDERALLY
FUNDED FINANCIAL ASSISTANCE IS
AN ESSENTIAL ELEMENT. OF MAKING
COVERAGE REAL FOR CONSUMERS.
THE PROMISE OF THE ACTIONS THAT
OUR STATE HAS TAKEN TO EMBRACE
THE BILL ON THE AFFORDABLE CARE
ACT WILL NOT BE REALIZED IF
CONSUMERS ARE PRICED OUT OF
COVERAGE. WHEN IT COMES THE
AFFORDABLE CARE ACT COVER
CALIFORNIA'S STRONG WERE STABLE
WE'RE WELL POSITIONED. TO
CONTINUE OUR ROLE OF THE
ROLLING CALIFORNIANS IN
AFFORDABLE AND QUALITY
COVERAGE. OPEN ENROLLMENT RIGHT
AROUND THE CORNER WERE POISED
TO LAUNCH A BIG STATEWIDE
CAMPAIGN. THE WILL HELP CUT
THROUGH THE NOISE AND REASSURE
CONSUMERS THAT WERE HERE
NATURAL. BUT WHAT WE RIGHTLY
DISCUSSED CONCERNS ABOUT THE
POTENTIAL OUTCOME THE
CALIFORNIA VERSUS TEXAS AND I
WANT TO DO A HUGE CALL OUT OF
APPRECIATION TO ATTORNEY
GENERAL BECERRA. WHO'S LED THE
NATION IN DEFENDING THE
AFFORDABLE CARE ACT. WE NEED TO
BEAR IN MIND THAT WE MAY BE AT
A POINT WHERE BUILDING ON THE
AFFORDABLE CARE ACT FEDERALLY
COULD ONCE AGAIN BE FRONT AND
CENTER. AS STRONG AS THE
AFFORDABLE CARE ACT IS WE NEED-TO CONTINUE TO BUILD AND
STRENGTHEN THE LAW. AND ADDRESS
REAL AFFORDABILITY CHALLENGES
THAT ARE THERE TODAY WITH THE
AFFORDABLE CARE ACT. WE NEED TO
BETTER ADDRESS RACIAL AND
ECONOMIC RACIAL AND ETHNIC
DISPARITIES IN HEALTH CARE. WE
NEED TO ADDRESS THE FRAGILITY
AND OFTEN ADEQUACY OF CURRENT
EMPLOYER SPONSORED INSURANCE.
THAT SHOULD BE WHAT WE'RE
TALKING ABOUT. AGAIN THANK YOU
DR PANDA MEMBERS THE COMMITTEE
FOR THE OPPORTUNITY TO
PARTICIPATE. DURING TODAY'S
HEARINGS PUBLIC BORDER
RESPONDED ANY QUESTIONS YOU MAY
HAVE AFTER THE TESTIMONY FROM
THE OTHER ABLE WITNESSES THANK
YOU. THANK YOU SO MUCH
PETERLEE- LET'S NOW MOVE ON TO-
WILL LIGHT BORN DIRECTOR OF
HEALTH CARE SERVICES IN G. C.
COOPER OR STATE MEDICAID
DIRECTOR AND CHIEF DEPUTY
DIRECTOR DEPARTMENT OF CARE
SERVICES A SENIOR TAG TEAMING
IT. GOOD ACTUALLY. WE HAVE
TRANSITIONED OVER-
UNFORTUNATELY I DR- DIRECTOR
LIKE PORN IS NOT ABLE TO SB
TODAY HE APOLOGIZES FOR HIS
ABSENCE AND SO I WILL. PROVIDE
THE TESTIMONY THIS MORNING AND
ANSWER ANY QUESTIONS ON BEHALF
OF. A MEDIC CAL AND SO I AM DC
COOPER THE CALIFORNIA STATE
MEDICAID DIRECTOR. I HATE TO
SAY THE ACA LEAD TO SIGNIFICANT
CHANGES IN COVERAGE EXPANSION
IS AN UNDERSTATEMENT- IT HAS
EXPANDED. OUR COVERAGE ACROSS
MEDIC CAL IN THE BROADER
HEALTHCARE DELIVERY SYSTEM IN
ECONOMY AND CALIFORNIA. IT HAS
BEEN A CATALYST FOR PAYMENT AND
DELIVERY SYSTEM REFORMS THAT
NOT ONLY TRANSFORMED WHO HAS
COVERAGE. BUT HOW IT'S PAID
FOR. MANY SPEAKERS BEFORE ME
HAVE HIGHLIGHTED THE PROFOUND
IMPACT THE ACS HAD ON
CALIFORNIANS AS A WHOLE. I WILL
FOCUS MY COMMENTS ON THE IMPACT
A TWO MINUTE CAL. ONE IN THREE
CALIFORNIANS GET THEIR CARE
THROUGH MEDICAID. MAKING DH CS
THE ARGEST HEALTHCARE
PURCHASER IN CALIFORNIA.
MEDICAID EXPANSION HAS HELPED
ON MANY LOW INCOME WORKERS AN
ESSENTIAL WORK PLACES ARE
INDUSTRIES WERE OFTEN NOT AFTER
JOB COVERAGE TO HAVE HEALTH
CARE COVERAGE. SOMETHING THAT
HAS BEEN INVALUABLE DURING THE
PUBLIC HEALTH EMERGENCY AND OUR
RESPONSE TO COPE IN IN
CALIFORNIA. ESEA HAS PROVIDED
MORE FINANCIAL SECURITY AND
OPPORTUNITIES FOR ECONOMIC
MOBILITY. RESEARCH SHOWS THAT
THE MEDICAID EXPANSION HAS MADE
IT EASIER FOR PEOPLE TO AFFORD.
NEEDED HEALTHCARE WHICH REDUCES
MEDICAL DEBT. PROBLEMS WITH
PAYING BILLS AND ADDICTIONS
ABOUT THE VICTIMS FELL 20% IN
EXPANSION STATES COMPARED TO
NON EXPANSION STATES AFTER
EXPANSION TOOK EFFECT. THIS IS
JUST ONE EXAMPLE OF NON HEALTH
IMPACT. OF THE ECA AND HOW IT
HAS HELPED IN BENEFITTED MANY
CALIFORNIANS IN PEOPLE ACROSS
THE NATION. TO SAY THAT THE ACA
IS HAVING A DIRECT IMPACT ON
MEDIC HOW. IS PROFOUND IMPACT
IT IMPACTS ELIGIBILITY FUNDING.
BENEFITS A VARIETY OF THE I'VE
BEEN A YOUR PROTECTION. SOON
I'M GONNA HIGHLIGHT A VARIETY
OF DIRECT IMPACT ON CAL I WILL
INCLUDE KIND OF. AN ELEGY
NUMBER TO PROVIDE CLIENTS TO
THE IMPACT OF SOMETHING LIKE
THE ACA. BEING ELIMINATED OR
REPEALED. AS MANY YEAR WHERE
THE ACA ESTABLISHED NEW
OPTIONAL. GROUP THAT HAS
CURRENTLY ASK FUNDED WITH 90%
OF FEDERAL FUNDING. THIS
REPRESENTS AN EIGHTEEN POINT
FIVE BILLION FEDERAL FUNDS IN
OUR CURRENT CALIFORNIA BUDGET.
IT ALSO INCLUDES COVERAGE FOR
OVER THREE POINT EIGHT MILLION
ADULTS IN CALIFORNIA. THE ACA
ALSO SIMPLIFIED ELIGIBILITY
RULES WHICH ELIMINATED
CONSIDERATION ASSETS AND
RESOURCES. FOR MOST NON ELDERLY
POPULATIONS I WHICH INCREASED
ENROLLMENT AMONG EXISTING
MEDICAL POPULATIONS SUCH AS
CHILDREN FROM FOUR POINT NINE
MILLION IN. TWO THOUSAND
THIRTEEN TO FIVE POINT TWO
MILLION IN TWENTY TWENTY.
FURTHERMORE IT ALLOWED YOUNG
ADULTS TO REMAIN ON THEIR
PARENTS HEALTH INSURANCE PLANS
UNTIL TWENTY SIX WHICH ALLOWED
FORMER FOSTER YOUTH TO RETAIN
MEDI CAL COVERAGE AND TELL
TWENTY SIX. WE CURRENTLY COVER
TWENTY TWO THOUSAND FORMER
FOSTER YOUTH UNDER THESE
PROVISIONS. IT ALSO ALLOWS FOR
HOSPITAL PRESUMPTIVE
ELIGIBILITY WHICH STREAMLINES
ENROLLMENT FOR THOSE WITH
IMMEDIATE NEEDS AND HELP
REDUCES UNCOMPENSATED HEALTH
CARE COSTS. WE CURRENTLY COVER
THIRTY THREE THOUSAND
INDIVIDUALS UNDER HOSPITAL
PRESUMPTIVE ELIGIBILITY EVERY
MONTH AND MEDICAL. THE IMPACT
THE AC IS HAD ON OUR SAFETY NET
IS SIZABLE. THE EXPANSION OF
MEDICARE HOW REDUCE COSTS FOR
CALIFORNIA COUNTY NEEDS AND
SAFETY NET FOR DOCTOR WRITERS I
REDUCING THE NUMBER OF
UNINSURED AND SHIFTING COSTS
FROM THE NEWLY ELIGIBLE
POPULATION TO THE STATE AND
FEDERAL GOVERNMENT. YOU TO THE
ACA UNCOMPENSATED CARE COSTS
FOR CALIFORNIA HOSPITALS
DECLINE FROM APPROXIMATELY FIVE
POINT TWO BILLION. IN TWENTY
TWENTY THREE. A TWO BILLION IN
TWENTY TWENTY. ALSO HIGHLIGHTS
SOME OF THE ADDITIONAL BENEFITS
BROUGHT FORTH BY THE ACA IN
MEDICAL. IN ADDITION TO
ENHANCING FUNDING FOR
PREVENTIVE SERVICES WHICH ARE
CLEARLY NEEDED FOR OUR CHILDREN
AND ADULTS IN THAT ACCOUNT. BUT
TO COMPLY WITH THE ESSENTIAL
HEALTH BENEFITS STANDARD IN THE
ACA MEDICAL ALSO ADDED NEW
BENEFITS FOR ALL POPULATIONS
INCLUDING BUT NOT LIMITED TO
MILD TO MODERATE MENTAL HEALTH
SERVICES. AND SUBSTANCE USE
DISORDER SERVICES AS WELL AS
THINGS LIKE CARDIAC AND
PULMONARY REHABILITATION. WITH
AN OPTIONAL EXPANSION COVERAGE
MANY ADULTS ARE ALSO RECEIVING
INCREASED ACCESS TO SPECIALTY
MENTAL HEALTH SERVICES AND
SUBSTANCE USE DISORDER SERVICES
DELIVERED BY THE COUNTIES IN
CALIFORNIA. IF THE ACA'S
REPEALED THIS COULD MEAN
INCREASED DEMAND FOR SERVICES
PROVIDED FOR NON MEDICAL
PROGRAMS AND COUNTIES MAY NOT
HAVE SUFFICIENT RESOURCES FOR
THOSE PROGRAMS. FULLY ABSORB
THE INCREASED DEMANDS. ECA ALSO
PROVIDED STATES WITH ADDITIONAL
FUNDING FOR I JUST ASKED NEARLY
FIRST CHOICE OR WHAT'S KNOWN AS
CISCO. CIPRO RECIPIENTS MAKE UP
43% OF THE OVERALL I JUST AS
POPULATION WHICH COULD HAVE
SIGNIFICANT IMPACTS ON MEDIC
HOUSE MOST VULNERABLE. WE ALSO
CONVERTED OUR PRIOR FAMILY
HEALTH PLANNING DEMONSTRATION-
WHICH ALLOWS SPORTS FANS THE
ELIGIBILITY TO THE STATE PLAN
THIS IS KNOWN AS F. PACKED
PROGRAM THE ACA GIVE HIGHER
REIMBURSEMENT ARE REBATES. FOR
COVERED DRUGS AND MADE
IMPROVEMENTS IN THE THREE FORTY
B. PROGRAM- INTEGRITY. WE ALSO
IT ALSO CONTAINED A NUMBER OF
DEMONSTRATION PROGRAMS- THAT
ALLOW CALIFORNIA TO ROLL OUT
THINGS LIKE OUR HEALTH HOMES
PROGRAM OR THE COUNTY CONNECT
DEMONSTRATION. AS YOU CAN SEE
THE ACA HAS ENABLED CALIFORNIA
TO LEVERAGE MEDIC HOW AS A TOOL
TO ADDRESS MANY OF THE COMPLEX
CHALLENGES FACING CALIFORNIA'S
MOST VULNERABLE RESIDENTS- WELL
TAKING A POPULATION HEALTH.
PERSON CENTERED APPROACH
PROVIDING SERVICES AND
IMPROVING OUTCOMES FOR ALL
CALIFORNIANS AS DEBRA MENTIONED
EARLIER- IS ALSO HELPED REDUCED
HEALTH DISPARITIES AND
INEQUITIES. WHICH IS SO
CRITICAL AT THE TIME AS A TIME
RIGHT NOW. TRACKING DOWN THE
ACA WOULD BE DISASTROUS FOR A
STATE BY CALIFORNIA AS WELL AS
THE ENTIRE NATION. IN UNDOING
THE PROGRESS WE HAVE MADE TO
PROVIDE HEALTH CARE TO MILLIONS
IT WOULD HARM COMMUNITIES AND
PROVIDERS WHO ARE PARTICULARLY
VULNERABLE UNDER THE PUBLIC
HEALTH AND ECONOMIC IMPACT OF
COPING. I'D BE HAPPY TO ANSWER
ANY QUESTIONS AT THE COMMITTEE
ON. THANK YOU DAISY COOPER- WE
WILL TAKE QUESTIONS AT THE END
OF THE PANEL- LET'S NOW MOVE ON
TO BEN JOHNSON AS THE PRINCIPAL
FISCAL POLICY ANALYST FOR
LEGISLATIVE ANALYST'S OFFICE.
HI YEAH GOOD AFTERNOON MISTER
CHAIR AND MEMBERS ON BEN
JOHNSON WITH THE LEGISLATIVE
ANALYST'S OFFICE. WE'VE BEEN
ASKED BY THE COMMITTEE TO
PROVIDE AN OVERVIEW OF THAT
CALIFORNIA FISCAL IMPACT IF THE
ACA WERE AND OVERTURNED IN ITS
ENTIRETY- AND WE FIRST JUST
WANT TO RECOGNIZE THAT THE
STATUS AS WAS PREVIOUSLY
DESCRIBED OF THE ACA. IS HIGHLY
UNCERTAIN AND THAT THERE ARE
MULTIPLE DIRECTIONS OF THE
SUPREME COURT COULD GO IN ITS
RULING INCLUDING OVERTURNING
THE LAW COMPLETELY UPHOLDING
THE LAW ON ITS ENTIRETY. OR
OVERTURNING SELECT PROVISIONS
AND THE OLD AND ULTIMATELY THE
FISCAL IMPACTS IN CALIFORNIA
FROM THE SUPREME COURT'S
DECISION WILL DEPEND
SIGNIFICANTLY ON WHICH OF THESE
DIRECTIONS THE SUPREME COURT
CHOOSES TO GO. WE DO HAVE A
HAND OUT- THAT WAS SHARED WITH
THE COMMITTEE THAT WILL FORM
THE BASIS FAR REMARKS AND THE
PUBLIC CAN ACCESS THIS HANDOUT
BE OUR WEBSITE. THE PREVIOUS
TESTIFIES PROVIDED AN EXCELLENT
OVERVIEW OF WHAT THE ACA DID
AND IT'S UNCERTAIN LEGAL STATUS
SO OFTEN GETS ON THE FISCAL
IMPACT OF THE ACA BEING
OVERTURNED. STARTING ON PAGE
TWO OF OUR HAND OUT WE ESTIMATE
THAT THE ACA DIRECTLY PROVIDES
TWENTY FIVE BILLION DOLLARS IN
FEDERAL FUNDING ON AN ANNUAL
BASIS TO CALIFORNIA STATE
GOVERNMENT LOCAL AGENCIES IN
THE STATE RESIDENTS. I KNOW
THAT THIS THIS THERE IS A
DISCREPANCY BETWEEN PREVIOUS
ESTIMATES BUT THAT'S REALLY
ONLY DUE TO A FISCAL YEAR
DIFFERENCE. AS WE HAVE PROVIDED
ESTIMATES FOR TWENTY NINETEEN
TWENTY WELL SIGNIFICANT
ADDITIONAL FEDERAL FUNDING IS
ESTIMATED- IN PART DUE TO THE
PANDEMIC. IN TWENTY TWENTY
TWENTY ONE. OVERTURNING THE
ENTIRE ACA WITHOUT REPLACEMENT
WOULD RESULT IN THE LOSS OF
THIS TWENTY FIVE BILLION
DOLLARS IN ANNUAL FEDERAL
FUNDING FOR THE STATE. WHICH
WOULD HAVE MAJOR NEGATIVE
CONSEQUENCES FIRST IT WOULD
SIGNIFICANTLY DISRUPT THE
STATE'S NEW ROUGHLY FOUR
HUNDRED BILLION DOLLAR
HEALTHCARE INDUSTRY WITH
PARTICULAR IMPACT ON PROVIDERS
THAT FORM THE SOCIAL SAFETY
NET. AND SECOND IT WOULD PLACE
AT RISK HEALTH CARE COVERAGE
FOR MILLIONS OF CALIFORNIANS
WHOSE HEALTH COULD SUFFER
SIGNIFICANTLY AS A CONSEQUENCE.
NEXT UP TURN TO SOME OF THE
POTENTIAL IMPACT OF SPECIFIC
IMPACTS OF OVERTURNING THE ACA.
AS YOU CAN SEE ON PAGE FOUR OF
THE HAND OUT UNDER THE ACA
MEDICOS GROWN SIGNIFICANTLY
BOTH IN TERMS OF ENROLLMENT AND
FUNDING. FROM TWENTY TWELVE
THIRTEEN A YEAR BEFORE THE ACA
GENERALLY TOOK AFFECT TO TWENTY
NINETEEN TWENTY ENROLLMENT IN
MEDI CAL BROUGH FROM NINETEEN
OR SEVEN POINT NINE MILLION
PEOPLE TO THIRTEEN MILLION
PEOPLE. OVER THE SAME TIME
PERIOD TOTAL ANNUAL FUNDING FOR
MEDICAL DOUBLED FROM FIFTY
MILLION FIFTY BILLION DOLLARS
TO ONE HUNDRED BILLION DOLLARS
WITH FEDERAL FUNDS ACCOUNTING
FOR OVER 75% OF THIS GROWTH IN
TOTAL FUNDING. AND WHILE SUCH
GROWTH CANNOT EXCLUSIVELY BE
ATTRIBUTED TO THE ACA IS
WITHOUT QUESTION THAT THE ACA
PLAYED A MAJOR ROLE IN THIS
GROWTH OF THE MEDICARE PROGRAM.
PRESS THE LARGEST CHANGE THE
ACA BROUGHT FOR MEDIC CAL IS
WHAT ULTIMATELY BECAME KNOWN AS
THE ACA OPTIONAL EXPANSION
WHICH EXPANDED MEDICAID
COVERAGE FOR THE FIRST TIME TO
CHILDLESS ADULTS. IN CONTRAST
TO TRADITIONALLY ELIGIBLE
ENROLLEES THE FEDERAL
GOVERNMENT PAYS 90% OF THE COST
OF COVERAGE FOR THE OPTIONAL
EXPANSION. CALIFORNIA ADOPTED
THIS EXPANSION AT ITS FIRST
OPPORTUNITY IN TWENTY FOURTEEN
AND TODAY AT THREE POINT SEVEN
MILLION MEDICAL MEMBERS ARE
COVERED THROUGH THE EXPANSION.
WE ESTIMATE THAT THE STATE
RECEIVED AT LEAST SEVENTEEN
BILLION DOLLARS IN FEDERAL
FUNDING THROUGH THE EXPANSION
IN TWENTY NINETEEN TWENTY. THIS
EXPANSION AS WELL AS OTHER
CHANGES TO MEDICARE RULES
FACILITATED BY THE ACA HAS
IMPROVED ACCESS TO HEALTHCARE
FOR A NUMBER OF OLDER A
POPULAR. POPULATIONS FOR
EXAMPLE THE CHANGES TO
ELIGIBILITY RULES HAVE
CONTRIBUTED SIGNIFICANTLY TO A
REDUCTION IN THE STATE'S
UNINSURED POPULATION. TODAY AN
INCREASING SHARE OF FORMERLY
INCARCERATED INDIVIDUALS HAVE
ENROLLED IN MEDICARE ALL
FOLLOWING THEIR RELEASE FROM
INSTITUTION IMPROVING THEIR
ACCESS TO CARE AND FINALLY AS
PREVIOUSLY NOTED- SIGNIFICANTLY
MORE WE ESTIMATE AROUND 45%
MORE ADULTS WITH SEVERE MENTAL
HEALTH CONDITIONS. ARE
RECEIVING TREATMENT THROUGH
MEDICARE L. A. COUNTY MENTAL
HEALTH SERVICES. ONE ADDITIONAL
ENHANCED FEDERAL FUNDING
OPPORTUNITIES THAT WISH BY THE
ACA THAT I WOULD BRIEFLY
MENTION IS THAT FOR PERSONAL
CARE SERVICES. THROUGH THE
STATE'S IN HOME SUPPORTIVE
SERVICES PROGRAM THE STATE
AVAILS ITSELF O THIS FEDERAL
FUNDING OPPORTUNITY WHICH
PROVIDES AROUND FOUR HUNDRED
MILLION DOLLARS ENHANCED
FEDERAL FUNDING ANNUALLY
RESULTING IN EQUIVALENT STAY
SAVINGS. SO TO SUMMARIZE THE
FISCAL IMPACT IF THE ACA WERE
OVERTURNED ENTIRELY STATE COULD
LOSE MORE THAN SEVENTEENPOINT
FIVE BILLION DOLLARS IN ANNUAL
FEDERAL FUNDING FOR MEDICAID
I'LL AND MILLIONS OF CURRENT
MEDICARE BENEFICIARIES COULD
LOSE THEIR COVERAGE. NEXT I'LL
TURN TO THE ACA AND COVER
CALIFORNIA WHICH STARTS ON PAGE
SEVEN OF OUR HAND OUT. AS NOTED
BY OUR FEATHER TESTIFIES
CALIFORNIA CREATED ITS OWN
HEALTH BENEFIT EXCHANGE CARL
CALLED COVERED CALIFORNIA WHERE
RELATIVELY LOW INCOME
CALIFORNIANS CAN AVAIL
THEMSELVES OF FEDERAL SUBSIDIES
THAT HELP PAY FOR THE COST OF
COVERAGE. IN TWENTY NINETEEN
TWENTY ABOUT ONE POINT TWO
MILLION RIGHT MILLION STATE
RESIDENTS RECEIVE SUCH
SUBSIDIES TOTALING MORE THAN
SEVEN BILLION DOLLARS.
OVERTURNING THE ACA WOULD
RESULT IN THE ELIMINATION OF
THESE FEDERAL SUBSIDIES AND
THIS WOULD BE HIGHLY DISRUPTIVE
FOR COVERED CALIFORNIA AND
COVERED CALIFORNIA THE
RESIDENTS WHO RECEIVE COVERAGE
THROUGH THE EXCHANGE. POLICY
HOLDERS WOULD LIKELY BEAR MUCH
MORE OF THE COST OF THEIR
PREMIUMS IN THE ABSENCE OF
THESE FEDERAL SUBSIDIES AND
FACING SUCH COST INCREASES MANY
POLICY HOLDERSWOULD LIKELY
CHOOSE TO DROP THEIR COVERAGE.
MAYBE BECOMING UNINSURED.
LESLIE I'LL BRIEFLY DISCUSS THE
ACA'S ESTABLISHMENT OF THE
PREVENTION AND PUBLIC HEALTH
FUND WHICH STARTS ON PAGE NINE
OF OUR HAND OUT. THIS ONGOING
FEDERAL FUNDING STREAM IS USED
TO EXPAND AND SUSTAIN PUBLIC
HEALTH PROGRAMS AND REFLECTS
ONE OF THE MORE FLEXIBLE.
HEALTH FUNDING STREAMS IN
TWENTY NINETEEN CALIFORNIA
STATE GOVERNMENT AND LOCAL
AGENCIES RECEIVED ABOUT FORTY
SIX MILLION DOLLARS OF THE
ANNUAL. WHICH HAS BEEN USED TO
SUPPORT IMMUNIZATIONS
EPIDEMIOLOGICAL AND LABORATORY
CAPACITY CHRONIC DISEASE
PREVENTION AND TO BUY TOBACCO
USE PREVENTION AND CESSATION
OVERTURNING THE ACA ENTIRELY
WOULD RESULT IN THE ELIMINATION
OF THIS FUND. AND COULD REDUCE
FEDERAL SUPPORT FOR THE PUBLIC
HEALTH ACTIVITIES JUST
MENTIONED. THAT CONCLUDES MY
PREPARED REMARKS REMARKS BUT
I'M HAPPY TO TAKE ANY QUESTIONS.
THANK YOU THANK YOU SO MUCH BEN
JOHNSON ALL RIGHT- NOW AGAIN
TURN IT TO QUESTIONS FROM
COMMITTEE. MEMBERS CENTER MONEY.
WELL THANK YOU MISTER CHAIRMAN
I WANT TO ALSO THANK ALL THE
MEMBERS OF THIS PANEL. IN TO
FOLLOW UP ON MY QUESTION TO THE
LAST PANEL. SEVERAL OF YOU HAVE
CITED THE IMPORTANCE OF.
TEXTING THE PROHIBITION ON
PUTTING A LIMIT ON ANNUAL OR
LIFETIME. COVERAGE BY INSURANCE
COMPANIES. COULD ANY OF YOU
EXPAND UPON ANY EXAMPLES OF THE
EITHER LACK OF ACCESS TO
MEDICAL CARE FOR THE ECONOMIC-
CATASTROPHE THAT CAN BEFALL AN
INDIVIDUAL OR A FAMILY WHO
EXCEEDS THE LIMIT OF THEIR
COVERAGE HAS EXISTED BEFORE.
THE AFFORDABLE CARE ACT- AGAIN
I'M JUST LOOKING FOR ANY
FURTHER INFORMATION ANY OF YOU
MIGHT PROVIDE FOR THOSE
WATCHING OR LISTENING WHO MAY
HAVE SOME SENSE OF THE
IMPORTANCE OF PROTECTING BANS
ON PRE EXISTING CONDITIONS BUT
AGAIN THE LIFETIME CAPS THE
ANNUAL CAP ON COVERAGE WHAT ARE
SOME EXAMPLES. OF HOW THAT
IMPACTS THE PATIENT COMMUNITY
CALIFORNIANS. IF WE LOSE THAT
PROTECTION. BUT CENTER MONITOR
WE HAVE AS A CRACK ABOUT IT
THAT'S OKAY FOR THE OTHER
PANELS. AND PERSONA NOTES
CENTER MONEY THANK YOU SO MUCH
FOR YOUR LEADERSHIP THE U. MANY
YEARS REALLY BEEN A CHAMPION
HEALTHCARE SO THANK YOU FOR
THAT IS. THE COUPLE I THINK
ABOUT THE PROTECTION THE
AFFORDABLE CARE ACT THE- ONE IS
AT THE EXTREMES BEFORE THE
AFFORDABLE CARE ACT. THERE WAS
IN MANY HEALTH POLICIES FOR
EMPLOYER AS WELL AS THE
INDIVIDUAL MARKET. CAPS ON
LIFETIME BENEFITS OR ANNUAL
CAPS. NOW IT DOESN'T AFFECT A
LOT OF PEOPLE. BUT IF YOU'RE A-
PARENT WHO HAS A PREEMIE. A
CHILD WHO NEEDS TO BE IN
INTENSIVE CARE IT CAN LITERALLY
BE MILLIONS OF DOLLARS- IF YOU
HAVE. CANCER YOU HAVE A NUMBER
OF CONDITIONS YOU CAN BLOW
THROUGH THE CAP AND IT HAPPENS
ALL THE TIME. BUT THE OTHER
PART THAT'S ONE OF FLAG IT'S
NOT JUST ABOUT. THOSE WHICH ARE
REALLY IMPORTANT BUT- YEAH WE
HEARD A MOMENT AGO FROM. DEPUTY
ATTORNEY GENERAL RANIERE ABOUT
HER MOTHER- NEED HIM IN THE
HOSPITAL FOR CALLED IT AND I'M
GLAD TO HEAR IT SEEMED LIKE SHE
GOT WELL AND GOT OUT OF THERE.
D. A. C. A. WORLD. WHEN SHE GOT
OUT OF THERE. FOR ABOUT. 20% OF
CALIFORNIANS. SHE WOULD HAVE
GOTTEN OUT OF THERE. WITH A
SIXTY THOUSAND DOLLAR BILL. AND
THE AVERAGE CALIFORNIA'S LOWER
INCOME. DOESN'T HAVE A THOUSAND
DOLLARS IN THE BANK LET ALONE
SIXTY THOUSAND DOLLARS IN THE
BANK. AND WHY NOT A PROBLEM.
IT'S A PROBLEM TWO FOUR. ONE
THAT PERSON IS WALKING AROUND.
WITH THE POTENTIAL LITERALLY
LOSING THEIR HOMES THEIR
LIVELIHOOD BECAUSE OF THE DEBT
TO A HOSPITAL THAT
UNCOMPENSATED DEBT. BUT MORE
THAN THAT. IT MEANS PEOPLE ARE
SCARED TO GO TO THE HOSPITAL
ARE SCARED TO GET TREATMENT
AREN'T GETTING CARE AT THE
RIGHT TIME JUST THINKING. OH MY
GOD. IF I MAY BE STUCK WITH A
SIXTY THOUSAND DOLLAR BILL. A
LITTLE WAIT LONGER. ONE OF THE
REASON WE'VE SEEN ACROSS THE
NATION AND ANOTHER'S. PERSON
SPOKE WAS COOPER DID. AROUND
HEALTHEQUITY. WE'VE SEEN ACROSS
AMERICA. THE LIKELIHOOD OF
DYING FROM COLD IT IS FAR
HIGHER FOR LATINOS AND AFRICAN
AMERICANS A BIG PART OF THAT IS
THEY'RE GETTING CARE SLOWER
THEY ARE GETTING TESTED AS
QUICKLY THIS IS IT REALLY LIKE
TO COVERAGE THAT'S REAL
COVERAGE. THANK YOU MISTER LEE
ANN I WANT TO THANK YOU FOR
YOUR LEADERSHIP IN BUILDING.
THE COVERED CALIFORNIA AND ONE
OF THE STRONGEST IF NOT THE
STRONGEST PROGRAM OF HEALTH
CARE COVERAGE THE UNITED
STATES. THANK YOU MISTER CHAIR
I DON'T KNOW IF OTHERS HAVE
COMMENTS FROM THE PANEL BUT I
DEFER BACK TO YOU RIGHT THANK
YOU- CENTER RUBIO AND THEN FOR
ANY OF THE REMOTE PARTICIPANTS
PLEASE USE THE RAZOR HAND
FEATURE IF YOU WISH TO SPEAK.
THANK YOU VERY MUCH AND I KNOW
THEY WERE ALL VERY OPTIMISTIC
THAT THIS WILL TURN OUT WELL.
AND WE WON'T HAVE T DEAL WITH
THIS BUT IN THE EVENT THAT THE
SUPREME COURT DOES STRIKE DOWN
THE AFFORDABLE CARE ACT- WHAT
ARE THEY DEPARTMENTS DOING IN
TERMS OF GETTING AHEAD AT THIS
ARE PREPARING TO. DO OUTREACH
TO SOME OF OUR COMMUNITIES
ESPECIALLY SECOND LANGUAGE-
COMMUNITIES WHERE THERE'S GONNA
BE A LOT OUT MASS CONFUSION AND
ANXIETY AND I THINK THIS
GENERALLY. YOU KNOW EVERYWHERE
IN CALIFORNIA BUT IS THERE
SOMETHING IN PLACE TO GET AHEAD
OF THIS HOW ARE WE GOING TO
DEAL WITH SOMETHING LIKE THIS.
TWENTY GETS HERE. CAN ANYBODY
ANSWER THEM. FOR SO I CAN START
AND THEN OTHERS CAN DEFINITELY
CHIME IN SO- AGAIN G. C. COOPER
HERE- ON YOU KNOW WE ARE
LOOKING AT A NUMBER OF ASPECTS
IN REGARDS TO A CONTINGENCY
PLANNING I THINK THERE WOULD
HAVE TO BE A SIGNIFICANT AMOUNT
OF CONVERSATIONS WITH THE
FEDERAL GOVERNMENT WITH CMS- IN
REGARDS TO THE MEDICAID PROGRAM
BUT THIS WOULD MEAN A LOT OF
THAT IS GOING TO ULTIMATELY
DEPEND ON WHAT IS DECIDED ON
THE BUT I AS WE OUTLINED IN THE
IMPACTS WE'RE TALKING ABOUT-
YOU KNOW THREE POINT EIGHT
MILLION ADULTS WHO ARE
CURRENTLY BEING COVERED BY THE
OPTIONAL EXPANSION. AS WELL AS
OTHERS WHO HAVE BENEFITTED FROM
ON THE. SIMPLIFIED ELIGIBILITY
RULES AND MET HOW THE IMPACT
WOULD BE SICK TO CAL ON WITH
EIGHT POINT FIVE BILLION
FEDERAL FUNDS CURRENTLY IN OUR
CURRENT BUDGET- WE WOULD HAVE
TO MAKE SERIOUS DECISIONS IN
CALIFORNIA AROUND COVERAGE-
CLEARLY IN CALIFORNIA THAT IS A
PRIORITY FOR NOT ONLY THE
MEDICAID PROGRAM BUT FOR THE
STATE AS A WHOLE I'M ENSURING
PEOPLE HAVE ACCESS TO HEALTH
CARE FUNDAMENTALLY BELIEVING
THAT HEALTHCARE IS A HUMAN
RIGHTS- IT THAT SOMEONE SHOULD
AUDIT ALL INDIVIDUAL SHOULD
HAVE ACCESS TO- THERE WOULD BE
HARD BUDGET DECISIONS IN FRONT
OF US BUT A LOT OF THAT'S
REALLY GOING TO DEPEND ON. THE
DECISIONS THAT ARE MADE SO IT'S
HARD TO DO YOU MUCH CONTINGENCY
PLANNING BECAUSE OF THERE BEING
SO MANY THINGS THAT STILL NEED
TO BE DECIDED I WOULD ALSO
IMAGINE WITH ANY SIGNIFICANT
CHANGE BUT WOULD BE HAPPY FOR
OTHERS TO WEIGH IN THERE WOULD
HAVE TO BE A TRANSITION OR GOT
A GLIDE PATH ON THEIR FEDERAL
PROTECTIONS A BENEFICIARY PER
PROTECTIONS IN REGARDS TO HOW
YOU WOULD TRANSITION OUT OF
COVERAGE LIKE SOMETHING LIKE
THIS HOWEVER STE A LOT OF
THINGS TO BE DECIDED- WE WORK
VERY CLOSELY WITH A LARGE
NUMBER OF ADVOCATES AND OTHERS.
MANY OF WHICH WERE GONNA SPEAK
LATER ON ON THIS COMMITTEE OUR
TO THIS COMMITTEE AND WE WOULD.
WORK VERY CLOSELY WITH OUR
STAKEHOLDERS AS WELL AS THE LAW.
IN EVER. BUT TO COME UP WITH
THE- PLAN OF HOW WE WOULD
ADDRESS. ANYTHING IN REGARDS
YOU ARE WHEN THEY COME OUT OF
THE- THE DECISION- BUT TO SAVE
THE IMPACT WOULD NOT BE- YOU
KNOW. BROUGHT IN CALIFORNIA IS
AN UNDERSTATEMENT ESPECIALLY
GIVEN THAT THAT THE BENEFITS
THAT HAVE BEEN COVERED. ON THE
UNDER THE ACA AND THE LIVES
THAT HAVE BEEN COVERED IN
MEDICARE. OPEN TO ANY OTHER
COMMENTS FROM THE OTHER
COLLEAGUES. YEAH ADULT OCCUPANT
I DON'T KNOW TO RAISE MY HAND
CAN I RESPOND AS WELL YES
PLEASE. READ THANK YOU VERY
MUCH IT IS IT ALL IN THE HOPE
IS THAT TALKING ABOUT
CONTINGENCY PLANS LIKE TALKING
ABOUT ADDING A FEW LIKE WHICH
THE TITANIC AND NOT AVOIDING AN
ICEBERG- WE ARE NOT SPENDING
TIME ON KONDISI PLANS IS ARE WE
REALLY FRANK ABOUT THAT WE'RE
SPENDING TIME GETTING PEOPLE
ENROLLED IN COVERAGE. IS TODAY
WERE IN OPEN ENROLLMENT WE ARE
MEDIKAL WILL BE ENROLLING
HUNDREDS OF THOUSAND PEOPLE IN
THE COMING MONTHS AND THE
NUMBER ONE THING CALIFORNIA NO
IS THEY CAN BE CONFIDENT THEY
WILL HAVE COVERAGE IS GOING TO
WORK FOR THEM. IN THE
FORESEEABLE FUTURE A FUTURE
WITHOUT THE ACA IS A
CATASTROPHIC FUTURE AND I THINK
THAT YOU KNOW THE LEGISLATORS
HERE IN WASHINGTON NEED TO
ADDRESS THAT REALITY- I THINK
PART OF THE POINT OF THIS
HEARING IS TO MAKE SURE NOT
ONLY CALIFORNIANS BUT A MEMBER
OF THE SUPREME COURT-
UNDERSTAND HOW CATASTROPHIC IT
SHOULD BE. AND THE AGAIN THE
ALTERNATIVES ARE SO GRIM THAT
IN A COULD SEE PLANS TO OUR
MINDS REALLY ARE WHAT WE CAN OR
SHOULD FOCUS OUR TIME ON ITS ON
THE JOB OF TODAY WHICH IS
GETTING HUNDREDS OF THOUSANDS
OF CALIFORNIANS ELIGIBLE TODAY
TO GET COVERAGE THEY NEED SO
THEY GET TESTED FOR CULVERT SO
THEY GET THE CARE THEY NEED AND
THAT'S WHAT OUR FOCUS AND-
AGAIN WE'RE LOOKING FORWARD TO
A- FUTURE WHEN WE'RE NO LONGER
TALKING ABOUT. EITHER SUPREME
COURT CASES REPEAL AND REPLACE
BUT ACTUALLY TALKING ABOUT
EXPANDING SUBSIDIES ADDRESSING
WHAT CALIFORNIANS DID FOR
MIDDLE CLASS CALIFORNIANS THAT
IN THE ACA GOT NO HELP UNTIL
THIS LEGISLATURE AND GOVERNOR
SOME. PUT IN PLACE NEW
SUBSIDIES FOR THE MIDDLE CLASS
THE SERVER THE SIGNAL FOR WHAT
WASHINGTON SHOULD BE DOING SO
WE'D RATHER PUT OUR EFFORTS
INTO SHOWING A BRIGHTER FUTURE
THAN SHOWING HOW. TO GET OUT A
LIFEBOAT TO THE TITANIC. THANK
YOU. AND JOHN DID YOU WANT TO
COMMENT CAN WE PUT FOR
SOMETHING OF THAT MAGNITUDE
GIVEN HOW MUCH FEDERAL FUNDING
WE GET HER THROUGH THE ACA.
YEAH I CAN BRIEFLY TOUCHED ADAM
FROM A PHYSICAL PERSPECTIVE
PLANNING FOR THAT EVENTUALITY
WOULD BE VERY CHALLENGING
TWENTY FIVE BILLION DOLLARS- IS
AN INCREDIBLY LARGE SUM OF
MONEY ARE START STATE GENERAL
FUND BUDGET THIS YEAR WAS.
BETWEEN ONE HUNDRED AND THIRTY
AND ONE HUNDRED AND FORTY
BILLION DOLLARS IS MY
UNDERSTANDING AND SO IT RESET
IT WOULD REPRESENT A SIZEABLE
INCREASE. IN THE NECESSARY
STATE RESOURCES TO EXTEND THE
AMOUNT OF COVERAGE AND
FINANCIAL SUPPORT FOR COVERAGE-
THAT CURRENTLY GOES TO
CALIFORNIA IN THE STATE SO THAT
WOULD BE. YOU KNOW NEED TO BE
VERY SERIOUS AND PERHAPS
DIFFICULT THAT DECISIONS WOULD
HAVE TO BE MADE IN THE STATE OF
HOW TO. RESPOND TO THIS LOSS OF
FUNDING AND HOW TO ENSURE A
CONTINUEDPROTECTIONS AND
COVERAGE FOR CALIFORNIANS.
THANK YOU I DON'T SEE ANY CANS
UP FOR REMOTE TESTIMONY SO I'M
GONNA ASK A FEW QUESTIONS THAN
US OF FIRST OF ALL STARTING
WITH A PETER LEVY WHEN THE
POINTS THAT YOU MADE IN YOUR
TESTIMONY WAS IS THAT THE
PREMIUMS ONLY WENT UP ABOUT
POINT 5% WHICH IS LESS THAN
INFLATION- CAN YOU PERHAPS
SPEAK TO WHAT THE ACA DID FOR
PREMIUMSVERTICALLY ON THE
INDIVIDUAL MARKET BECAUSE IF I
RECALL AND SMALL BUSINESS OWNER
AND THE PREMIUMS ARE GOING UP
LIKE 10% 11% 9% EVERY YEAR. SO
SINCE THE IMPLEMENTATION OF
COVERED CALIFORNIA. HOW PREMIUM
INCREASES BEEN AFFECTED.
BECAUSE OF THE ACA HE'S BIG
THAT. ABSOLUTELY DR BENNETT AND
THANKS FOR THE QUESTION LEADING
UP REMIND YOU BEFORE THE ACA
PREMIUMS WERE BASED ON HEALTH
PLANS EXCLUDING SICK PEOPLE. BY
SAYING WE DON'T WANT YOU IF YO
HAD A PREVIOUS CONDITION NUMBER
ONE NUMBER TWO HAVING BENEFIT
DESIGNS AND NO ONE UNDERSTOOD
SO THEY WERE A BARRIER FOR
PEOPLE GETTING CARE SO
PROVIDING AS LITTLE CARE AS
POSSIBLE THOSE ARE COVERED AND
THAT'S ONE OF THE BILL THE
PREMIUM AND THEN HUGE AMOUNTS
FOR OVERHEAD THAT OUR
CONTROLLED BY SOMETHING CALLED
MEDICAL LOSS RATIOS. WHICH
STATE HEALTH PLANS MUST NOW
SPEND. THE VAST MAJORITY
PREMIUMS ON HEALTH CARE. SO
WHAT'S HAPPENED SINCE THE ACA
IN CALIFORNIA- THE REASON WE'VE
DONE A PHENOMENAL JOB OF
KEEPING PREMIUM INCREASE OF
RELATIVELY LOW IS. WE'VE GOT
HEALTHY PEOPLE IN. WE MAKE IT
WORK FOR EVERYONE MORE PEOPLE
GETTING IN MEANS A HEALTHIER
RISK MIX. AND I WANT TO LOOK AT
THE LAST THREE YEARS TO MAKE IT
CLEAR ABOUT THE DIFFERENCE
BETWEEN LOCAL ACTION AND
FEDERAL ACTION. THREE YEARS AGO
TWENTY NINETEEN. THE FEDERAL
GOVERNMENT ANNOUNCED THAT THERE
WOULD NO LONGER BE. A FEDERAL
PENALTY. BUT IN THAT YEAR
PREMIUMS IN CALIFORNIA WENT UP
ABOUT NINE PERCENT. BECAUSE
HEALTH PLANS SAID. PEOPLE ARE
GOING TO. ABANDON COVERAGE%
BECAUSE THAT EXTRA KNOWLEDGE OF
THE PENALTY WAS ENOUGH TO KEEP
MEANT. CALIFORNIA THE AND I
REALLY NEED TO PRAISE THIS
LEGISLATURE THIS GOVERNOR DID
TWO BIG THINGS IN INDIVIDUAL
MARKETS. ADDED SUBSIDIES STATE
SUBSIDIES SUPPLEMENT THE
FEDERAL WHICH MEANS MORE PEOPLE
TO SIGN UP BUT ALSO SAID WE'RE
GONNA STATE PENALTY. WHAT
HAPPENED LAST YEAR OR PREMIUMS
WENT UP POINT 8% THIS YEAR
THEY'RE GOING UP POINT FIVE.
THAT MEANS OVER THE THREE YEARS
SINCE DONALD TRUMP HAS BEEN IN
OFFICE IN CALIFORNIA. THE
AVERAGE PREMIUM INCREASE HAS
BEEN LESS THAN 3% AND THE
REASON IS. HEALTH CARE PREMIUMS
ARE DRIVEN BY WHO'S INSURED AND
UNDER THE ACA HAVING POLICIES
THAT ENCOURAGE THOSE WHO ARE
INJURED TO GET CARE WHEN THEY
NEED IT THAT'S A WORKING MARKET
PLACE THAT'S A MODEL THAT WORKS
NOT HAVING SHE PREMIUMS BECAUSE
YOU'RE DENYING PEOPLE ACCESS TO
CARE AND HAVING INSURANCE
COMPANIES GAMING THE SYSTEM TO
ACTUALLY NOT BE THERE WHEN YOU
NEED IT I THINK THAT'S A REALLY
THE MODEL WHAT THE AC IS
WORKING PRETTY WELL IN
CALIFORNIA. EVEN THOUGH
SUBSIDIES ACTUALLY SHOULD BE
RICHER FOR LOWER INCOME
CALIFORNIA PEOPLE STILL NEED
HELP BUT WE GOT A SYSTEM THAT'S
WORKING WELL YOU LOOK OUTSIDE
OF CALIFORNIA TEXAS ALMOST ONE
OUT OF FIVE TEXANS WITHOUT
INSURANCE ABOUT EIGHTEEN
PERCENT. AND THAT'S BECAUSE
THEY HAVEN'T EXPANDED MEDICAID
AND IN THE INDIVIDUAL MARKET
PREMIUMS HAVE SKYROCKETED SO
HIGH THERE ARE NOT UNSUBSIDIZED
PEOPLE LEFT EXCEPT FOR SICK
PEOPLE CALIFORNIA HAS OVER
EIGHT HUNDRED THOUSAND
UNSUBSIDIZED CALIFORNIANS WE
CAN STILL AFFORD INSURANCE
BECAUSE OUR EFFORTS BRING
ENOUGH PEOPLE IN THE POOL TO
KEEP PRICES DOWN FOR EVERYBODY.
NO THANK YOU I THINK THAT'S A
VERY IMPORTANT POINT- BECAUSE I
OFTENTIMES PEOPLE KNOW THEY'RE
CONCERNED ABOUT HOW FAST
PREMIUMS ARE GROWING BUT THE
FACT AND COVER CALIFORNIA IN
THE LAST TWO YEARS. EACH YEAR
IT'S GONE UP BY LESS THAN A
PERCENT WHICH IS I BELIEVE LESS
THAN INFLATION. I WOULD ALSO
POINT OUT I THINK WHEN-
SCHWARZENEGGER'S GOVERNOR
LOOKING HEALTH REFORM HERE
CALIFORNIA PRE ACA THOSE
ESTIMATED THAT FOR EVERY PERSON
WHO ACTUALLY HAD INSURANCE-
THERE WAS PART WE TRY TO
SUBSIDIZE THE THOUSAND DOLLARS
PER. PERSON FOR THE PEOPLE WHO
DIDN'T HAVE INSURANCE BECAUSE
PEOPLE DON'T HAVE INSURANCE
DON'T STOP GETTING SICK THEIR
PROBLEMS DON'T GO AWAY. SO THEY
WILL EVENTUALLY SHOW FOR CARE
AND THAT CARE BECAUSE THEY
CAN'T AFFORD IT. WILL THEN BE
SENSUALLY PASSED ON TO EVERYONE
ELSE WHO HAS INSURANCE AND WHO
IS ABLE TO FINANCE IT. AND SO
IT CREATED A LOT OF-
DYSFUNCTIONAL THIS. FINANCING
WHICH I THINK YOU SEE A HELP
ADDRESS. I GUESS THE OTHER
QUESTION I DO WANT TO TEST YOU
PURELY IS- YOU KNOW WE TALK
ABOUT AND PEOPLE SAY WELL LOOK
THERE'S A LOT OF MONEY AND- I
THINK- YOU KNOW BEN JOHNSON
TALKED ABOUT. CAME TO THE STATE
AND WE'RE PROVIDING CITY
SUBSIDIES. WHERE DOES THAT
MONEY GO- THE I MEAN THERE.
THERE ARE PEOPLE WHO ACTUALLY
TAKE CARE OF PEOPLE RIGHT
DOESN'T CREATE JOBS. FOR A
COUPLE THINGS NOTED IS- PUT IN
AMERICA IN CALIFORNIA WILL
REMIND YOU THAT. ABOUT HALF OF
CALIFORNIANS HAVE HEALTHCARE
COVERAGE TO THEIR EMPLOYER. NOW
ABOUT A THIRD THROUGH MEDICARE
L. AND THE BALANCE THROUGH
COVERED CALIFORNIA THE SOURCES.
IF YOU HAVE EMPLOYER COVERAGE.
YOU'RE GETTING A FEDERAL TAX
SUBSIDY TO GET THAT COVERAGE.
IF YOU COULD NOT ACCOUNT YOU
GET A FEDERAL STATE SUBSIDY TO
COVER. THE INDIVIDUAL MARK WAS
THE ONE MARKET WHERE PEOPLE ARE
SAYING YOU'RE ON YOUR OWN. THE
ACA SAID NO WE'RE GOING TO GIVE
EVERYONE A LEG UP. THE OTHER
THING THE ACA SAID IS. FIFTEEN
YEARS AGO SOME HEALTH PLANS
LITERALLY WE'RE SPENDING HALF
OF THE PREMIUM DOLLARS ON
HEALTHCARE. AND THE OTHER HALF
ON MARKETING ON PROFIT ON YOU
KNOW COP TO EXECUTIVES. NOW
OTHERS ARE DIFFERENT MIX BUT
SOME OF THESE PLANS WERE PRETTY
BAD PLANS. NOW THOUGHTHE
AFFORDABLE CARE ACT SAYS. IF
YOU ARE OFFERING A HEALTH CARE
PLANS. TO LARGE EMPLOYERS YOU
MUST SPEND AT LEAST EIGHTY FIVE
CENTS ON A DOLLAR FOR
HEALTHCARE. HEALTH CARE
PREMIUMS ARE GOING TO
HEALTHCARE WHICH MEANS PEOPLE.
THE VAST MAJORITY OF SPEND IT
HEALTH CARE OUR NURSES AND
DOCTORS AND AIDS IN HOSPITALS
OR DOCTORS AND STAFF IN A
CLINICAL OFFICERS IT'S PEOPLE.
AND IT'S PEOPLE DOING WHAT WE
WANTED TO DO PROVIDING CLINICAL
CARE IT'S NOT GOING. TO WITH
ALL DUE RESPECT TO MY FRIENDS
IN THE INSURANCE INDUSTRY NOT
GOING INSURANCE EXECS BUT IT'S
NOT GOING TO MARKET. BUT WE DO
MARKETING BY GETTING MORE
PEOPLE THAN WE LOWER THE COST
BUT IT'S NOT ABOUT PICK PLAN
EXPRESSES PLAN WHY IT'S ABOUT
GETTING COVERED THAT'S WHAT WE
WANT MONEY TO BE SPENT ON IT.
GETTING PEOPLE IN THE DOOR AND
THEN MAKING SURE THEY GET THE
CARE THEY NEED. OKAY THANK YOU
AND THE APPRECIATE YOU POINTING
OUT THAT- A PRE ACA THAT. A LOT
OF MONEY IN SYSTEM ONE WASN'T
GOING TO CARE. SO DC COOPER-
APPRECIATE IT THANK YOU SO MUCH
FOR YOUR PRESENTATION ON MEDIC
CAL I DID NOT TOUCH ON MENTAL
HEALTH BECAUSE- IN A WORD COBIT
NOW AND- CERTAINLY THE VIRUS
ITSELF IS IT IS SOMETHING THAT
WE NEED TO BE SURE PEOPLE HAVE
ACCESS TO NOT YOU KNOW THE
TESTING AND THE TREATMENT. BUT
ALSO I THINK THERE'S A LOT OF
STRESS AND STRAIN PEOPLE TALK
ABOUT THE INCREASE MENTAL
HEALTH BURDEN. THAT'S HAPPENING
BECAUSE OF CODED- CAN YOU SPEAK
A LITTLE BIT TOO IF THE WHAT
WOULD HAPPEN IF THE ACA GOT
OVERTURNED TO PEOPLE'S ACCESS
TO MENTAL HEALTH THROUGH THE
MEDICAID PROGRAM. SURE I'M SO.
THRILLED A MEDIC CAL EXPANSION-
OR OPTIONAL EXPANSION PROVIDING
GET ON MEDI CAL SERVICES TO
INDIVIDUALS OR ADULTS WHO
PREVIOUSLY WERE NOT ELIGIBLE
FOR MEDICARE NOW. ON THEY
DIDN'T HAVE DEPENDENTS A
GREATLY EXPANDED WHO'S ALSO
GETTING MENTAL HEALTH. AND
SUBSTANCE USE DISORDER
SERVICES. WILL BREAK IT DOWN
INTO THE TWO DIFFERENT PIECES
THE FIRST ONE IS WHEN WE
EXPANDED COVERAGE FOR THE
ESSENTIAL HEALTH BENEFITS WE'VE
ADDED THE MILD TO MODERATE
SERVICES THOSE ARE THE- MENTAL
HEALTH SERVICES THAT ARE
PROVIDED TO OUR MEDICARE
MANAGED CARE PLANS. ON THAT IS
SOMEONE WHO IS EXPERIENCING
ANXIETY. DEPRESSION I'M NEEDS
COUNSELING SERVICES AND
MEDICATION MANAGEMENT I'M THAT
WAS ADDED THROUGH THE ACA- IT
IS SO CRITICAL ESPECIALLY IN
TIME. OF THE PUBLIC HEALTH
EMERGENCY TO ENSURE OUR
BENEFICIARIES BOTH CHILDREN.
YOUTH AND ADULTS ARE HAVING
ACCESS. TO THAT MILD TO
MODERATE MENTAL HEALTH SERVICE.
WE CRITICAL ESPECIALLY WHEN YOU
STILL OF. WHO PREVIOUSLY DID
NOT HAVE ACCESS TO NOT ONLY ALL
BENEFITS BY BENEFITING OF
JOINING MEDIC CAL BUT
SPECIFICALLY I'M MENTAL HEALTH
AND SUBSTANCE USE DISORDER
SERVICES. CRITICAL IN ADDITION
BY ADDING IN THE ADULT INTENT
INTO MEDIC HOW THOSE WHAT'S
HISTORICALLY BEEN CALLED
CHILDLESS ADULTS AND INTO MEDIC
HOW ALSO EXPANDED THE NUMBER OF
PEOPLE WHO ARE BENEFITING FROM
SPECIALTY MENTAL HEALTH
SERVICES IN YOUR HIGHER ACUITY
SUBSTANCE USE DISORDER SERVICES
THAT ARE COUNTIES OVERSEE. SO
THAT WOULD BE A PRETTY
SIGNIFICANT IMPACT OF PEOPLE
ARE NO LONGER HAD ACCESS TO
SUCH CRITICAL SERVICES
ESPECIALLY IN LIGHT OF A
PROBATE AND WE AGREED THAT IS
SO CRITICAL TO ENSURE PEOPLE
ARE HAVING ACCESS TO THOSE
SERVICES. AND THOSE COULD BE
YOU KNOW PUT IN SEVERE
JEOPARDY- AS I MENTIONED
EARLIER AND INCREASED DEMAND
BOB WOULD MEAN THAT THOSE
TRANSITION IF WE WERE NO LONGER
PROVIDING NUMBER PEOPLE WERE NO
LONGER ELIGIBLE FOR MEDICARE
HEALTH. IT WOULD SWITCH TO THE
NON MEDICAL PROGRAMS THAT
COUNTIES OVER FEET OVERSEE FOR
YOU KNOW MENTAL HEALTH SERVICES
IN THEY MAY NOT HAVE SUFFICIENT
RESOURCES ON TO FUND THOSE
TYPES OF PROGRAMS EITHER HARD
DECISIONS THAT THE STATE WOULD
HAVE TO MAKE IN THE FUTURE-
WHEN IT IS COVERED TODAY. IT IS
EIGHT A RIGHT FOR INDIVIDUALS
IN OUR MEDIC HOW TO HAVE ACCESS
TO ALL LEVELS OF MENTAL HEALTH
SERVICES AND SUBSTANCE USE
DISORDER SERVICES. I'M IN WE
REALLY JUST CAN'T FATHOM A
FUTURE ON WHERE WHERE THAT'S
NOT A RIGHT AND INDIVIDUALS
ESPECIALLY ON THOSE WHO ARE HIT
HARDEST OFTEN ON BY THE PUBLIC
HEALTH EMERGENCY AND THOSE WHO
WOULD NOT BE ABLE TO AFFORD
POTENTIALLY TO RECEIVE THOSE
SERVICES. IF THEY WERE NOT
AVAILABLE THROUGH MEDICARE- SO
IT COULD HAVE A GREAT IMPACT IN
REGARDS TO ACCESS TO MENTAL
HEALTH AND SUBSTANCE. USE
DISORDER SERVICES IN CALIFORNIA.
I KNOW THANK YOU SO MUCH
JESSICA. AND THAT FIRST OF ALL
AT THE BASE. PRE COATED HAD
CERTAINLY TREMENDOUS DEMAND FOR
MENTAL HEALTH. BUT WITH COVETED
AND- IN SOMETIMES PEOPLE JOKE A
LITTLE BIT ABOUT THAT YOU KNOW
I'LL CALL USES UP WITH COVE IT
BUT THE REALITY IS THAT-
ANXIETY DEPRESSION IS UP AND-
SUBSTANCE USE THIS OP. AND SO-
BY REPEALING THE ACA WE
ACTUALLY- REDUCE THE ABILITY OF
PEOPLE TO GET. THE NEEDED
SERVICES HELP THEY NEED TO GET
THROUGH. THE CURRENT SITUATION.
AND FINALLY FOR A BEN JOHNSON
AT IT AGAIN REALLY APPRECIATE
YOUR PRESENTATION- I DO WANT
FOCUS A LITTLE BIT ON THE
PREVENTION FUNDING YOU'D
MENTIONED AT THE END. YOU KNOW
THE ACA DID ESTABLISH THE
PREVENTION FUND ACTUALLY
UNFORTUNATELY FEDERAL
GOVERNMENT INCLUDING THE TRUMP
ADMINISTRATION'S CUT BILLIONS
AND BILLIONS OF DOLLARS FROM
THIS WHICH WOULD HAVE PERHAPS
MADE US BETTER PREPARED TO FACE
COATED- BUT THEY'RE STILL A
LITTLE BIT LEFT- CAN YOU
PERHAPS SPEAK TO IF THEY SEE IS
OVERTURNED IN THE PREVENTION.
OF THE PREVENTION PUBLIC HEALTH
FUND WAS THEN ELIMINATED HOW-WOULD THAT IMPACT OUR- ABILITY
TO CONTINUE TO RESPOND TO COBIT.
I'M ABSOLUTELY SEVEN THE PUBLIC
PREVENTION PUBLIC HEALTH FUND
HAS HISTORICALLY FUNDED-
CERTAIN- CERTAIN ACTIVITIES
RELATED TO EPIDEMIOLOGICAL AND
LABORATORY CAPACITY IN THE
STATE AS WELL AS HAS GENERALLY
SUPPORTED IMMUNIZATIONS ALL
WORK WHICH IS ALL GOING TO BE
CRITICAL CAPACITY FOR
CONTINUING TO. MEET THAT MEET
THE NEEDS OF ADDRESSING THAT
CORONAVIRUS SOME ENDEMIC HERE
INTO THE FUTURE. SO THE WELL
THE FUNDING IS NOT NECESSARILY
THE SORT OF LARGEST COMPONENT
OR THE LARGEST RISK IT WOULD
SORT OF CHALLENGE THEY WOULD
CONTINUE TO CHALLENGE THE SORT
OF. INFRASTRUCTURE THAT MANY
HAVE QUESTIONS SORT OF WHETHER
OR NOT IT WAS SUFFICIENTLY
RESOURCE TO BEGIN WITH SO.
ABSOLUTELY THERE IS A- AND-
THERE'S THE POSSIBILITY THAT
THE REDUCTION IN THIS FUNDING
SOURCE WHICH IS AMONG THE MOST
FLEXIBLE FUNDING SOURCES THAT-
IT PARTIALLY FUNDS A BLOCK
GRANT THAT THE STATE CAN
FLEXIBLY FLEXIBLY DEPLOY. TO
MEET THE PUBLIC HEALTH
CHALLENGES OF THE DAY- IF THAT
WERE TO GO AWAY IT WOULD
FURTHER STRAIN OUR PUBLIC
HEALTH INFRASTRUCTURE. THANK
YOU. RIGHT IS ARE THERE ANY
OTHER QUESTIONS OR COMMENTS C.
NO HANDS UP RIGHT SO AGAIN I
WANT THANK YOU SO VERY MUCH-
FOR YOUR TESTIMONY IT'S BEEN
EXTREMELY INFORMATIVE AND
HELPFUL SO AGAIN I THINK PETER
LEAVE FROM COVERED CALIFORNIA
DC COOPER STATE MEDICAID
DIRECTOR AND THEN JOHNSON FROM
LET'S THAT ALICE OFFICE THANK
YOU SO VERY MUCH. NOW TO MOVE
ON TO OUR NEXT PANEL WHERE WE
CAN HEAR FROM. THREE CALIFORNIA
CONSUMERS. THE MERE YOU DID-
FROM SAN DIEGO. ANGELA EILERS
FROM ORANGE COUNTY AND-
CAROUSEL FROM SACRAMENTO SO
LET'S START WITH THE MERIT DID-
YOU CAN SPEAK TO YOUR
EXPERIENCES WITH THE ACA AS A
CONSUMER. HI THERE HOW ARE YOU
GUYS GOOD WE CAN HEAR YOU THANK
YOU GREAT SO- THE HEADLINE FOR
MY STORY IS THAT IN TWENTY
FIFTEEN I WAS ONE YEAR OUT OF
HAVING EMPLOYER COVERAGE. WHEN
I LEFT- THE TEACHING PROFESSION
TO MOVEMENT ENTREPRENEURSHIP SO
I STARTED A SMALL BUSINESS I
PURCHASED HEALTH PLAN ON THE
COVER CALIFORNIA EXCHANGE AND
IN SEPTEMBE OF TWENTY FIFTEEN
I WAS IAGNOSED WITH A VERY
RARE SOFT TISSUE TUMOR. AND
WITHIN. THIRTY DAYS I RACKED UP
A HUNDRED AND FIFTY SEVEN
THOUSAND DOLLARS IN MEDICAL
BILLS. WHICH CHIU SURGERIES TO
HOSPITAL STAYS ALL KINDS OF. IF
IT'S IMAGING AND OTHER PRETTY
INTENSIVE- MEDICAL CARE NOT
REALLY SHORT PERIOD OF TIME.
AND SO THE REASON WHY YOU SEE A
HOLLOW SO IMPACTFUL FOR ME IS
THAT HAD I NOT BEEN ON A
SUBSIDIZED PLAN RESPOND COVERED
CALIFORNIA I PROBABLY WOULD
HAVE TO DECLARE BANKRUPTCY TO
THOSE MEDICAL BILLS SO EVEN
AFTER. THE NEGOTIATED RATE HAD
KICKED IN FOR MY SERVICES THAT
I USE-I OWED MY- CARE
PROVIDERS FIFTY THREE THOUSAND
DOLLARS AND HAVING LEFT A
STABLE JOB TO MOVE IN
ENTREPRENEURSHIP I DIDN'T HAVE
FIFTY THREE THOUSAND DOLLARS
LYING AROUND READY TO GO. AND
SO TO GO BACK TO WHAT SENATOR
MINING OTHERS TALK ABOUT THE
ANNUAL CAPS WERE REALLY
IMPACTFUL FOR ME WITH THE ACA
SO IN THAT CASE I HAD AN OUT OF
POCKET MAX OF SEVENTY FIVE
HUNDRED DOLLARS. AND WHILE THAT
WAS NOT YOU KNOW EASY I SENT A
TEXT RIGHT YOU SIGNIFICANTLY
LESS PAINFUL THAN TRYING TO
COME UP WITH FIFTY THREE
THOUSAND DOLLARS. AND THE OTHER
THING SINCE THAT TIME IS THAT
BECAUSE THIS TUMOR THAT I HAD-
I'LL BE CLEAR FOR FIVE YEARS AS
OF SEPTEMBER OF THIS YEAR BY
THIS TUMOR CAN RECUR SOMETIMES
DECADES LATER AND SO I A
REQUIRE. CITY FOLLOW UP
INCLUDING- MRI DOT MIND
COLLEGES ORDERS FOR ME AND THAT
IS EXACTLY THE KIND OF THING
THAT IF WE DIDN'T HAVE
GUARANTEED ISSUE- I VERY WELL
MAY BE DENIED COVERAGE FOR THIS
IF WE GO BACK TO A PRE ACA. I'M
NOT A MEDICAL INSURANCE AND SO
FOR ME I THINK THE KEY PILLARS
IN THE MOMENT. THAT WERE
INCREDIBLY IMPACTFUL WERE ON
THE IN YOU'LL ARE OUT OF POCKET
MAX I'M THAT THAT REALLY SAVED
ME THERE AND THEN SINCE THEN
IT'S BEEN GUARANTEED ISSUE- AS
WELL AS LIKE THE COMMUNITY
RATED BECAUSE EVEN THOUGH I
DON'T PURCHASE A PLAN ON THE
EXCHANGE ANYMORE. ON OUR
BUSINESS HAS GROWN NOW AND WERE
ON WERE WE ARE A SMALL BUSINESS
PLAN NOW ON THROUGH OUR
BENEFITS ADMINISTRATOR BUT I'M
IF WE GO BACK TO THAT IF I
DIDN'T. WORK MY CURRENT COMPANY
I'D BE EXACTLY THE SAME
POSITION OF NEEDING TO GET
INSURANCE AND. THANK YOU SO
MUCH FOR YOUR PRESENTATION AND
IT'LL EILERS. GOOD AFTERNOON
SENATORS IT IS AN HONOR TO
SPEAK TO YOU TODAY I SIT HERE
AS ONE MOM OF ONE CHILD WITH
SERIOUS MEDICAL COMPLEXITIES
BUT I KNOW I REPRESENT
THOUSANDS OF FAMILIES JUST LIKE
MINE THROUGHOUT OUR GREAT
STATE. I DO HOPE I HONOR THEM
ALL WELL MY NAME IS ANGELA
EILERS AND I MIGHT HIS MOM MY
GUESS IS THE THIRD CHILD BORN
TO US AFTER CENTS WINS. I HAD
REALLY HOPED THAT I WOULD HAVE
A GIRL AFTER TWO RAMBUNCTIOUS
BOYS. I AM SO LUCKY THEN THAT
CAME TRUE. MY GOD ALONG WITH
HER TWO OLDER BROTHERS ARE MY
SOUL. THEY ARE EVERYTHING TO ME
AND THIS IS WHY I AM HERE TODAY.
MY DAUGHTER WAS BORN ON A
THURSDAY NIGHT IN SEPTEMBER OF
TWO THOUSAND NINE THREE WEEKS
AHEAD OF SCHEDULE AFTER HAVING
TWO BOYS SENT STRAIGHT TO THE
NICK YOU AFTER THEIR BIRTH IT
WAS A NICE CHANGE OF PACE TO
HAVEOUR BABY IN OUR ROOM TO
CUDLE AND LOVE ON. IMMEDIATELY
MY GUESS TROUBLED A LOT THOSE
FIRST FEW DAYS. BY HER BIRTHDAY
AND LYFT USE DIAGNOSIS OF THE
CONGENITAL HEART DEFECT. I HAD
NO IDEA WHAT THAT MEANT FOR HER
OR HER FAMILY. I DIDN'T REALIZE
AND THE REAL ACOSTA RIGHT WE
JUST UNMARKED ON. AT MY GUESS
SPENT A FEW WEEKS IN THE NICK
YOU LEARNING TO EAT ON HER OWN.
WHEN SHE WAS FINALLY ABLE TO
COME HOME WE BREATHED A SIGH OF
RELIEF AND FELT OUR FAMILY WAS
COMPLETE AND WE CAN BEGIN
LEVINE AS A FAMILY OF FIVE. WE
HAD ORDERS TO FOLLOW UP WITH
THE PEDIATRIC CARDIOLOGISTS.
HER HEART- MINOR HEART MURMUR
TURNED OUT TO NOT BE SO MINOR.
BY THREE HAPPENS ALL MAKE IT
WAS SHOWING SIGNS OF FAILING TO
THRIVE. HER CARDIOLOGISTS
DECIDED THAT AT THAT POINT. SHE
WOULD NEED INTERVENTION. MIKE
HAD HER FIRST OPEN HEART
SURGERY I NEVER KNEW A TINY
BABY COULD HAVE THAT MANY TEAMS
AND WIRES CONNECTED TO HER
LITTLE BODY BUT THERE WE WERE
SEEN AT FIRST HAND. WE LIVE IN
THE NEXT FEW MONTHS IN FEAR
FEAR LOSING HER BABY IN THE
MIDDLE OF THE NIGHT AS HER
FIRST SURGERY HAD NOT DONE
ENOUGH TO REPAIR HER CARDIAC
ISSUES. MIKE UNDERWENT HER
SECOND OPEN HEART SURGERY AT
THE AGE OF ELEVEN MONTHS OLD
WITH ANOTHER STATE AND THE
CARDIOTHORACIC INTENSIVE CARE
UNIT. BEFORE HER FIRST BIRTHDAY
SHE HAD HIT ALMOST FIVE HUNDRED
THOUSAND DOLLARS IN MEDICAL
EXPENSES. WHICH IS HALFWAY TO
THE STANDARD LIFETIME CAP OF
THE MILLION DOLLARS. AT THIS
POINT I WAS A STAY AT HOME MOM
AND MY HUSBAND WAS EMPLOYED AT
A SMALL TO MEDIUM SIZED COMPANY
WHO OFFERED EMPLOYER PROVIDED
HEALTH CARE. NAY NONE ABSENT
HEALTH INSURANCE PLAN UNTIL
THREE YEARS LATER WHEN MY
HUSBAND WAS LAID OFF FROM HIS
JOB. WITH IT WHEN OUR HEALTH
INSURANCE. AND I WAS DEVASTATED
WE VIEWED OUR HEALTH CARE AS
ESSENTIAL TO OUR FAMILY AS A
WHOLE OVER OUR HEADS AND FOOD
ON OUR TABLE. WITHOUT IT OUR
DAUGHTER WOULD NOT SURVIVE
RIGHT. HOWEVER BECAUSE OF THE
AFFORDABLE CARE ACT WAS
ENACTED. JUST A FEW YEARS PRIOR
MY HUSBAND DECIDED TO VENTURE
OUT ON HIS OWN AND START HIS
OWN BUSINESS. WE KNEW WE COULD
PURCHASE OUR OWN HEALTH CARE
PLAN BECAUSE THE AFFORDABLE
CARE ACT GUARANTEED AS A PRE
EXISTING CONDITIONS COULD NOT
BE DENIED COVERAGE. MICHAEL IS
A LIFE OF ANY OTHER LITTLE GIRL
SHE'S IN THE FIFTH GRADE AND
SHE ACTUALLY STARTED HER HYBRID
LEARNING TODAY. SHE LOVES
READING AND IS OBSESSED WITH
HARRY POTTER. SHE'S THE GIRL
SCOUT WHO LEFT HER TRUE AND AS
FOR TRIPS TOP COOKIE SELLER
THIS PAST YEAR. SHE PERFORMS AN
ICE SKATING COMPETITIONS AN
AERIAL SHOWCASES. SHE LOVES HER
FRIENDS HER PARENTS AND HER
BACKYARD FAMILY BARBECUES. SHE
HAS TAKEN OUT BAKING AND
TENNIS. AND I SAY ALL OF THIS
BECAUSE IT IS ONLY POSSIBLE.
SHE HAS LIVED THIS LIFE BECAUSE
OF THE AFFORDABLE CARE ACT. SHE
SEES A TEAM OF DOCTORS FROM
CARDIOLOGY TO NEUROLOGY- AND
ORTHOPEDIC SURGEONS SHE NEEDS
AN MRI EVERY SIX TO NINE
MONTHS. AND I KNOW HOW MUCH
EVERY SINGLE ONE OF THOSE
APPOINTMENTS COSTS. AND THE ACA
IS A LIFELINE FOR US BECAUSE MY
CAN'T BE DENIED COVERAGE
BECAUSE OF HER PRE EXISTING
CONDITION AND SHE CANNOT BE
DROPPED FROM COVERAGE. FOR
EXCEEDING A LIFETIME CAP. I'M
GREAT FOR THIS. I WORRY EVERY
DAY WHAT WHAT TO MY FAMILY AND
MY CHILD. SO THIS LAW BE RULED
UNCONSTITUTIONAL AT THE SUPREME
COURT. I KNOW WHAT IT HAS MEANT
FOR US AND HOW IT HAS BENEFITED
US- AND I THANK YOU ALL FOR
YOUR TIME TODAY. THANK YOU
THANKS VERY MUCH AND FINALLY WE
HAVE A CAROUSEL. THANK YOU
SENATOR PAN IT'S NICE TO SPEAK
WITH ALL OF YOU AGAIN- I LIVE
WITH ACTUAL SPINAL ARTHRITIS
DEPRESSION ANXIETY PTSD AND
AUTISM. AND AS A NOTE I USE
THEY THEM PRONOUNS. IN TWO
THOUSAND THIRTEEN I LEARNED
THAT I HAD THE SAME DISEASE AS
MY DAD AFTER DOCTORS COULDN'T
FIND ANYTHING WRONG. AS A
FORMER COLLEGE ATHLETE THIS
NEWS TURNED MY WORLD UPSIDE
DOWN. THE DISEASE ACTUAL SPANO
ARTHRITIS IS A LIFELONG
CONDITION THAT CAN CAUSE SPINAL
FUSION AND DAMAGE OTHER JOINTS
AND ORGANS IT'S PAINFUL
EXHAUSTING AND PROGRESSIVE. AND-PATIENTS NEED ROUTINE
SPECIALIZED TREATMENT AND CARE.
SO I KNEW I HAD THIS DISEASE
BUT I DIDN'T HAVE A DIAGNOSIS
AND I DIDN'T HAVE HEALTH
INSURANCE. AND THE ACA WAS
EIGHT MONTHS AWAY. I COULD
BARELY FUNCTION SO I NEEDED TO
BEGIN TREATMENT SOON BUT I
DIDN'T WANT TO BE FOR HAVING A
PRE EXISTING CONDITION. I
NEEDED INSURANCE FIRST. SO I
APPLIED FOR A BARE BONES PLAN
ON A PART TIME SALARY AND WHEN
AN INSURANCE REPRESENTATIVE
INTERVIEWED ME ABOUT ANY HEALTH
ISSUES. I LIED. I TOLD HER MY
HEALTH WAS GREAT. I LIED MY WAY
INTO CHEAP HEALTH INSURANCE. MY
PLAN HAD HIGH COPAYS AND
DEDUCTIBLES. WHEN I SAW A
RHEUMATOLOGIST FOR THE FIRST
TIME I BEGGED HIM TO DIAGNOSE
ME BASED SOLELY ON MY SYMPTOM
HISTORY AND AN OFFICE VISIT
EVEN THOUGH BLOOD WORK AND X.
RAYS WERE REQUIRED. I SHOULD
HAVE BEEN GRIEVING THIS LIFE
CHANGING DIAGNOSIS INSTEAD I
WAS STILL VERY SICK AND BEING
FORCED TO MAKE CHOICES THAT PUT
MY HEALTH AT RISK LIKE SAYING
NO THE NECESSARY TRUE TESTS AND
MONITORING. I ABSOLUTELY DON'T
WISH MY EXPERIENCE ON ANYONE.
WHEN THE ACA ARRIVED I GOT A
SUBSIDIZED PLAN THROUGH COVERED
CALIFORNIA I CAN FINALLY GET
ADEQUATE CARE WITHOUT WORRYING
ABOUT THE COST I COULD AFFORD
MEDICATIONS IMAGING AND BLOOD
WORK I CAN GET PHYSICAL THERAPY
AND SEE A PSYCHIATRIST AND I
COULDN'T BE DISCRIMINATED
AGAINST BECAUSE OF MY
UNDERLYING CONDITION. LATER
WHEN I HAD TO STOP WORKING I
WAS AUTOMATICALLY ENROLLED IN
MEDICARE. THANKS TO THE
MEDICARE MEDICAID EXPANSION AND
I HAD ACCESS TO IN HOME
SUPPORTIVE SERVICES TO HELP ME
LIVE INDEPENDENTLY. TODAY I AM
ON FEDERAL DISABILITY AND I
RECEIVED BOTH MEDICAL AND
MEDICARE. THE ACA DEFINITELY
ISN'T PERFECT BUT REPEALING IT
OR PORTIONS OF IT IS LITERALLY
A DEATH SENTENCE FOR MILLIONS
OF PEOPLE INCLUDING A LOT OF MY
OWN FRIENDS. THE MOST IMPORTANT
THING I SHOULD BE DOING IS
CARING FOR MY HEALTH. NOT
CONTINUING THE FIGHT FOR THE
RIGHTS HAVE HEALTH CARE AS I
HAD TO DO FOR THE LAST SEVEN
YEARS. PLEASE DO EVERYTHING YOU
CAN TO FIGHT FOR PEOPLE LIKE ME
TO HAVE QUALITY RELIABLE
AFFORDABLE HEALTH CARE. THANK
YOU AND I'M HAPPY TO ANSWER ANY
QUESTIONS. THANK YOU VERY MUCH
AND I WANT TO THANK EACH OF YOU
FOR SHARING YOUR VERY PERSONAL
STORIES- THE TAKES A LOT OF
COURAGE. AND I REALLY
APPRECIATE THAT THANK YOU FOR
THAT- QUESTIONS FROM COMMITTEE
MEMBERS CENTER MINING. THANK
YOU MISTER CHAIRMAN I JUST WANT
TO JOIN YOU IN THINKING. THESE
THREE WITNESSES FOR SHARING
THEIR THEIR STORIES IN THE
COURAGE. THEY'VE MANIFEST NOT
JUST IN BEING PUBLIC TODAY BUT-
THROUGH THEIR- RESPECTIVE FROM
PATHWAYS- TRYING TO SEEK HEALTH
CARE AND MAINTAIN HEALTH FOR
THEMSELVES AND THEIR FAMILIES
AND I THINK. IT COMES FROM THIS
TESTIMONY FOR ME. IS FOR PEOPLE
FIGHT FOR ACCESS FOR MEDICAL
COVERAGE THERE IS CLEARLY A
PSYCHOLOGICAL IMPACT FOR THE
FOR THOSE THAT LIVE IN THE
UNCERTAINTY OF NOT KNOWING IF
THEIR PLAN WILL COVER. THEIR
CONDITION IF THEY WILL MAX OUT
ON COVERAGE LIMITS IT SATCHER
AND WHILE E'VE HEARD SOME
TESTIMONY ABOUT THE ACA ALSO
EXPANDING COVERAGE TO INCLUDE
MENTAL HEALTH SERVICES- NO
AMERICAN SHOULD HAVE TO ADD TO
THE TRAUMA OF. OF HEALTH
CHALLENGES THE UNCERTAINTY OF
WHETHER THEY WILL HAVE ACCESS
TO THE HEALTH CARE SYSTEM SO
NOT REALLY A QUESTION FOR PANEL
MEMBERS BUT MAYBE JUST
ENCOURAGEMENT THAT YOU CONTINUE
TO SHARE YOUR STORIES- IF
THERE'S WRITTEN FORM OF THE
TESTIMONY YOU GAVE TODAY
SHARING THAT WITH OUR ATTORNEY
GENERAL'S OFFICE. IN MAY BE
SENDING IT TO MEMBERS OF
CONGRESS AND I DON'T KNOW IF
MEMBERS OF THE SUPREME COURT
TAKE PERSONAL MAIL BUT I WOULD
SEND YOUR STORIES TO MEMBERS OF
THE U. S. SUPREME COURT AS WELL
IN AGAIN. WHAT'S AT STAKE HERE
IS SO GREAT AND IT GOES BEYOND
JUST ACCESSING TREATMENT FOR
ILLNESS AND DISEASE BUT THE
VERY MENTAL HEALTH OF OUR STATE
AND OUR NATION SO AGAIN THANK
YOU FOR YOUR VERY STRONG
TESTIMONY ALL THREE OF YOU.
THANK YOU CENTER MINING FOR THE
REMOTE MEMBERS IF YOU WISH TO.
MAKE A COMMENT PLEASE RAISE
YOUR HAND I SEE NO HANDS RAISED
AT THE MOMENT- I JUST. YES HAVE
OCCURRED WELL QUESTION FOR ALL
THREE IN A WAY ALTHOUGH WITH
THE- WELL THINGS WE TALK ABOUT
WITH THE ACA IS- THAT- WHAT WE
DIFFICULT TO REFERENCE OF JOB
LOCK RIGHT SO IF YOU HAPPEN A
LOT WORK FOR A LARGE COMPANY.
YOUR ABILITY TO ACTUALLY GO OFF
AND START YOUR OWN BUSINESS- IS
LIMITED BY THE FACT THAT WITH
YOUR SMALL BUSINESS OWNER- OR
YOUR EMPLOYEE OF A SMALL
BUSINESS. OFTENTIMES THE
UNDERWRITING WOULD CAUSE A
PROBLEM WITH THE SMALL BUSINESS
BE ABLE TO GET HEALTH CARE
COVERAGE FOR ACTUALLY THE
ENTIRE POOL OF EMPLOYEES AND
I'M A SMALL BUSINESS OWNER OF
FAT THAT FACED THE FACT THAT
ONE TURNS COMPANY WE WANT TO
OFFER HEALTH INSURANCE TO ARE.
A SMALL BUSINESS EMPLOYEES
THEY'RE LOOKING HAD A VERY VERY
SMALL POOL AND SEEING IF
SOMEBODY IS GOING TO BE VERY
EXPENSE GIVE PERHAPS- GIVEN
SOME OF YOUR EXPERIENCES- WE
HAVE MARY DAVID AND ANGELA
EILERS AND I KNOW CARES YOU
TALK A LITTLE BIT ABOUT.
FIGURES TO IS A LITTLE BIT BUT
IT'S. AN HOW DO YOU SEE THE ACA.
IN ADDITION TO ALLOWING YOU TO
INTO. ALSO YOU MORE FREEDOM TO
BE ABLE TO PURSUE. THINGS IN
TERMS OF YOUR- CAREER YOUR JOB-
COMPARED TO PRE ACA WHERE- YOU
YOU WOULDN'T. HAVE THOSE
OPTIONS PERHAPS BECAUSE OF YOUR
MEDICAL BECAUSE OF YOUR
CONDITION OR YOUR CHILD'S
CONDITION. I LOOK TO JUMP IN ON
THE STATE'S OKAY SENATOR
DONNELLY'S SO AGAIN THIS IS IN
AMERICA- YOU KNOW YOUR QUESTION
IS A PROVOCATIVE ONE IN MY CASE
I WOULD NOT HAVE LEFT MY PRIOR
CAREER STARTED TO AN ENTIRELY
NEW CAREER- HOW DOES NOT HAVE
THE OPTION TO GET COVERAGE. BY
ANY CHANGE IN CALIFORNIA SO IN
THAT CASE IT WAS ABSOLUTELY A
CATALYST FOR ENTREPRENEURSHIP
ON MY PART- I CAN'T SAY IT'S
ALWAYS BEEN PERFECT BUT I LEFT
THAT CAREER SIX YEARS AGO AND
NOW. I'M OUR COMPANY EMPLOYS
TWENTY FIVE PEOPLE AND SO
THAT'S A PERFECT EXAMPLE OF HOW
THE STABILITY THAT THE DCA IN
THE COVER CALIFORNIA EXCHANGE
OFFERED SOMEONE LIKE ME REALLY
HAS CHANGED WHAT HAS BEEN MY
LIFE MY CAREER AND ALSO FOR THE
PEOPLE THAT WE EMPLOY. AND I
THINK THAT'S A TESTAMENT TO YOU
KNOW THE WAY THAT THAT HEALTH
CARE COSTS CAN EITHER BE A
DRIVER FOR ENTREPRENEURSHIP IN
MY CASE WERE HAD THIS NOT BEEN
THE LAW PROBABLY WOULD HAVE
BEEN A HINDRANCE AND I WOULD
HAVE BEEN START DOING SOMETHING
WORKING FOR SOMEONE ELSE THAT
YOU CAN PLAY PEOPLE IN.
BUSINESS I'M REALLY PROUD TO
RUN. THANK YOU. THE OTHER
WITNESSES WONDER. US SENATOR I
CAN SPEAK TO THAT- EVEN THOUGH
MY STORY IS DIFFERENT- THE
MEDICAID EXPANSION ACTUALLY
ALLOWED ME TO STOP WORKING- MY
HEALTH WAS- GETTING SO BAD THAT
I WAS ONLY GOING TO WORK AND
THEN COLLAPSING AS SOON AS I
GOT HOME BUT BECAUSE OF MY
ABILITY TO SORT OF MAINTAIN AND
MANAGE MY HEALTH BETTER ON
MEDICAID- I WAS ABLE TO BEGIN
FREELANCING AND DOING WRITING
WHICH IS A PASSION OF MINE SO
IT ALLOWED ME TO WORK. IN A WAY
THAT I COULD ACTUALLY MANAGE
RATHER THAN BEING PUSHED INTO.
A MAKING MY HEALTH WORSE BY
WORKING A REGULAR JOB. THANK
YOU CARES AND I THINK IT IS
IMPORTANT REMINDER THAT
ACTUALLY MANY OF THE PEOPLE ON
MEDICARE NOW ACTUALLY ARE
EMPLOYED OR DO WORK- I THINK
SOMETIMES THERE'S A MISNOMER
THAT PEOPLE ARE MEDIC CAL- ALL
OF THAT THEY'RE NOT WORKING AT
ALL ACTUALLY VAST MAJORITY OF
THE HOME. ADULTS ACTUALLY HAVE
SOME FORM OF THEIR EMPLOYMENT
OR- OR OTHER TYPES OF WORK.
OKAY AND ANY OTHER COMMENTS SIR
QUESTIONS. I DON'T SEE ANY
HANDS UP. AGAIN I WANT TO THANK
YOU AGAIN EACH OF. OUR OUR
CONSUMER TEST FIRES- NEARLY DID
ANGELA EILERS AND CAROUSEL
THANK YOU SO VERY MUCH FOR YOUR
TESTIMONY AND FOR SHARING YOUR
PERSONAL STORIES HERE WITH OUR-
COMMITTEE AND- AT THIS HEARING
AND I WISH YOU ALL THE BEST.
FOR YOURSELVES AND YOUR
FAMILIES AND YOUR CHILD. AND
HOPEFULLY COMMONSENSE WILL
PREVAIL AND- WILL BE ABLE TO
CONTINUE THE PROTECTIONS THAT
THE AC AFFORDED AND ACTUALLY
IMPROVE ON THEM AS WE MOVE
FORWARD AS- AS WE GO FORWARD SO
WE CAN THANK YOU VERY MUCH FOR
YOUR TESTIMONY IS YEAH. THANK
YOU VERY MUCH TAKE CARE THANK
YOU. THANK YOU. THANK YOU.
RIGHT WE'RE GONNA MOVE ON DOWN
TO OUR NEXT PANEL OF HEALTH
CARE PROVIDERS WE HAVE
JENNIFER. PACHINKO SCO RETTKE.
RIVERSIDE UNIVERSITY HEALTH
SYSTEM MEDICAL CENTER CLINICS-
RESTING HOSPITALS WE HAVE
LESLIE OF ASTOR COMING C. OF
LIVINGSTON HEALTH CENTER MERCED
COUNTY REVERSING THE FEE
CLINICS. AND BETH GRIFFITHS.
THIS CLINICAL PROFESSOR
DIVISION INTERNAL MEDICINE AT
UCSF WHO IS GOING TO BE
ADDRESSING FROM- AT THE PER
PROVIDER HEALTH CARE- PHYSICIAN
PERSPECTIVES SO LET'S BEGIN
WITH THE JENNIFER OF CRUIKSHANK
WELCOME. THANK YOU SENATOR PAN.
IN THIS HEARING TOGETHER TODAY
I'M HAPPY TO BE HERE RIVERSIDE
UNIVERSITY HEALTH SYSTEM IS A
MAJOR SAFETY NET PROVIDER IN
OUR COMMUNITY IF FOUR HUNDRED
THIRTY NINE THAT LEVEL TWO
TRAUMA CENTER SERVING ADULTS
YEAH. THANK YOU AFTER
CONVERGENCE IAN THANK YOU AFTER
CAN PATIENT CARE. ADDITIONALLY
WE ARE THIRTY SIX PRIMARY AND
SPECIALTY CANNOT CLINICS
LOCATED ACROSS THE COUNTY.
BEING OVER THREE HUNDRED AND
FORTY THOUSAND PATIENTS
ANNUALLY OF WHICH 70% ARE
COVERED BY MEDICARE. 78%
REPRESENT COMMUNITIES OF COLOR.
THE IMPLEMENTATION OF THE
AFFORDABLE CARE ACT
SPECIFICALLY THE MEDICAID
EXPANSION HAS BEEN INSTRUMENTAL
FOR OUR PATIENTS AND OUR
DELIVERY SYSTEM MORE THAN FORTY
SEVEN THOUSAND MEDICARE
EXPANSION INDIVIDUALS. ARE
RECEIVING THEIR PRIMARY CARE AT
ARE YOU A- BUT MORE PEOPLE
ENROLLED IN MEDICAID HOW WE'VE
BEEN ABLE TO FOCUS OUR ENERGY
ON IMPROVING CARE PATIENTS
THESE. OUTCOMES IN COORDINATION.
SOME EXAMPLES ARE EXPANDING
ACCESS TO PRIMARY CARE BY
OPENING NEW SITES ACROSS THE
COUNTY INCLUDING A CLINIC THAT
WILL BE OPENING INCOMES X.
SHARE. HELLO KIDDING PRIMARY
CARE WITH BEHAVIORAL HEALTH
SERVICES IMPROVING COMPLEX CARE
MANAGEMENT BY EMBEDDING
COMMUNITY HEALTH WORKERS.
EDITOR'S INTO OUR TEAMS REDUCE
UNNECESSARY HOSPITALIZATIONS
AND EMERGENCY FROM THAT THAT.
HE'S EVER IMPROVING UP AGAINST
AND HAVE MADE SIGNIFICANT
IMPROVEMENTS IN PATIENT. IN
FACT WE ARE TOP PERFORMERS UP
19% OUR HIGHER THAN A THIRD OF
OUR MEDICARE PAY FOR
PERFORMANCE AS YOURS MY PRIME
PROGRAM. WE ARE SCREENING MORE
THAN 90% OF OUR PATIENTS FOR
DEPRESSION THEREBY POSITIVELY
IMPACTING OVER TWENTY THOUSAND
PATIENTS LIVE. RATER THAN 90%
COMPLIANCE WITH PRE AND
POSTNATAL CARE IMPROVES THE
SECTOR RIGHT BREAST FEEDING AND
LEVERAGING TELEHEALTH AND ALL
THESE SERVICES AND ACT ON THEM
HERE. ARE YOU IT IS COMPLETED
THOUSANDS OF FOCUS DISPARITY
REDUCTION ASSESSMENT IN THE
PAST FIVE YEARS THAT HELP
REDUCE. EACH RACE SB. THANK IS.
THE OF THE MEDICAID EXPANSION
COULD UNDERMINE ALL OF THIS
WORK RESULTING IN MASSIVE
FINANCIAL LOSSES OUR SYSTEM AND
HARM OUR LOW INCOME PATIENT
POPULATION. ARE YOU AND ARE YOU
ARE YOU H. US ALONE COULD LOSE
ONE HUNDRED TWENTY ONE MILLION
DOLLARS ANNUALLY. THIS INCLUDES
ALL OF THE PATIENT CARE REVENUE
AND SUPPLEMENTAL FUNDING WE
RECEIVED FOR THIS POPULATION.
THAT WASN'T FUNNY WOULD
COMPROMISE HOW WE DELIVER CARE
TO STABILIZE ACTS WITH. SORRY
TWENTY STABILIZE ACCESS TO
SERVICE FOUR THOUSAND THAT
WOULD REQUIRE REDUCE OPTIONS
FOR CARE IMPORTANTLY CLOSE
CLINICS ELIMINATION OF THE ACA
WOULD ALSO HAVE BRUTAL EFFECTS
IN OUR LOCAL ECONOMY. BACK IN
TWENTY SEVENTEEN UNIVERSITY
CALIFORNIA ESTIMATED RIVERSIDE
COUNTY COULD LOSE EIGHT HUNDRED
NINETY TWO MILLION DOLLARS IN
GDP AND AN ESTIMATED TWELVE
THOUSAND INDIVIDUALS COULD LOSE
THEIR JOB. LET ME CONCLUDE WITH
THE PATIENT STORY. TWENTY
EIGHTEEN THREE YEAR OLD SINGLE
MOTHER UNDERWENT A MAMMOGRAM
AND ULTRASOUND DETECTED BREAST
CANCERS THEY SHOULD BEGIN
TREATMENT WITH US AND THEN
ROLLED IN MEDICARE. TODAY SHE
CONTINUES THAT TREATMENT. AND I
NEED TO BE HELD HOMES PROGRAM.
AND GETTING WEEKS HERBAL MAN.
AS WELL AS WORKING WITH
IMMIGRATION TO FACILITATE
GETTING HER APPEARANCE HERE TO
HELP HER TAKE CARE FOR
MENTORING HER THREE. HAD SHE
BEEN RELUCTANT TO SEEK CARE
BECAUSE SHE WAS UNINSURED THE
OUTCOME WOULD HAVE BEEN VERY
DIFFERENT AND HER YOUNG
CHILDREN WILL LIKELY BE WITHOUT
THEIR MOTHER'S DAY. REFUNDABLE
PATIENTS WHO OFTEN FACE MANY
HURDLES. HAVING ACCESS TO
HEALTH CARE THROUGH MEDICAID-
IS OFTEN A DEFINING FACTOR THAT
ALLOWS AN INDIVIDUAL TO STAY
HEALTHY ENOUGH. AND GET YOUR
NEED WITHOUT BREAKING THE- ANY
MEDICARE LITERALLY CAN MEAN THE
DIFFERENCE BETWEEN BEING ABLE
AGING CONTRIBUTE MEANINGFULLY
TO SOCIETY ARE BECOMING LAST
AND FINANCIALLY DESTITUTE. A
LIMITATION OF THE MEDICAID
EXPANSION WOULD BE DEVASTATING
TO OUR HEALTH SYSTEM AND THE
VERY PATIENTS WITH THEIR IT IS
MY HOPE THAT WE CAN CONTINUE
BUILDING ON THIS PROGRESS.
FURTHER IMPROVE ACCESS BODY NOW
COMES FOR OUR PATIENTS I LOOK
FORWARD TO THIS DISCUSSION
TODAY AND WILL SUPPORT HIM IN
THE QUESTIONS FOLLOWING HIM.
THANK YOU. THANKS VERY MUCH.
FOR YOUR TESTIMONY THE EX. OF
THIS MOVEMENT TO LESLIE ABBAS
THE COMINGS FROM. VIDEO
BUILDINGS AND HEALTH CENTER
WELCOME. THANK YOU GOOD
AFTERNOON SENATOR PAN AND
MEMBERS OF THE SENATE HEALTH
COMMITTEE I THANK YOU FOR THE
OPPORTUNITY TO ALLOW ME TO
SPEAK TODAY I'M TO GET SOME
PERSPECTIVE ON THE ACA AND THE
IMPORTANT ROLE IT PLAYS IN
SUPPORTING ACCESS TO CARE. HI
MY NAME IS LESLIE RUSTIC
CUMMINGS AND I AM THE CEO FOR
LIVINGSTON COMMUNITY HEALTH
CLEAR AND NONPROFIT FEDERALLY
QUALIFIED HEALTH CENTER
PROVIDING THE CARE I YOU OVER
TWENTY THOUSAND YOU NEED
PATIENCE AND THAT COUNTIES THAT
MERCED STANISLAUS COUNTY SO AND
SAN JOAQUIN VALLEY. I'M HAD THE
PROPER NUMBER AND CALIFORNIA
HEALTH ADVOCATES IN THE COUNTY
BOARD MEMBER FOR THE CENTRAL.
CALIFORNIA ALLIANCE FOR HEALTH.
THANK YOU IMPORTANT INCLUDE THE
PERSON. I COMMUNITY HEALTH AND
BECAUSE WE VERY MUCH BELIEVE
THAT WE ARE- I'M AT EIGHT
ESSENTIAL PART OF THE BACKBONE
OF THE SPEAKING AT CARE
DELIVERY SYSTEM CALIFORNIA.
ENSURING THAT THERE IS ACCESS
TO MEDICAL OR BEHAVIORAL HEALTH
ORAL HEALTH SOCIAL SERVICES AND
SUBSTANCE USE TREATMENT AND I'M
IN A LOT OF CASES AS WELL. IT'S
IMPORTANT TO NOTE THAT TO DATE
THERE ARE OVER THIRTEEN HUNDRED
COMMUNITY HEALTH CENTERS IN
CALIFORNIA PROVIDING. HIGH
QUALITY COMPREHENSIVE CARE AND-
AS THAT MISCUE BURKE POINTED
OUT FROM DH CS AND THREE POINT
EIGHT MILLION OF THOSE ARE
ADULTS ENROLLED IN MEDICAID
HOW. WE ARE DELIVERING HERE TO
SEVEN POINT TWO MILLION PEOPLE
INCLUDING OVER TWO HUNDRED
THOUSAND INDIVIDUALS
EXPERIENCING HOMELESSNESS.
WHICH. IS ROUGHLY ONE IN SIX
CALIFORNIANS. FOR THE CAN IS
THAT ARE CENTERS. MY HEALTH AND
MANY OTHERS ON THE EIGHTEEN IS
JUST AND UNDENIABLE SUCCESS IN
CALIFORNIA THE UNINSURED RATE
DROPPED ACROSS ALL RACIAL AND
ETHNIC GROUPS. I THINK IT IS
GREAT WHAT THE GREATEST GAINS
SEEN AMONG THOSE- IN THE LATINO
COMMUNITY. BECAUSE OF THE ACA
HAS ALREADY BEEN MENTIONED AS
SIXTEEN POINT EIGHT MILLION
CALIFORNIANS AND PRE EXISTING
CONDITIONS CANNOT BE DENIED
COVERAGE. AND ACCORDING TO A
RECENT STUDY BY THE CALIFORNIA
HEALTH CARE FOUNDATION
COMMUNITY HEALTH CENTERS ARE
NOW PROVIDING CARE 254% OR ONE
POINT THREE MILLION. NEW
PATIENTS ENROLLED IN
CALIFORNIA'S. MEDICAID MANAGED
CARE PROGRAMS. DESPITE AND I.
FEDERAL CAL CONTINUES TO
SUCCESSFULLY ENROLL LOW INCOME
CHILDREN AND YOUNG ADULTS
REGARDLESS OF THEIR IMMIGRATION
STATUS. INTO MEDICARE FOR
HEALTH COVERAGE. THEIR
FINANCIAL SUCCESS THE FINANCIAL
SUCCESSES ASSOCIATED WITH THE
ACA GAVE US AND CONTINUES TO
GIVE US THE ABILITY TO EXPAND
OUR SERVICES MUCH LIKE JENNIFER
CHRISTIAN PUT JUST POINTED OUT
IN HER PRESENTATION AS WELL. I
THINK IT'S IMPORTANT TO ME HERE
WHEN THE MEDIA THAT I'M HAVING
THE ACA AND PLACE ALSO PREPARED
US FOR TODAY TO PROVIDE
CONTINUITY OF CARE THROUGH THE
CODE NINETEEN PANDEMIC. AND
ALLOWED US TO HAVE THE
INFRASTRUCTURE IN PLACE TO HIT
OUR OPERATIONS TO MAINTAIN
CHRONIC CARE MANAGEMENT
PREVENTIVE SERVICES AND
BEHAVIORAL HEALTH SERVICES. WE
NOT CONTINUE TO PROVIDE YOU
PROVIDE THIS CARE WITHOUT THE
BENEFITS OF TELEHEALTH. AND
ALSO THE ABILITY TO HAVE BEEN
ALLOW GREATER FLEXIBILITY
DURING THAT DECLARE AN
EMERGENCY THE MEDIC HOW
POPULATION. AT THE HEALTH HOME
TO SO MANY MEDICARE COVERAGE
CREATED THE TRUSTED.
RELATIONSHIPS NEEDED FOR COVER
NINETEEN TESTING AND FOLLOW UP
CARE. FINALLY REPEALING THE ACA
WOULD CREATE SIGNIFICANT COST
BARRIERS FOR LOW INCOME
PATIENTS TO CONTINUE TO ACCESS
HEALTHCARE WHICH MEANS THAT
MANY. BLACK INDIGENOUS AND
PEOPLE OF COLOR WILL LIKELY
LOSE COVERAGE AND STOP
RECEIVING NON EMERGENCY HEALTH
CARE. WHEN MEDICARE COVERAGE
LINKED TO A SIGNIFICANT SHIFT
IN HOW WE ADDRESS CHRONIC
DISEASE AND OBESITY TWO FACTORS
LINKED TO COPE IN NINETEEN
SEVERITY AND MORTALITY IN ACA
REPEAL WOULD MAKE IT NEAR
IMPOSSIBLE TO RESERVE RESERVE
REVERSED. THE INEQUITABLE
INEQUITABLE BURDEN OF THAT MADE.
FOR THE- FARK OVER A
POTENTIALLY CA RIDICULOUS BE
DENNIS TO OUR RESEARCH AND
RECOVERY. THANK I JUST WANTED
TO THAT FOR THIS FOR THE SIMPLE
CONVERSATION. WHEN AND FEDERAL
ENVIRONMENT THAT CONTINUES TO
THREATEN AND DESTABILIZE
CALIFORNIA'S HEALTH CARE SYSTEM
WE NEED TO BE INVESTING IN AND
SUPPORTING BOTH COVERAGE AND
ACCESS. THANK YOU SO MUCH FOR
ALLOWING ME TO MAKE SOME
COMMENTS TODAY. THANKS VERY
MUCH. OF YOUR TESTIMONY AND
THEN FINALLY WE HAVE DOCTOR
BETH GRIFFITHS- FROM THE
DEPARTMENT DIVISION OF INTERNAL
MEDICINE AT UCSF. THANK YOU SO
MUCH SENATOR PAN AND THANK YOU
FOR THE OPPORTUNITY TO ADDRESS
THE COMMITTE ABOUT THE
DEVASTATING IMPACT OF ACA
REPEAL FOR PATIENTS AND
PHYSICIANS ACROSS CALIFORNIA.
I'M A GENERAL INTERNIST AT UCSF
AND PROVIDE PRIMARY CARE FOR
ADULTS IN SAN FRANCISCO AND
BEYOND I CARE FOR PATIENTS WITH
NEARLY EVERY TYPE OF INSURANCE
MEDIKAL MEDICARE COVERED
CALIFORNIA AND EMPLOYER
SPONSORED INSURANCE. IT IS ONE
OF THE GREAT JOYS OF MY
PRACTICE THAT I CAN PROVIDE THE
SAME KIND OF CARE TO ALL OF MY
PATIENTS FROM MY PATIENTS WHO
ARE EXPERIENCING HOMELESSNESS
TO MY PATIENTS WHO ARE DEANS
AND CEOS. WITHOUT THE ACA THIS
TYPE OF PRACTICE IN WHICH
EVERYONE HAS ACCESS TO THE SAME
QUALITY OF CARE AND MOST OF THE
SAME TESTING AND SUBSPECIALISTS
SIMPLY WOULD NOT BE POSSIBLE
COUNTLESS OTHER PHYSICIAN
PRACTICES IN CALIFORNIA WOULD
BE SIMILARLY DEVASTATED. MUCH
HAS ALREADY BEEN SAID TODAY
ABOUT THE CATASTROPHE THAT
WOULD ENSUE IF FEDERAL FUNDING
FOR MEDICAID EXPANSION. AND
SUBSIDIES FOR COVERED
CALIFORNIA AS WELL AS THE ACA'S
MANY PROTECTIONS WERE TAKEN
AWAY. THE CONSEQUENCES OF
PEOPLE NO LONGER BEING ABLE TO
ACCESS ANY MEDICAL CARE ARE
PERHAPS MORE OBVIOUS SO I HOPE
TO ADDRESS SOME OF THE SLIGHTLY
MORE SUBTLE DEVASTATION. BEFORE
THE ACA MUCH OF THE CARE FOR
PEOPLE WHO ARE NOW INSURED
UNDER MEDICAID EXPANSION WAS
PROVIDED ON AN EMERGENCY ONLY
BASIS. FOR NEARLY ENTIRELY AT
COUNTY HOSPITALS AND FREE
CLINICS. I HAVE WORKED IN ALL
OF THESE SETTINGS AND I FIRST
WANT TO ACKNOWLEDGE THE
TREMENDOUS PEOPLE WHO PROVIDE
CARE AND THEM AND THE
EXCEPTIONAL CARE OFTEN
PROVIDED. HOWEVER IN A PRIMARY
CARE PRACTICE SUCH AS MINE WE
OFTEN SAVE LIVES NOT IN
DRAMATIC MADE FOR TV WAYS. BUT
THROUGH CARE AND TRUST BUILT
OVER YEARS. ASKING SOMEONE TO
CHANGE THEIR DOCTOR OR HEALTH
SYSTEM AFTER LOSING COVERAGE IS
NO SMALL THING. EVEN IF THERE
WERE ONE TO ACCEPT THEM. MANY
OF MY PATIENTS TO HAVE MEDICAL
HAVE COME TO ME FOR A REASON
MANY HAVE A HISTORY OF TRAUMA.
AND SEEKING CARE AT THE COUNTY
HOSPITAL THAT IS ALSO THE
TRAUMA CENTER AN ARRANGEMENT
VERY COMMON IN CALIFORNIA
BRINGS UP ENOUGH TRAUMA THAT
THEY WOULD AVOID CARE IF THIS
WERE THE ONLY OPTION. WITH
RAMPANT UNEMPLOYMENT RELATED TO
THE KOBE NINETEEN PANDEMIC MY
COLLEAGUES AND I HAVE SEEN THE
CONFUSION. STRESS AND IMPACT ON
HEALTH WHEN PEOPLE ARE
UNEXPECTEDLY FORCED TO CHANGE
INSURANCE OR LOSE INSURANCE
ALTOGETHER. FROM LOSING A
DOCTOR YOU FINALLY COME TO
TRUST. TO FIGURING OUT NEW
RULES ABOUT WHICH PRESCRIPTIONS
ARE COVERED. AND WHICH ARE NOT.
IF THE ACA'S REPEALED THIS
CHAOS WOULD AFFECT MILLIONS
MORE CALIFORNIANS AND LEAVE
THEM WITH MANY FEWER OPTIONS TO
TURN TO. AND WHILE CRUCIAL
INSURANCE COVERAGE IS ONLY PART
OF THE EQUATION. IF
CALIFORNIANS TO SUCCEED IN
PROVIDING QUALITY AFFORDABLE
CARE TO ALL CALIFORNIANS WE
CANNOT AGAIN SEPARATE INSURANCE
COVERAGE FROM TRUE ACCESS TO
CARE. IN THIS BEING THE ACA HAS
PROVIDED SUPPORT TO MANY
WORKFORCE DEVELOPMENT PROGRAMS.
IF THOSE PROGRAMS ARE NOT
CONTINUE CALIFORNIA'S HEALTH
CARE WORKFORCE SHORTAGE WILL BE
EXAM. AND PATIENTS WILL NOT BE
ABLE TO ACCESS QUALITY MEDICAL
CARE. OVER THE LAST SEVERAL
YEARS CALIFORNIANS AND THEIR
PHYSICIANS HAVE EMBRACED THE
ACA I'M DOING ITS STRUCTURE IN
THE MIDDLE OF A PANDEMIC WOULD
HAVE DEVASTATING REAL LIFE
CONSEQUENCES FOR MY PATIENTS
AND MY COLLEAGUES ACROSS THE
STATE MANY OF WHOM ARE ALREADY
STRUGGLING IN THE MIDST OF THE
PANDEMIC. THIS IS WHY ALL OF US
MUST DO ABSOLUTELY EVERYTHING
IN OUR POWER TO PROTECT AND
BUILD UPON THE GAINS MADE BY
THE ACA. THANK YOU AND I'M
HAPPY TO TAKE ANY QUESTIONS.
THANKS VERY MUCH. WHAT ARE THE
QUESTIONS OR COMMENTS FROM
COMMITTEE MEMBERS FOR THIS
PANEL. OKAY I DON'T. SEE ANY
HANDS UP FOR THE REMOTE
PARTICIPANTS. JUST A VERY BRIEF
FIVE QUESTION FOR- ACTUALLY I
THINK BOTH- JENNIFER CRUIKSHANK
AND LESLIE ABOUT THE COMINGS-
SO I REALLY CAN'T CREATE ALL
THE PANELISTS TALKING ABOUT THE
IMPACT OF THE C. ON PATIENTS
AND THAT SHOULD CERTAINLY
ALWAYS COME FIRST- BUT I DO
WANT TO TALK ABOUT SOME OF THE
ECONOMIC IMPACTS SO HE JUST. IN
A VERY BRIEF CANCER- SHE IS
POSSIBLE SIR SAFETY AC WAS
REPEALED WHAT WOULD THAT DO TO
YOUR WORK FORCE AND HOW MANY
JOBS DO YOU THINK YOU'D- BE
WOULD BE LOST- IN IT AT YOUR
FACILITY. WHICH OF COURSE HAS
AN IMPACT ON THE COMMUNITY- AND
IF THE ISSUE WAS REPEALED. I'LL
START THIS IS GEN THANK YOU
VERY MUCH I JUST DIDN'T ME
ENTER IT AGAIN. ARE YOU
INTERESTED BE PHASING OUT ONE
HUNDRED TWENTY ONE MILLION
DOLLAR LOSS IN FUNDING FOR
SERVICES THAT WE CURRENTLY
PROVIDE. ENOUGH OF OUR A LITTLE
OVER EIGHT HUNDRED MILLION
DOLLAR BUDGET SO ABOUT 15% OF
OUR BUDGET WOULD BE LAST WHICH
MEANS THAT WE WOULD HAVE TO
LOOK BACK. AT OUR ON. THE
SERVICES THAT WE'RE PROVIDING
AND START TO EVALUATE WHICH
ONES WE CAN AND CANNOT CONTINUE
TO PROVIDE THE WE WOULD HAVE IF
WE CLOSE RANKS. M. IF WE
ELIMINATED SERVICES. THOSE ARE
THE KINDS OF THINGS BATES THAT
REPORT FROM TWENTY SEVENTEEN
DEMONSTRATED THE COUNTY
RIVERSIDE WITH LIZ WHILE
THOUSAND. TWELVE THOUSAND
POSITIONS ACROSS THE COUNTY
THAT'S PRETTY SIGNIFICANT IN
OUR REGION. AND I DON'T HAVE A
NUMBER FOR YOU ABOUT. WHAT THAT
WOULD LOOK LIKE FOR US BUT I
WOULD ALSO SAY WE'D BE LOOKING
AT. HOW MANY FREE HOW MUCH FREE
CARE WE CAN GIVEN HOW MANY FREE
PRESCRIPTONS WE CAN ACTUALLY
CONTINUE TO FILL. AND WE'RE
PROVIDING A LOT OF SERVICES TO
UNINSURED. AS WELL THAT WE
WOULD HAVE TO. SCALE BACK THEM.
BECAUSE WE CAN'T AFFORD TO
FUNCTION. THANK YOU. THE
LEGISLATIVE THE COMING YOU'RE
RUNNING. OR HELLO HAVE. SO AND
I THINK AND I THINK FOR US THE
IMPACT WOULD ACTUALLY BE FAR
GREATER AND WE EXPANDED ACCESS-
NOT BUYING OVER AT THAT SIX
ADDITIONAL ACCESS POINTS THAT
ALL COME WITH STAFFING THAT
WENT ALONG WITH EACH ONE OF
THEM AND SO AND IF WE AND I IF
I HAD TO PUT A PERCENTAGE TO IT
OUR OUR EXPANSION OF ACCESS TO
SERVICES COULD BE CLOSER 230%
OF OUR BUDGET BECAUSE OF THE
ADDITIONAL MEMBERS WE WERE ABLE
TO SEARCH AND THAT WAS OVER THE
COURSE OF TIME FOR THAT- AFTER
THE PORTAL CARE ACT. WAS PASSED
ON AND SO I THINK THAT WOULD
ACTUALLY RESULT IN THE CLOSURE
OF CLINICS REDUCTION OF OURS
AND CERTAINLY LAYOFFS OF STAFF
AND BECAUSE OF THE- YOU KNOW
THE CUTS IN FUNDING AND THE-
ACCESS FOR THOSE PATIENTS AND
BE UNDER THE INCREASE IN THE
UNINSURED SO FOR US IT WOULD
BE- YOU KNOW BLESSED ACCESS
LESS ACCESS POINTS AND MOST
LIKELY EIGHT IMPACT TO. THE
WORK FORCE AS LONG. THANK YOU.
ANY OTHER QUESTIONS OR- I WOULD
JUST MAYBE. COULD WE ONE OTHER
POINT BEFORE THE ON TO ALLOW
TEN THIS WEEK HEARD OF THE CUT.
THAT WERE HAPPEN. A ONE BE SURE
PEOPLE UNDERSTAND THAT SO SOME
PEOPLE MAY SAY WELL GEE I'M NOT
A MEDIC HOW BY COVERED
CALIFORNIA OF COMMERCIAL
INSURANCE HOW DOES IT IMPACT ME
BUT WHEN A PROGRAM LET'S SAY.
AT RIVERSIDE- WHERE YOU KNOW
PORTION THE PATIENTS ARE
MEDICARE PORTION PATIENTS ARE
COVERED CALIFORNIA AND THEN
THEY HAVE THESE CUTS. AND A
CLOSE THE PROGRAM THAT PROGRAM
IS THE NIGHT NOT JUST FOR THOSE
PATIENTS BEFORE ANYONE WHO
LIVES IN THE AREA. ANYONE WHO
LIVES IN THE AREA NO MATTER
WHAT INSURANCE YOU HAVE OR HOW
MUCH CASH YOU HAVE. AND I THINK
THAT'S SOMETHING WE NEED TO
KEEP IN MIND THAT PEOPLE HAVE
BUILT. DEVELOP SERVICES THAT
NOT JUST SERVE PEOPLE WHO ARE
ON MEDICARE OUT OF COURSE NEED
THEM PEOPLE WHO ARE BUYING
COVER CALIFORNIA. THE HEALTH
CARE SYSTEM YOU KNOW HOSPITALS
AND PHYSICIANS AND CLINICS AND
OTHER NETWORKS THEY HAVE YOU
KNOW. AND THEN A FIGHT AND ARE
ABLE TO SUPPORT SERVICES FOR
THE ENTIRE COMMUNITY. THAT
PERHAPS IT IS ONLY THE
COMMERCIALLY INSURED. THAT
WOULD THERE NOT BE ENOUGH
SUPPORT. TO PATIENTS AND
REVENUE TO BE ABLE TO MAKE THAT
PROGRAM COULD YOU GO BUT
BECAUSE IT'S NOW THESE OTHER
PEOPLE HAVE COVERAGE AND I
THINK WE NEED TO KEEP THAT MIND
WE'RE ALL IN IT TOGETHER WHEN
IT COMES TO THIS. SO AND LESS
ANY OF THE WITNESSES WHICH TO
DISAGREE WITH THAT STATEMENT TO
IN TERMS OF THEIR RUNNING THE
PROGRAM WILL. WILL MOVE ON TO
OUR NEXT PANEL BUT I WANT THANK
YOU EACH OF YOU. OF OUR- THE
PANEL AGAIN- JENNIFER
CRUIKSHANK OF RIVERSIDE
UNIVERSITY HEALTHSYSTEM LESLIE
ABOUT THE COMINGS. BUT THANKS
AND HEALTH CENTER AND DR
GRIFFITHS AT UCSF THANK YOU SO
MUCH FOR YOUR TESTIMONY. THANK
YOU. RIGHT WE'RE NOW GOING TO
MOVE ON TO OUR PANEL. OF
ADVOCATES I'M HERE SO WE HAVE A
CONSUMER BUSINESS ADVOCATES
AND- THE TEST FIRES ARE GEORGE-
BUT TERIA CEO OF COLLECTIVE
CHOICE INSURANCE SOLUTIONS- GEN
FLORI HAD A POLICY ADVOCATE THE
WESTERN CENTER OF LONG POVERTY
A JFFREY REYNOSO EXAM DOCTOR
THE LATINO COALITION FOR
HEALTHY CALIFORNIA CHRISTIAN
YOUNG POLICY ADVOCATE THE
CALIFORNIA CHAMBER OF COMMERCE
AND FINALLY ANTHONY WRIGHT
EXECUTIVE DIRECTOR OF HEALTH
ACCESS CALIFORNIA SO LET'S
BEGIN WITH THE GEORGIA ABOUT
TERIA. WELCOME THANK YOU CENTER.
I'M GONNA SHARE THE INSURANCE
AGENT PERSPECTIVE ON ENROLLING
CONSUMERS INTO THE AFFORDABLE
CARE ACT AND AS I MENTIONED MY
AS MENTIONED MY NAME'S GEORGE
BALL TERIA AND I'M THE CEO OF
COLLECTIVE CHOICE INSURANCE
SOLUTIONS. WE ARE ALSO A MEMBER
OF THE CALIFORNIA ASSOCIATION
OF HEALTH UNDERWRITERS AND AS A
CERTIFIED INSURANCE AGENT- OUR
AGENCY HAS ENROLLED MORE THAN
SEVENTY THOUSAND PEOPLE INTO
COVERED CALIFORNIA AND TO
MEDICARE. AND I ALSO WANT TO
SHARE SOMETHING THAT SOME
PEOPLE DON'T KNOW IS THAT
INSURANCE AGENTS HAVE BEEN
ROLLED BETWEEN 47% AND 50% OF
THE PEOPLE INTO COVERED
CALIFORNIA THAT'S THEMSELVES.
AND INSURANCE AGENTS OF ALSO
BEEN THE LARGEST. NON
GOVERNMENT FUNDED- IN ROLLER
INTO THE MEDICARE PROGRAM SINCE
TWO THOUSAND FIFTEEN IN OTHER
WORDS WE DO THAT WORK FOR FREE-
AND THEN MOST RECENTLY
INSURANCE AGENTS HAVE BEEN THE
LARGEST ROLLER INTO COVERED
CALIFORNIA- DURING. NINETEEN
AND IT'S ALL THE DESTRUCTION OF
OUR OFFICES AND- WORKING WITH
ALL THE DESTRUCTION HAPPEN
EARLY MARCH AND APRIL- WE'VE
HELPED THOUSANDS OF PEOPLE-
GAIN ACCESS AND NAVIGATE LOSING
THEIR JOBS SPONSORED COVERAGE
DURING THIS TIME SO- AND A
LITTLE BACK HISTORY PRE CA- I
STARTED MY CAREER AS A HEALTH
INSURANCE AGENT TWO THOUSAND
TWO- FOR NINE YEARS I DROVE
THIRTY FIVE THOUSAND MILES PER
YEAR. SEEN MORE THAN. TWO
THOUSAND. IN IN THE SYSTEM
GETTING AND IN PRICING DIEGO
RIVERSIDE SEAMER DINO- ORANGE
COUNTY LOS ANGELES AREAS YEAH I
ALSO HELP PEOPLE NORTHERN
CALIFORNIA OVER THE PHONE. AND
I REALLY ENJOYED HAT I DID
DURING THAT TIME DURING
PRESEASON GAME- NAPPIES I MET A
LOT OF AMAZING INTERESTING
CALIFORNIANS BUT I ALSO HELPED
A LOT OF PEOPLE. AND BUT THERE
WAS TIMES WHERE- I RAN INTO
SITUATIONS WHERE MY HANDS WERE
TIED FIVE I RAN INTO A
PERSONALIZATION WAS MAKING
FIFTEEN HUNDRED DOLLARS A MONTH
EIGHTEEN THOUSAND DOLLARS A
YEAR THERE WAS ABSOLUTELY NO
AFFORDABLE OPTION FOR THAT
PERSON TO GET HEALTH INSURANCE
AND SO THOSE PEOPLE I JUST HAD
TO SAY. I'M SORRY I CAN'T HELP
YOU I RUN INTO PEOPLE LIKE THE
PREVIOUS- PEOPLE SPOKE ABOUT
THEIR OWN HEALTH CONDITIONS AND
I WOULDN'T GO SEE THEM I WOULD
TALK TO ME ON THE PHONE. AND
THEY WOULD TELL ME YOU KNOW
THEY WERE LOOKING FOR THEIR
LIFE TO GET HEALTH INSURANCE
BECAUSE SHE WAS RECENTLY
DIAGNOSED WITH CANCER I LOST MY
JOB. AND YOU KNOW THOSE KINDS
OFSITUATIONS. MY HANDS WERE
TIED THAT PERSON COULD NOT GET
HEALTH INSURANCE. AND YOU KNOW.
WHEN YOU DO LEFT THOUSANDS OF
TIMES. OVER AND OVER AND OVER
AGAIN AND I HAVE TO ALMOST
EMOTIONALLY GET MYSELF BACK TO
THAT PLACE WHERE I REMEMBER
THOSE THINGS BECAUSE IT'S BEEN
SO LONG SINCE I'VE HAD TO EVEN
TELL A PERSON THAT THEY
COULDN'T GET HEALTH INSURANCE
BECAUSE THEIR HEALTH CONDITIONS
BECAUSE OF THE ACA. I DON'T
WANT TO LOSE THE ABILITY TO
HELP PEOPLE THE WAY IDEA AND-
SO I WANT TO ENCOURAGE. IN THE
STATE AND- TO DO WHAT WAS
NECESSARY TO PROTECT THE CA AND
PLAN FOR CONTINGENCIES- AROUND
IT AND I WANNA. LET YOU KNOW
THAT YOU KNOW INSURANCE AGENTS
I'M SOME OF THE CONSUMER
ADVOCATES THERE ALSO SPEAK
AFTER ME- OUR ORGANIZATION
MYSELF ARE HERE TO HELP THIS
COMMITTEE AND WE'RE ALSO HERE
TO HELP THE LEGISLATURE AND
HELPING CONSUMERS NAVIGATE THE
TRANSITION OF ANY CHANGES THAT
WE NEED TO MAKE. AND AS A
PERSON WHO'S USED TO
UNFORTUNATELY DEALING WITH A
DIFFICULT- HEALTH- A QUESTIONS
OR QUESTIONS ABOUT HEALTH
INSURANCE I'M NOT HERE TO
ANSWER ANY QUESTIONS- FOLLOWING
OF THE SECTION THANK YOU. THANK
YOU SO VERY MUCH FOR THE
TESTIMONY OF THE WILL TAKE
QUESTIONS AT THE END OF THE
PANEL LET'S MOVE ON TO CHEN
FLORI. POLICY ADVOCATE WITH THE
WESTERN CENTER ALLOW POVERTY.
GOOD AFTERNOON AS MENTIONED I'M
GENTS LAUREATES WESTERN CENTER
ON LAW AND POVERTY WHERE THE
STATE'S LARGEST AND OLDEST
LEGAL SERVICES SUPPORT CENTER.
AND I WORKED MOST OF MY CAREER
IN EITHER AT WESTERN CENTER
ITSELF OR AT LEGAL SERVICES AND
HELPING PEOPLE ACCESS
HEALTHCARE MOTIVATED BECAUSE OF
MY OWN EXPERIENCES AND NOT
BEING ABLE TO ACCESS HEALTH
CARE AND THE EXPERIENCES OF MY
FAMILY. BEFORE THE ACA- THOSE
OF US AT LEGAL SERVICES WHO ARE
HELPING PEOPLE WHO ARE
UNINSURED ACCESS HEALTH CARE
THE TYPICAL STORY WOULD GO LIKE
THIS. IF YOU ENCOUNTERED ONE OF
THE 20% OF CALIFORNIANS WHO WAS
UNINSURED AND NEEDED HEALTH
CARE. THERE WAS REALLY ONLY ONE
ROUTE TO HELP THEM THE PRIVATE
MARKET WAS ESSENTIALLY CLOSE TO
THEM AS JUST MENTIONED BY THE
SPEAKER BEFORE. AND SO FOR
EVERYBODY ELSE THAT MEANT
WAITING UNTIL YOU WERE CHU
SICK- TO WORK AND BECAUSE YOU
COULDN'T WORK YOU WERE SO POOR
THAT YOU NOW QUALIFY FOR
MEDICARE THAT WAS THE ONLY WAY
TO ACCESS COMPREHENSIVE HEALTH
CARE FOR WHAT YOU MIGHT NEED-
AS MENTIONED BY PREVIOUS
SPEAKERS YOU COULD GET
EMERGENCY SERVICES ARE
SOMETIMES CERTAIN SERVICES
THREE OR COUNTY BUT- OFTEN NOT
THE COMPREHENSIVE HEALTH CARE
THAT YOU NEED IT- I'M GONNA
GIVE A FEW EXAMPLES TO
ILLUSTRATE. ONE OF THE FIRST
CASES THAT I WORKED ON AND WE
WERE ACTUALLY HELPING AN
INDIVIDUAL WHO HAD BEEN UNABLE
TO ACCESS HER COUNTY HEALTH
CARE PROGRAM BECAUSE SHE WAS
DETERMINED TO BE A FEW DOLLARS
OVER THE INCOME LIMIT BASED ON
THE WAY TO CALCULATE ENTERING
TOWN. AT THAT POINT SHE HAD
BEEN DIAGNOSED WITH COLON
CANCER. HI AND AT THE POINT
THAT SHE WAS DIAGNOSED IT WAS.
FAIRLY TREATABLE AND IT WOULD
HAVE BEEN FAIRLY ROUTINE TO
TAKE CARE OF. SO THROUGHOUT THE
CASE WHAT WE ARE ON THE ONE
HAND SUING THE COUNTY. SHE
DETERIORATED VERY MUCH EVERY
PHONE CALL WITH HER YOU COULD
TELL SHE WASSICKER. AT THE
POINT THAT ARE CANCER BECAME
STAGE FOR AND SHE COULD NO
LONGER WORK THEN WE COULD GET
ARE ON MEDI CAL. WE WERE
ULTIMATELY SUCCESSFUL IN HER
CASE BUT THE SUFFERING THAT SHE
WENT THROUGH IN THAT PROCESS
WAS WHAT MANY PEOPLE WENT
THROUGH- TO GIVE ANOTHER
EXAMPLE. YOU KNOW BECAUSE YOU
ARE ELIGIBLE FOR MEDICARE AND
BASIS OF DISABILITY DOESN'T
MEAN THAT IN ITSELF IS AN EASY
DETERMINATION. IT WS OFTEN A
CATCH TWENTY TWO FOR A LOT OF
PEOPLE TO GET THE DISABILITY
DETERMINATION BECAUSE AFTER ALL
YOU NEED ACCESS TO A DOCTOR WHO
CAN PROVE THAT YOU HAVE A
DISABILITY- WITHOUT ACCESS TO
MEDICAL CARE IT BECOMES VERY
HARD TO PROVE THAT- ON THE
OTHER SIDE. THIS STATE THEN HAD
TO PROCESS ALL OF THESE
DISABILITY APPLICATIONS WE HAD
ANOTHER CASE AGAINST THE STATE
BECAUSE OF DISABILITY
APPLICATIONS WERE BEING DELAYED
BECAUSE THEY'RE SO LABOR
INTENSIVE. THE STATE CAN'T JUST
GIVE OUT HEALTH CARE TO PEOPLE
WITHOUT MAKING SURE THAT THEY
FIT THE CRITERIA BY WHICH THE
FEDERAL GOVERNMENT WOULD
REIMBURSE THEM. ONE OF OUR
PLAINTIFFS IN THIS CASE DIED
DURING THE CASE- AND I STILL
REMEMBER HAVING TO TELL ONE OF
THE OTHER PEOPLE THAT WORKED ON
THE CASE AN INTERN WHO WAS JUST
YOU KNOW IN LAW SCHOOL WORKING
WITH THIS INDIVIDUAL ON THE
DECLARATION. WHEN HE ASKED
ABOUT HOW SHE WAS DOING AND HOW
IT WAS GOING HAVING TO BREAK
THAT NEWS TO HIM. AND THEN
FINALLY JUST ANOTHER CASE THAT
WAS VERY TYPICAL WHEN I WORKED
AT A LOCAL PROGRAM IN LOS
ANGELES OFTEN PEOPLE HAD TO GO
TO HEARING- IF THEY WEREN'T
OUTRIGHT DETERMINED TO HAVE A
DISABILITY. BY THE MEDICARE
PROGRAM. AND IN PREPARING HER
FOR THE HEARING YOU KNOW I WAS
GOING BACK AND FORTH WITH HER
WITH A TYPICAL QUESTION SHE
MIGHT BE ASKED. AND MAKING SURE
THAT SHE WAS READY TO ANSWER
THEM. ADD IT BECOMES VERY
EVIDENT THAT WHEN YOU'RE GOING
THROUGH THIS PROCESS WHAT
YOU'RE DOING IS YOU'RE
BASICALLY ASKING SOMEONE TO
STAND IN FRONT OF AN
ADMINISTRATIVE LAW JUDGE AND
ASKED THAT JUDGE TO RECOGNIZE
THEIR HUMANITY. TO BELIEVE THEM
THAT THEY REALLY HAVE A HEALTH
CONDITION AND THAT THEY'RE NOT
TRYING TO AS WE WOULD YOU KNOW
PEOPLE SAY AT THE TIME BILL
BECAUSE THE SYSTEM. AS IF IT IS
EVER BILKING A SYSTEM TO TRY TO
ACCESS HEALTH CARE SO THAT YOU
CAN WORK OR SO THAT YOU CAN BE
SELF SUFFICIENT. AND IN THE
PROCESS OF THIS QUESTIONING YOU
KNOW SHE JUST LOOKED ME
STRAIGHT IN THE EYE AND SHE
SAID. GEN YOU KNOW I WOULD LOVE
NOTHING MORE THAN TO HAVE A
JOB. EVERY JOB THAT I'VE HAD
RECENTLY I HAVE BEEN FIRED FROM
BECAUSE I KEEP MISSING WORK
BECAUSE I'M SICK. WOULD YOU
HIRE ME. AND YOU KNOW JUST
RECOGNIZING THAT SOMEBODY NOT
ONLY DO THEY RECOGNIZE THE
INHUMANITY OF THE SYSTEM BUT
THEY KNOW HOW PEOPLE LOOK AT
THEM. THEY KNOW THAT PEOPLE ARE
LOOKING AT THEM AS LAZY OR IS
NOT DESERVING OF CARE. AND YOU
KNOW IT JUST IT SPEAKS TO WHERE
WE WERE BEFORE THE ACA AT JUST.
HOW IN HUMANE OUR SYSTEM WAS
THAT WE WOULD WASTE PEOPLE'S
HEALTH WE WOULD WASTE PEOPLE
SELF SUFFICIENCY. AND WE WOULD
BASICALLY WAY AND TELL PEOPLE
DETERIORATED SO MUCH THAT THEY
COULD NOT CARE FOR THEMSELVES
BEFORE OFFERING ANY SORT OF
LENDING HANDS- AND THEN I ALSO.
WANT TO REFLECT BACK ON THE ON
THE PREVIOUS SPEAKER AND ON
WHAT I THINK A LOT OF THE
DOCTORS. YOU KNOW MAY HAVE FELT
AS WELL- ALL OF THE INDIVIDUAL
CONSUMERS IMPACTED BY THIS.
DEFINITELY OFTEN COME INTO A
LIFE THREATENING SITUATION AND
I UNDERSTAND THE ANXIETY THAT
SO MANY PEOPLE FEEL RIGHT NOW
THAT THE ACA AS UNDER THREAT.
THERE'S ALSO AN ANXIETY THAT
MANY OF US HEALTH ADVOCATES
ALSO FEEL BECAUSE WHEN WE WERE
WORKING WITH PEOPLE THAT WE
COULD NOT HELP. THERE'S A
VICARIOUS TRAUMA THAT HAS
SUFFERED THERE WHEN YOU HAVE TO
TELL PEOPLE. I'M SORRY COME
BACK WHEN YOU'RE TOO SICK TO
WORK THERE'S NOTHING THAT WE
CAN DO FOR YOU RIGHT NOW. HAPPY
TO ANSWER ANY QUESTIONS
AFTERWARDS THANK YOU. THANK YOU.
LET'S NOW MOVE ON TO JEFFREY
REYNOSO EXECUTIVE ACTOR LATINO
COALITION FOR HEALTHY
CALIFORNIA. OKAY YOU DOCTOR PAN
AM MEMBERS OF THE COMMITTEE-
I'M JEFFREY ALSO SECOND
DIRECTOR FOR THE LEGISLATION
PROBABLY CALIFORNIA I WE
REPRESENT THE HEALTH NEEDS OF
NEARLY 40% OF OUR STATE'S FORTY
MILLION RESIDENTS THE COMING
NINETEEN PANDEMIC HAS
DISPROPORTIONATELY IMPACTED OUR
COMMUNITY WITH THE LATEST C. PH
DATA REPORTING LIVE IN LATINOS
REPRESENT THE- 60% CASES A
NEARLY 50% DEATHS. LATINOS ARE
MORE LIKELY TO WORK IN THE
CENTRAL APPLICATIONS INCLUDING
FARMWORKERS DOMESTIC WORKERS
RESTAURANT WORKERS IN OTHER
OCCUPATIONS THAT MAKE IT
POSSIBLE FOR ALL CALIFORNIANS
TO CONSIDER LIVING OUR LIVE
STREAM THIS PANDEMIC IF OUR
WORK IS ESSENTIAL ARE WE
HEALTHCARE SHOULD BE SENSITIVE.
YEAH CAN I MAKE RECESSION IS
CITY LINE ASKED ME THE HARDEST
ACCORDING TO RECENT POLLING
DATA FROM HARVARD SCHOOL OF
PUBLIC HEALTH NPR LATINOS ARE
THE MOST LIKELY TO HAVE BEEN
NEGATIVELY IMPACTED WITH CUTS
TO OURS ARE JOB LOSSES THAT'S
THE RAINY THAT 36% OF
CALIFORNIA LOCULES WHEN
EMPLOYER SPONSORED COVERAGE.
THE PUBLIC CHARGE REALLY BY THE
CURRENT FEDERAL MINISTRATION
HAS CAUSED CONFUSION AMONG OUR
IMMIGRANT FAMILIES THIS IS XENA
PHOBIA AND STOMACH RESELLERS
HAS OMITTED A CULTURE OF FEAR
OTHER INSTITUTIONS LEAD TO DIS
ENROLLMENT AND UNDERGONE MENTAL
HEALTH AND SOCIAL SERVICES
PROGRAMS DELAYED PREVENTIVE
HEALTH CARE SERVICES AND
ULTIMATELY PREMATURE DEATH OUR
COMMUNITY. AC'S MEDICAID
EXPANSION AND STATE HEALTH
INSURANCE EXCHANGES RESULTED IN
CALIFORNIA LOCULES EXPERIENCING
THE LARGEST DROP OF AN
INSURANCE OF EIGHTY RACIAL OR
ETHNIC GROUPS AT THE START OF
THE CA WOMEN'S YUSHIN TWENTY
THIRTEEN TWENTY SEVEN POINT 9%
LATINOS WERE UNINSURED AND BY
TWENTY EIGHTEEN THAT NUMBER
DROPPED MORE THAN HALF TO
TWELVE POINT FOUR PERCENT. THAT
I DON'T STATE INVESTMENT IN
MARKETING IN OUR REGION
INCLUDING ENROLLMENT NAVIGATORS
PROGRAM AND CAN YOU HEALTH
CENTER AND CBO PARTNERSHIPS
WITH CRITICAL INSIGHT ENOUGH
OUR COMMUTES INTO COVERAGE ON
THE GROUND AND YET AMONG THE
REMAINING ENSURING CALIFORNIA
LATINOS ARE THE MOST LIKELY TO
BE UNINSURED AT 63% ACCORDING
TO UCLA TRISTEZA. ONE OF THE.
PRIMARY FACTORS DRIVING THIS
RATE IS AND HE STATUS I DON'T
LEVEL THE C. BLAH YOU KNOW. A
COMMUNITY FROM THE LAW IN
CALIFORNIA HAVE ELEVEN. BY
EXPANDING. BEYOND THE A- BUT
FULL MEDICAL COVERAGE LONG KIDS
A UNIT. REGARDLESS OF THE-
STATUS WE SAW MORE TO DO IN OR
TAKES AND POLICE THIS ACCESS
DOCUMENTS YEARS AND WORKING
ADULTS. WHEN INSTITUTION INSIST
REMOTE. TO ACCESSING HEALTHCARE
AND DELIVER SERVICES IN MY- AND
CULTURE. WE KNOW THAT ARE
MOTIVATED AND YOU LICENSE
HEALTH CARE THEY NEED TO KEEP
THEMSELVES AND THEIR FAMILIES
HEALTHY. ALANIS COMMITTEE HAVE
THE MOST TO GAIN FROM THE
AFFORDABLE CARE ACT AND WE ALSO
HAVE THE MOST TO LOSE. A
SUPREME COURT RULING
OVERTURNING THE AFFORDABLE CARE
ACT WOULD HAVE DISASTROUS
HEALTH AND ECONOMIC EFFECTS FOR
STATE. MOVING US BACKWARD ON
OUR COLLECTIVE PROGRESS IN
TACKLING RACIAL ETHNIC HEALTH
DISPARITIES FOR DISH TV
HEALTHEQUITY. I WANT THE
MEMBERS OFTHE COMMITTEE FOR
THIS CONVERSATION- AND TACKLING
THE HARD WORK. CREATING A
TWENTY FIRST CENTURY HEALTH
SYSTEM THAT IS ACCESSIBLE
AFFORDABLE HIGH QUALITY AND
AFFORDABLE FOR ALL CALIFORNIANS
ALSO HAPPY TO QUESTIONS. OKAY
THANKS VERY MUCH- DIFFERENT SO.
NOW LET'S MOVE ON TO KRISTEN
YOUNG- POLICY ADVOCATE THE
CALIFORNIA CHAMBER OF COMMERCE.
WELCOME GOOD AFTERNOON THAT MR
CHAIRMAN AND COMMITTEE MEMBERS
TOTALING COMING CLEAR.
MICROPHONES WORK IN. YES SO IT
MAY NAME IS PRESS YOUNG FROM
THE CAL. J. OF COMMERCETHANK
YOU SO MUCH FOR ME PER. AND
HERE IT'S MUCH I'LL BE SPEAKING
TODAY FROM AN EMPLOYER. BASED
NOW FROM CAL CHAMBERS POSITION
WE DON'T WANT TO SEE THE ACA
REPEAL ESPECIALLY IF THERE'S
NOT A VIABLE REPLACEMENT THE
EMPLOYER MANDATE THAT CAME
ALONG WITH THE ACA HAS BEEN
IMPLEMENTED IN AND AFFECT. OVER
FIVE YEARS NOW AND SO TO GET TO
THE POINT WHEREEMPLOYERS AND
INSURERS WERE ABLE TO OFFER.
ACA COMPLIANT PLANS IS A HUGE
LEFT IT TOOK. A HUGE FINANCIAL
OBLIGATION IT TOOK A HUGE-
WORKER POWER OBLIGATION IT TOOK
AN ARMY OF LAWYERS YOU CAN
IMAGINE. AND WE'RE AT A POINT
NOW WHERE ACA COMPLIANT PLANS
ARE BEING OFFERED IN THE
WORKPLACE SO. THE CONCERN IS IF
YOU REPEAL THE AFFORDABLE CARE
ACT WITHOUT A VIABLE
REPLACEMENT. IT'S PUTTING
EMPLOYERS AND INSURERS IN A
POSITION AGAIN WHERE THEY'RE
GONNA HAVE TO RECREATE. A
WORKPLACE- A HEALTH PLAN.
FRAMEWORK WHICH WOULD PROBABLY
MEAN MORE LAWYERS MORE TIME
MORE MONEY ANOTHER HUGE HEAVY
LIST- NO WOMAN LOOK AT THE
POTENTIAL OF AN ACA REPEAL
WHAT'S IT LOOK LIKE. FROM AN
EMPLOYER BASED PERSPECTIVES. I
WISH I HAD MORE ANSWERS FOR YOU
TODAY AND I WISH I WAS OFFERING
MORE INSIGHT IT'S A HUGE
QUESTION MARK TO BE SURE- IT'S
REALLY DIFFICULT TO PROJECT. ON
THE SMALL. EMPLOYER MARKET.
COOLEY OFFER EMPLOYERS HEALTH
TO DO THREE SHOP PROGRAM
THERE'S A TAX CREDIT THAT'S
ASSOCIATED WITH THAT OBVIOUSLY
THE TAX CREDIT WOULD BE IN
JEOPARDY THE C. WERE TO BE
REPEALED- IN REGARDS TO LARGE
EMPLOYERS. THAT LANDSCAPE IS
ALSO ONE THAT'S UNPREDICTABLE
THIS TIME THE THOUGHT IS YOU
WOULD GO BACK TO A PRE ACA.
FRAMEWORK IN SO WHAT WOULD THAT
MEAN WELL. UNDER THE ACA LARGE
EMPLOYERS MEANING FIFTY OR MORE
EMPLOYEES THAT WORK FOR A AN
ORGANIZATION. THE FULL TIME
WORKERS ARE THE ONES THAT ARE
SUPPOSED TO GET COVERED BY THE
EMPLOYER SPONSORED PLAN. NOW
FULL TIME WORKERS UP TO FORTY
HOURS A WEEK ON THE BBC IT'S
THIRTY HOURS A WEEK- FOR HOURS
WORKED SO THE IDEA IS IF THERE
IS A REPEAL OF THE ACA.
EMPLOYERS ARE NOW OFFERING
THEIR OWN PLANS AGAIN LIKE THEY
DID A- DECADE AGO. THE THOUGHT.
IS THE PLANS WOULD LIKELY BE
EXTENDED TO FULL TIME WORKERS
GOING FORTY HOURS A WEEK AS
OPPOSED TO THOSE WORKING THIRTY
HOURS A WEEK IN THAT SAME VEIN
YOU PROBABLY SEE AN ELIMINATION
OF HEALTH PLAN COVERAGE FOR
EMPLOYEES WORK PART TIME OR
SEASONAL OR TEMPORARY- AGAIN TO
BE UP TO THE ORGANIZATION SO
THESE ARE JUST THOUGHTS-
ADDITIONALLY A REPEAL THE ACA
COULD MEAN THIRTEEN INCREASE
THE AMOUNT THAT- EMPLOYEES WHO
ELECT GROUP HEALTH PLAN
COVERAGE REQUIRED TO CONTRIBUTE.
SO WHEN YOU LOOK AT THE CREASE
AC FRAMEWORK ESPECIALLY LARGER
EMPLOYERS. THE PREVIOUS-
COVERAGE WAS RATHER
COMPREHENSIVE AND ROBUST IT WAS
THE SMALLER SEGMENT WHERE YOU
SAW A LOT OF VARIATION SO IT
REALLY IS UP IN THE AIR RIGHT
NOW AS TO WHAT WOULD HAPPEN
WITH EMPLOYER SPONSORED PLANS
AND THAT'S INCLUSIVE OF I
BELIEVE A HUNDRED EIGHTY
MILLION PEOPLE ACROSS THE
UNITED STATES THAT'S HOW THEY-
BEGIN THEIR HEALTH INSURANCE-
SO THAT'S LOOKING AT THINGS
FROM. THE MICRO PERSPECTIVE
WITHIN THE WORKPLACE NOW FROM
THE MACRO PERSPECTIVE LOOKING
AT THE CALIFORNIA JOB SECTOR IN
THE JOB SEGMENT ANOTHER HUGE
QUESTION MARK WHAT'S IT GONNA
DO THIS THERE'S REPEAL WITHOUT
FEDERAL DOLLARS ROLLING AND
YOU'RE TALKING ABOUT CERTAIN-
SEGMENTS OF THE HEALTHCARE
MARKET. THAT MIGHT BE AN ISSUE
YOU'RE LOOKING AT PEOPLE
NEEDING TO ALLOCATE POSSIBLY
MORE MONEY TO THEIR HEALTHCARE
SO MAYBE THEY'RE NOT SPENDING
IN OTHER PLACES QUITE AS MUCH
THAT COULD AFFECT THE- BASIC
ECONOMICS OF THE WORKPLACE- LOT
OF UNKNOWNS RIGHT NOW SO I DO
APPRECIATE THE TIME I DO
APPRECIATE THE CONSIDERATION
THANK YOU SO MUCH FOR. ALLOWING
US TO BE A PART OF THIS. THANK
YOU VERY MUCH PERSON YOUNG FOR
YOUR PRESENTATION. AND NOW WILL
WRAP UP THIS PANEL WITH-
ANTHONY WRIGHT EXECUTIVE
DIRECTOR OF HEALTH ACCESS
CALIFORNIA. GOOD AFTERNOON-
AGAIN MY NAME IS ANTHONY RIGHT
OUT OF THE EXECUTIVE DIRECTOR
OF HEALTH ACCESS CALIFORNIA
STATEWIDE HEALTHCARE CONSUMER
ADVOCACY COALITION I WANT TO
THANK YOU. ALL RIGHT SHARE
GIVEN HAN AND- THE COMMITTEE.
NOT JUST FOR HOLDING THIS
HEARING IT REALLY DIVING INTO
THE CALIFORNIA SPECIFIC IMPACT
OF. THIS DISTURBING COURT CASE.
AND EFFORTS RESPECT ON THE
AFFORDABLE CARE ACT BUT ALL THE
WORK THAT YOU'VE DONE OVER MANY
YEARS. THAT HAS LED TO
CALIFORNIA HAVING THE BIGGEST
DROP IN THE UNINSURED RATE OF
ALL FIFTY STATES. THAT HAS LED
TO THE DOCTORS THE ABOMINATION
BUT IMPROVEMENTS. OF OUR
HEALTHCARE SYSTEM- ANDA LOT OF
THAT PROGRESS IS IN PERIL WITH
THIS- WITH THIS COURT CASE THAT
A LOT OF WHAT WE'VE DONE HAS
BEEN UNDER SO USING THE
FOUNDATION AND THE FRAMEWORK.
OF THE AFFORDABLE CARE ACT AND
EVEN THOUGH A LOT OF IT IS-
CALIFORNIA SPECIFIC AND. AND
THAT WE HAVE A LOT OF PRIDE IN
A LOT OF THAT. WEST ON IT DOWN
THE AND IF TIME THE WERE TO BE
AWAY. AND A LOT OF IT WOULD.
POTENTIALLY KALAU. I IT WAS
PARTICULARLY BY THE TESTIMONY
BY- OUR INDIVIDUAL- PATIENTS
TELLING THEIR STORIES. WHO YOU
KNOW TALK ABOUT NO BASIC ACCESS
TO CARE LIFE AND DEATH ACCESS
TO CARE. BUT I THINK ALSO
HINTED AT HOW THIS IS. THIS IS
NOT JUST ABOUT. YOU KNOW THE
FOUR MILLION PLUS PEOPLE THAT
CASEY COOPER. IDENTIFIED BETTER
DEPENDING ON THE IMPROVEMENTS
EXPANSIONS AND MEDIC OUT BY THE
HUNDREDS OF THOUSANDS OF. OF
CALIFORNIANS GETTING SUBSIDIES
AND ACCESS TO COVER TO COVER
CALIFORNIA. THAT WOULD
POTENTIALLY LOSE IT- THAT- THIS
IS ABOUT ALL CALIFORNIANS WOULD
EITHER- POTENTIALLY HAVE THEIR
EMPLOYER BASED. HEALTH IMPACT
OR YOU KNOW WHO BECAUSE OF THE
CUTS TO THE HEALTHCARE SYSTEM
THAT- WOULD YOU. SEE THE
PROVIDERS THAT THEY RELY ON-
PACKAGE- CUTBACKS STAFFING AND
SERVICES. REGARDLESS OF WHAT
THEIR- INCOME WAS I THINK MORE
BROADLY IT'S VERY BASIC
QUESTIONS ABOUT. SECURITY ABOUT
PEACE OF MIND. BUT WHETHER
PEOPLE CAN- MAKE HE LIFE
CHOICES WITHOUT HAVING- THAT
SORT OF SPECTER OF BEING OF YOU
KNOW NOT HAVING. BASIC HEALTH
COVERAGE. BE AVAILABLE TO THEM
THAT'S WHAT'S AT STAKE IN THIS-
I'M ACTUALLY. AT THE END IN
THIS. THE SUPREME COURT CASE. I
WOULD SAY. I THINK YOU KNOW THE
QUESTION OF YOU KNOW HIGH THAT
THAT OF WHAT HAPPEN THE ENTIRE.
OR MUCH OF THE EAST WAS DOWN
AND- YOU KNOW IT'S A NOT A KIND
OF SOMETHING THAT WE
EXPERIENCED HERE IN CALIFORNIA
AS A FEW SPEAKERS INDICATED.
BECAUSE YOU KNOW WE KNOW WHAT
THE WORLD WAS LIKE IT WAS YOU
KNOW TERM THE WILD WILD WEST IN
FACT I WOULD SAY THE
CALIFORNIA. IN BOTH AREAS OF
COVERAGE AND CONSUMER
PROTECTION AND COST CALIFORNIA
JUST JUST DIDN'T HAVE THESE
PROBLEMS WE WERE THE POSTER
CHILD FOR THESE PROBLEMS YOU
KNOW IN COVERAGE WE HAD THE
SEVENTH HIGHEST UNINSURED RATE
IN THE NATION PRIOR TO THE
FORMAL CARE ACT LOS ANGELES.
PROBABLY WAS GROUND ZERO. FOR
HAVING ON THIS THING SUCH A
HIGH PERCENTAGE OF PEOPLE WHO
ARE UNINSURED CENTRAL VALLEY
RIGHT UP THERE WITH IT- WITH
REGARD TO CONSUMER PROTECTION
PEOPLE WERE DENIED FOR PRE
EXISTING CONDITIONS NOT EVEN
AFFORD A- DENIED FROM GETTING
INTO COVERAGE. BUT IN SOME
CASES THEY'RE COVERED WAS
RESCINDED AFTER THE FACT WHEN
IT WAS FOUND THAT THEY HAD A
PRE EXISTING CONDITION- ARE
THESE BOTH THE THINGS GENERATED
NATIONAL HEADLINES AND HELP
PROMPTED THE POINT OF REFORM.
AND THE SAME WITH OUR PREMIUM
INCREASES ONE PARTICULAR
PREMIUM INCREASE. OF PROPOSING.
39% WHAT IS OUR- HAS BEEN
CREDITED AS ONE OF THE LAST
THAT WE- ACTUALLY LED TO THE-
OF THE AFFORDABLE CARE ACT. SO
WE. WE HAVE. THAT EXPERIENCE
AND I HAVE THAT EXPERIENCE
HAVING. BEEN IN MY AT ACCESS.
OR NEARLY TO DEATH NOW. I WOULD
SAY. I WILL ALSO SAY IN THAT
EXPERIENCE THAT YOU KNOW WE
WORK TO TRY TO DEAL WITH THESE
ISSUES. POINT BY POINT- OVER-
OVER THE YEARS PRIOR TO THE
AFFORDABLE CARE ACT AND IT WAS
REALLY HARD WITHOUT THE
FRAMEWORK IN THE FINANCING. OF
THAT THE FEDERAL GOVERNMENT
PROVIDED THROUGH THE ACA- IT'S
NOT LIKE WE DIDN'T TRY TO-
PROVIDE PROTECTION FOR PEOPLE
EXISTING CONDITIONS BUT IT'S
VERY HARD TO DO THAT WITHOUT
THAT. MONEY AND LEX IT WOULD
HAVE HAD FINANCING WITHOUT THE
FRAMEWORK. AND YOU KNOW SOME OF
IT IT'S ABOUT THIS FEDERAL
PREEMPTION THERE IS YOU KNOW
ABOUT. YOU KNOW FIVE SEVEN
MILLION CALIFORNIANS OR IN
FEDERALLY REGULATED PLANS THAT
WE CAN'T TOUCH AT THE STATE
LEVEL EVEN IF WE PROVIDE THOSE
PROTECTIONS AT THE STATE LEVEL.
IN OTHER WORDS- BUT IT'S ALSO
ABOUT THE FINANCING- THE L. A.
MENTIONED- YOU KNOW OVER TWENTY
FIVE BILLION DOLLARS THE
MEDICAID EXPANSION AND THE
SUBSIDIES AND COVERAGE
CALIFORNIA ALONE. BUT THE
LEGISLATORS WHO RUN THIS
COMMITTEE. EQUIVALENT IF YOU
ARE TRYING TO FIND OUT MONEY IN
THE STATE BUDGET. YOU WOULD
HAPPEN- ON UNDO ALL OF THE
FUNDING. FOR ALL OF HIGHER
EDUCATION UCCS USE. DURING THE
HOLIDAYS AND ALL OF CORRECTIONS
COMBINE. IN ORDER TO MAKE UP
THE EQUIVALENT AMOUNT OF MONEY.
THAT IT. WAS THAT WE GET
THROUGH THE AFFORDABLE CARE ACT
BETTER HEALTH SYSTEM GETS-
THROUGH THE ACA. SO YOU KNOW
WE- CAN WE GO GO IT ALONE IF WE
IF WE LOSE KEY ELEMENTS OF THE
AFFORDABLE CARE ACT. IT WOULD
BE MORE OF A SALVAGE OPERATION
IT WOULD BE ONE OF THOSE
LIFEBOATS- OF FOR A HANDFUL OF.
FOLKS THAT PETER LEE TALKED
ABOUT RATHER THAN. KEEPING
WHICH IS TO AVOID THE ICEBERG
HEATING IS HOW CAN WE.PREVENT
THAT THE- IT'S THE-
CATASTROPHIC. OF THE OUR YOU
KNOW OF AS THIS. YOU KNOW
EITHER THE COURTS AND YOU KNOW
GUYS. TO ATTORNEY MR LEAD THAT
NASH GUARD. OR IS HE OUR
FEDERAL REPRESENTATIVES. TO
FIND ALTERNATIVES- YOU KNOW
THROUGH THE CONGRESS AND
OTHERWISE AND THAT'S WHAT I
FINALLY WANT TO SAY IS THAT.
YOU KNOW SOME PEOPLE SAID WHY-
AGAIN THIS IS SO IMPORTANT YOU
KNOW AND SOME PEOPLE SAY WELL
MAYBE IT WON'T HAPPEN MAYBE
THIS WILL HAPPEN AT THE- OAK.
MAYBE THERE WILL BE A MUCH MORE
NARROW RULING OR NOT A ROOF.
WILLING AT ALL TIMES REPORT BUT
EVEN A NON ZERO CHANCE OF THE
CATASTROPHE THAT IS BEING
DESCRIBED HERE. IS WORTH
SHOUTING FROM THE ROOFTOPS AND
THE FACT THAT NONZERO CHANCE
DOES YOU KNOW POTENTIALLY IS
GOING TO GET. A LITTLE A LITTLE
BIT MORE LIKELY IN THE NEXT.
FEW WEEKS- IS IT SOMETHING THAT
AND WE SHOULD BE OUR- HAVE OUR-
HAVE OUR BORROWED FIVE ALARM
FIRES OUT READY. BECAUSE OF THE
POTENTIAL IMPACTS TO MAKE SURE
THAT. THAT AMOUNT THAT CHANCE
DOES BECOME ZERO IN IT. THE
GOOD WORK OF. OF THE ADVOCACY
OF THE PEOPLE WHOSE BUTTONED UP
OR END UP. ON THE LIFT THE
LEGISLATORS AGAIN THANK YOU FOR
DOING THIS TESTIMONY JUST-
UNDERLINING THE REAL IMPACTS
YOUR IN CALIFORNIA. WHICH YOU
KNOW IN THE MOST UNDER THE
AFFORDABLE CARE ACT AND HAS THE
MOST TO LOSE. THANK YOU. THANK
YOU. RIGHT US. QUESTIONS ARE
CALM FROM COMMITTEE. THIS SO
LEYVA. DID YOU HAVE YOUR HAND
UP THERE. YOU THINK YOU VERY
MUCH PAN. I JUST HAVE TO SAY
HERE TO WHOLE. AND IN SO PROUD
OF EVERYONE BEEN A- OF THE
AFFORDABLE. ACT AND EVERYONE
WHO'S BEEN A PART OF
IMPLEMENTING IT. AND IT'S I
JUST WANT TO COMMENT ON HOW
SHOCKING IT IS STILL IS TO ME.
THAT WE HAVE ELECTED OFFICIALS
IN THE FEDERAL GOVERNMENT WHO
HAVE TAXPAYER FUNDED HEALTH
CARE BUT ARE TRYING TO DE FUND
HEALTH CARE. FOR THE SICKEST
PEOPLE IN OUR SOCIETY BUT NOT
JUST THAT EVERY HUMAN BEING
DESERVES ACCESS TO AFFORDABLE
HEALTH CARE. AND I WANT TO SAY
THANK YOU SO MUCH TO THE
CONSUMERS. WHO SHARE THEIR VERY
PERSONAL STORIES- WHEN I WAS
WITH THE UFCW AND WE WERE
NEGOTIATING BENEFITS FOR OUR
MEMBERS. WE'VE HEARD THE
STORIES FROM PEOPLE WHO WORK IN
GROCERY STORES. EVERYONE NEEDS
ACCESS TO HEALTH CARE BECAUSE
YOU NEVER KNOW WHAT'S GOING TO
HAPPEN IN YOUR LIFE. AND WE
ALSO KNOW THAT WHEN PEOPLE
ROUTINELY GET CHECKUPS. THEY
DON'T WAIT UNTIL THE LAST
MINUTE WHEN IT'S SUPER SERIOUS
AND COST THE WHOLE SYSTEM MORE.
SO I JUST- I THINK SENATOR
MONNING SAID IT BUT I WOULD
ENCOURAGE THE CONSUMERS. TO
WRITE YOUR STORY SENATE TO
MEMBERS OF CONGRESS REALLY IT
TO CONGRESS AND THE SENATE TO
THE SUPREME COURT- AND JUST
DON'T BELIEVE ALL THAT RHETORIC
THAT WE'RE HEARING FROM.
REPUBLICANS WHO MANY OF THEM
HAVE- TAXPAYER FUNDED HEALTH
CARE AS WELL AND I JUST ALSO
WANT TO IN BY SAYING WHEN WE
WERE SIGNING PEOPLE UP ON THE
AFFORDABLE CARE ACT. ON COVER
CALIFORNIA. TEN YEARS AGO WHEN
IT WAS FIRST ENACTED THE PEOPLE
CAME THROUGH THE DOORS OF MY
LOCAL UNION. HADN'T HAD HEALTH
CARE IN TWENTY YEARS OR LONGER
OR FOR THEIR WHOLE LIFE YOU CAN
TELL. YOU CAN TELL WHEN PEOPLE
HAVEN'T HAD ACCESS HEALTH CARE
AND I AM HAPPY BE IN OF THE-
WHERE I CAN TRY AND HELP. AND
WE JUST WHO YOU ELECT MATTERS-
NO ONE SHOULD BE DENYING PEOPLE
HEALTH CARE I'M SO PROUD OF THE
WORK THAT EVERYONE WHO'S TALKED
HERE TODAY HAS DONE- FOR. THE
AFFORDABLE CARE ACT FOR COVER
CALIFORNIA PETERLEE IF YOU'RE
STILL ON A GREAT JOB YOU'RE
DOING WONDERFUL WORK. AND THE
MONEY THAT CALIFORNIA RECEIVES
WHEN WE TALK ABOUT THE HEALTH
CARE PROVIDERS THIS IS A HUGE
SO. THAT HELPS THE ECONOMY OF
CALIFORNIA AND OF COURSE EVERY
INDIVIDUAL WHO NEEDS HEALTH
CARE SO. DR PAN THANK YOU FOR
PUTTING THIS TOGETHER THANK YOU
FOR EVERYONE WHO PARTICIPATED-
I WILL CONTINUE TO FIGHT DO
WHATEVER I CAN TO MAKE SURE
EVERYONE HAS ACCESS. TO
AFFORDABLE HEALTH CARE THANK
YOU. THANK YOU CENTER LEYVA. I
THINK THAT WAS A PRIME MORE
COMMENT THAN A QUESTION SO I'M
GONNA MOVE ON THEN TO CENTER
RUBIO. WELL DOCTOR CAN I THINK
I HAVE A LITTLE BIT OF COMMENTS
RATHER THAN QUESTIONS BUT YOU
KNOW I'LL JUST FOLLOW ON THE
FOOTSTEPS OF SENATOR LEYVA I
REALLY JUST ALSO WANTED TO
HIGHLIGHT AND- THANK THE WORK
THEY EVERYONE STAND IN THIS. IN
THIS REGARD BECAUSE I KNOW THAT
IT'S SO MUCH HARDER TO HAVE
SOMETHING IN FOR SOMETHING TO
BE DISMANTLED AND I KNOW WHEN I
THINK OF. SO MANY PEOPLE THAT
ARE FOR DESTROYING IT THE
AFFORDABLE CARE ACT THEY DON'T
UNDERSTAND THAT IT'S A SYSTEM.
THAT'S JUST GONNA CRUMBLE
THERE'S SO MANY THINGS THAT ARE
TIED TO THE AFFORDABLE CARE ACT
FROM. SERVICE PROVIDERS TO JOBS
TO THE SURROUNDING ECONOMY. AND
IN ORDER FOR CALIFORNIA TO
CONTINUE TO BE HEALTHY WE NEED
TO STATE. THAT WITH WHAT WE
HAVE AND SO HOPEFULLY YOU KNOW
WHEN IT COMES TO ADVOCATING NOW
SENATOR LEYVA SAID WE NEED TO
MAKE SURE THAT. YOU KNOW PEOPLE
REACHING OUT TO THE TO THE- OF
CONGRESSIONAL MEMBERS AND NOT
THE SENATE AND PUTTING THEIR
STORIES OUT THERE THIS IS
SOMETHING THAT'S REALLY GOING
TO HURT. IN PARTICULAR THE
INNER CITY COMMUNITIES LATINOS-
JUST IN GENERAL THE LOW INCOME
FAMILIES AND SO I JUST WANT TO
THANK EVERYONE THAT'S SPOKEN
HERE TODAY THE PERSONAL STORIES
AND- AND EVERYONE WHO'S STILL
WORKING TO MAKE SURE THAT IT.
STAYS WHERE IT'S AT AND TO YOU
FOUNDER. THANK YOU FOR BRINGING
US TOGETHER I THINK THIS IS A
TIMELY CONVERSATION BECAUSE-
YOU KNOW I HAVE ANXIETY OVER
THIS AND I AND I'M GONNA BE
OKAY BUT I HAVE ANXIETY OVER
THE PEOPLE THAT ARE. ARE YOU
KNOW COULD STAND TO LOSE WHAT
THEY HAVE IN THEIR COVERAGE AND
DO YOU KNOW I COMING FROM.
HOUSEHOLD THAT DIDN'T HAVE
INSURANCE AS A CHILD I KNOW HOW
SCARY IT CAN BE SELF. THANK YOU
TO EVERYONE AND I JUST I THINK
THE DOCTOR PAN BEFORE THIS IS
OVER FOR BRINGING US TOGETHER
TODAY. THANK YOU AND ACTUALLY-
WE DO ACCEPT BOTH COMMENTS AND
QUESTIONS FROM COMMITTEE
MEMBERS I WHEN I MADE MY REMARK
WAS JUST MORE DIFFUSED. SO THAT
THAT I DIDN'T THINK ANYONE NEED
TO. ANSWER QUESTION OR RESPOND
FOR WHAT THE- SELF. ASSEMBLY
COMMENTS PROOF I TO. ONE TO.
SETTLES IN THE HANDS UP I TWO
ONE TWO. ALSO MAKES MY OWN
COMMENTS- THE FIRST ONE I DO
WANT TO THANK ALL THE ADVOCATES
WHO WHO'S WHO'S SPOKEN AND-
SHARED YOUR EXPERIENCES. YEAH
WE'VE IMPLEMENTED THE ACA FOR
TEN YEARS WE TALKED ABOUT
SUCCESSES- IT'S NOT PERFECT AND
DEAL WE'VE DONE WORK ON IT
WE'RE STILL CONTINUING TO WORK-
ACTUALLY FRANKLY ONE OF THE
THINGS I'M DISAPPOINTED ABOUT
IS AT THE FEDERAL LEVEL IT'S
BEEN SO POLITICIZED. THAT IN
CONGRESS- INSTEAD OF WORKING TO
IMPROVE THE THINGS THAT COULD
BE IMPROVED- IF YOU TRY TO
PROVE IT YOUR THEN FOR IT AND
THEREFORE PEOPLE WOULDN'T VOTE
FOR IMPROVEMENTS. RIGHT AND
INSTEAD WE KEEP HAVING THIS
CYCLE ABOUT DO WE REPEAL THE
ACA ARE NOT INSTEAD OF TALKING
ABOUT LOOK THIS IS THE LAW OF
THE LAND WE NEED TO MOVE
FORWARD. I DO ALSO WANT TO
THANK ATTORNEY GENERAL THE
SERRA AND HIS TEAM FOR CARRYING
ON THIS FIGHT. TO THE SUPREME
COURT- I WOULD MAKE NOTE OF
THAT- WELL CERTAINLY I THINK
WHEN THE AC IS BEING PASSED
AND- PEOPLE LOOKED AT THE
INDIVIDUAL MANDATE AND THE
PENALTY. THAT THE PROBABLY WERE
IN A POLICY ANALYST YOU'LL
POLICY PEOPLE AND MEMBERS OF
CONGRESS TO MAKE COMMENTS ABOUT
HOW THAT'S TIED TO OTHER
PORTIONS PARTICULARLY THE
PROVISIONS RELATED TO PRE
EXISTING CONDITION PROTECTIONS
AND AS THE- DIFFICULTY MENTION
DOUBTS NOT JUST ONE. THING IT'S
ACTUALLY A WHOLE SET OF THINGS
IN IN THE LAW THAT DOES THAT
BUT I THINK ALSO SINCE WE'VE
EXPERIENCE- IN THE NATION AFTER
CONGRESS ESSENTIALLY ZEROED OUT
THE PENALTY THE FACT THAT THE
AC ITSELF STILL CONTINUES TO
FUNCTION. AND ACTUALLY
FUNCTIONED RELATIVELY WELL.
THAT YOU KNOW. COMMENTS THAT
PEOPLE MADE A HOW. ESSENTIAL
THAT IT IS IN TERMS OF LINKING
IT TO ALL THE OTHER PROVISIONS
HOPEFULLY- THE SUPREME COURT.
WELL FIRST WHILE THE SUPREME
COURT RECOGNIZES THAT STATE
THAT THIS IS A THIS IS A
CONSTITUTIONAL LAW AND IT SAYS
SHOULD NOT BE OVERTURNED BUT-
EVEN IN TERMS OF SEVERABILITY-
THE INDIVIDUAL MANDATE IF
THERE'S ANY QUESTIONS ABOUT
THAT CERTAINLY. THE EIGHTIES
BEEN OLD FUNCTION IN THIS
COUNTRY- EVEN WITH A ZEROED OUT
INDIVIDUAL MANDATE- AS- BUT
CONGRESS BUT- THE OTHER THING I
ALSO WANT TO JUST MAKE AN
OBSERVATION AND- CERTAINLY
HEARD FROM OUR CONSUMERS AND TO
REALLY APPRECIATE THE TESTIMONY
FROM GEORGIA. TERRY OF
INSURANCE AND CHEN FLORI AND-
AND ALSO FOR- FROM OTHERS AS
WELL AS- ACTUALLY WHAT KIND OF
WHAT THE ACA DOES. IN TERMS OF
GIVING AMERICANS FREEDOM. ALL
RIGHT. YOU KNOW OFTENTIMES
PEOPLE THINK FREEDOM IS
SOMETHING THAT ONLY PEOPLE OF A
CERTAIN IDEOLOGY TALK ABOUT
THAT THIS IS ABOUT THIS IS
ABOUT FREEDOM. RIGHT TO FREEDOM
FROM FEAR TO FREEDOM OF PEOPLE
TO BE ABLE TO MAKE DIFFERENT
KIND OF CAREER CHOICES WE HEARD
ABOUT THAT FROM CONSUMERS. AND
THAT WILL THE SUPREME COURT
TAKE THIS FREEDOM AWAY FROM
AMERICANS. AND I THINK THAT'S
REALLY THE QUESTION THAT'S
COMING BEFORE THE SUPREME COURT
AND THANKS TO OUR ATTORNEY
GENERAL MANY OTHERS. THE
CONGRESS PASSED THE LAW THE
PRESIDENT SIGNED THE LAW. THAT
IS GIVEN NEW OPPORTUNITIES TO
AMERICANS. BY PROVIDING THEM
HEALTHCARE. AND SO IS THE
FREEDOM TO BE TAKEN AWAY. AND I
THINK IN THIS HEARING WE HEARD
WHAT IT WAS LIKE TEN YEARS AGO
WE CAN FORGET A LOT OF THINGS.
OVER A DECADE. BUT WE HEARD
ABOUT WAS LIKE FOR. AND WHAT'S
BEEN SENSE IT'S NOT PERFECT WE
NEED TO DO MORE. WE'RE NOW THE
PEERS CODED A THINK THAT SERVE
PERHAPS UNDERSCORES FOR PEOPLE.
HOW IMPORTANT IT IS MAYBE IT'S
A REMINDER BUT WE HAVE THE
PROTECTIONS OF THE ACA RIGHT
NOW AS WERE STRUGGLING TO COPE
IT. IMAGINE THEY'RE TAKEN AWAY.
WHAT THAT MEANS. SO I THINK ARE
WITH THAT- I JUST I GUESS
THAT'S AGAIN MY COMMENT- FOR
NOW- BUT AGAIN I WANT TO THANK
ALL THE WITNESSES- WHO HAVE A
TESTIFYING PARTICULARLY. THE
WITNESSES WE JUST HEARD FROM.
AND IS THERE ANY OTHER COMMENTS
OR QUESTIONS FROM COMMITTEE
MEMBERS PERFORM WITH PUBLIC
COMMENT. CASEY NO HANDS UP. ALL
RIGHT. SO WE'RE NOW GOING TO
MOVE ON TO ANYONE WHO WANTS TO
PROVIDE PUBLIC COMMENT. DUE TO
THE CONSTRAINTS REGARDING THE
LENGTH HEARING SIGNAL THE
CONSIDERATIONS. INCLUDING
PROTOCOLS- I THE COMMITTEE
CHAIR- WILL BE INSTITUTING A
TIME LIMIT ON TESTIMONY OF ONE
MINUTE FOR PUBLIC COMMENT WE'RE
GOING TO BEGIN WITH ANYONE HERE
IN THE GALLERY WHO WISHES TO
TESTIFY. ALL RIGHT I DON'T SEE
ANYONE UP IN THE GALLERY WE'RE
NOW GOING TO MOVE ON TO ANY
WITNESSES IN ROOM ONE TWELVE.
YOU NOT SEE ANYONE IN ROOM ONE
TWELVE FIVE PUBLIC COMMENT NOW
WE'RE GONNA MOVE ON TO THE
TELECONFERENCE OFFICE. SO WE'RE
GONNA MOVE ON WE'RE GONNA MOVE
TO WITNESSES WAYNE PROVIDE
PUBLIC COMMENT VIA THE
TELECONFERENCE- SERVICE. 02:32:20.698 --> 02:32:22.166 AND MODERATOR IF YOU
WOULD PLEASE PROP THE
INDIVIDUALS WAITING TO
PROVIDE PUBLIC COMMENT --
PLEASE YELLING ON THE PHONE
LINE IF YOU WOULD LIKE TO
PROVIDE PUBLIC COMMENT PLEASE
PRESS ONE ZERO AT THIS TIME
-- NICK KNOWLEDGE MATTEL NOT
VERY WILL THEN PROVIDE YOU A
NUMBER YOU'LL BE ANNOUNCED BY
THAT NUMBER FORMER READY IF
YOU'RE ONCE AGAIN IF YOU'D LIKE
TO RIDE PUBLIC COMMENTS PLEASE
PRESS ONE ZERO AT THIS TIME
OKAY AND BEFORE WE BEGIN
WITH THE PUBLIC COMMENT
MONARCHY PLEASE GIVE ME
-- THE TOTAL NUMBER OF
PEOPLE WAITING TO TESTIFY
YES AT THIS TIME WE HAVE
THIRTEEN IN THE QUEUE FOR
PUBLIC COMMENT OKAY THANK
YOU SO WHEN WE GO AHEAD
AND BEGIN SO THANK YOU
MODERATE WILL BEGIN WITH
WILL BEGIN WITH NUMBER
THIRTY EIGHT PLEASE GO AHEAD
GOOD AFTERNOON SHARON
MEMBERS WANTED TO HEAR WHAT
THE CALIFORNIA PAN ETHNIC
HEALTH NETWORK WE JUST WANT
TO APPRECIATE THIS ROBUST
CONVERSATION TODAY -- AND
UNDERSCORED THE FACT THAT
ACROSS CALIFORNIA AND ACROSS
OUR NATION WE KNOW THAT HEALTH
DISPARITIES ALREADY EXISTS
AND KOBE NINETEEN HAD ONLY
MADE A BAD SITUATION WORSE YOU
OVERWHELMINGLY BLACK LOOKING
ON THE CALENDAR AMERICANS
HAVE SUFFERED THE GREATEST
BURDEN OF COPING NINETEEN
AND AS A RESULT WILL HAVE
AN UNDERLYING CONDITION WITH
ANY COMPLICATIONS RELATED
TO CALL THAT AS WELL REMOVAL
OF THE ECA WILL ONLY DEEPEN
EXISTING DISPARITIES FOR
COMMUNITIES OF COLOR AND SO
IT'S INCREDIBLY IMPORTANT THAT
WE PRESERVE THE NAY BECAUSE
IT REALLY HAS CHANGED LIVES
FOR THE BETTER AND WANT TO
THANK YOU AGAIN FOR HOLDING
THAT CONVERSATION VERY HELPFUL
THANK YOU NEXT THE WITNESS
NEXT WE'LL MOVE TO NUMBER
THIRTY NINE PLEASE GO AHEAD
GOOD AFTERNOON TAKE ORDERS
ON BEHALF OF THE CALIFORNIA
ASSOCIATION OF HEALTH
UNDERWRITERS AND OUTDATED
NAME ELOQUENTLY RELATED BUT
YOU CAN'T ANALYSTS PUMP AREA
COMPANY WITH THE LARGEST STATE
RIGHT DECENT HEALTH INSURANCE
AGENTS BROKERS AND PROFESSIONAL
AND OUR MEMBERS ARE GRATEFUL
TO NOT BE UNDERWRITING ANYONE
THANKS TO THE AFFORDABLE CARE
ACT NAME CHANGE WERE COMING
AND THE CUSTOMERS ARE WORKING
TO HELP MILLIONS OF INDIVIDUAL
CALIFORNIANS FAMILIES AND
BUSINESSES EVALUATE SELECT
ENDING USED THEIR HEALTHCARE
COVERAGE DURING A PANDEMIC THE
EXCHANGE ISSUED AN EXTENDED
NUMEROUS SPECIAL ENROLLMENT
PERIOD AGENTS WORKED AROUND THE
CLOCK TO ENSURE THAT MILLION
CALIFORNIANS WERE ABLE TO
MAINTAIN COVERAGE IN EXISTING
OR NEW CHANNEL TO MEET THEIR
NEEDS EVEN BASES THAT COVER
CALIFORNIA AND ARE CRITICAL
PARTICIPANTS IN THE CHANGES
THAT AND PASSIONATELY COMMITTED
TO HELPING THE COMMUNITY AND
BUILD ON THE THINK THAT THAT
THE ACA OPTIONS ACCESS AND
AFFORDABILITY IRRESPECTIVE
OF THEIR OUTSTANDING I THANK
THE CHAIR COMMITTEE MEMBERS
IN FACT THE ORGANIZING THE
THANK YOU NEXT ONE IS
NEXT WE'LL GO TO NUMBER
TWENTY EIGHT PLEASE GO AHEAD
GOOD AFTERNOON THIS IS REBECCA
GONZALEZ THE DIRECTOR OF
GOVERNMENT RELATIONS FOR
THE NATIONAL ASSOCIATION OF
SOCIAL WORKERS CALIFORNIA
CHAPTER WE REPRESENT NINE
THOUSAND PROFESSIONAL SOCIAL
WORKERS WITH A DEGREE IN
SOCIAL WORK WORK FROM AN
ACCREDITED SCHOOL OF SOCIAL
WORK EXPRESS OUR CONCERN GLOBAL
MIRACLE COMMUNITY TO HAVE
BENEFITTED FROM THE H.
BA I WANT TO THANK DR CANNON
CENTER MINING FOR HIGHLIGHTING
THE NEED FOR MENTAL HEALTH
SERVICES THE PANELISTS HAVE
PROVIDED AN EXCELLENT OVERVIEW
ON HOW THE EPA EXPANDED
THE PENSION BENEFITS WHICH
HAVE ALLOWED CARE FOR MILD
TO MODERATE MENTAL HEALTH
SERVICES SO THAT PEOPLE
WITH DEPRESSION ANXIETY AND
PTSD CAN BE OBSERVED THESE
SERVICES HAVE ALWAYS BEEN
ESSENTIAL BUT ESPECIALLY DURING
TOBIN WHERE MORE PEOPLE ARE
EXPERIENCING A MENTAL HEALTH
CONDITION ESPECIALLY IN RACIAL
AND ETHNIC COMMUNITIES BEEN
DISPROPORTIONATELY IMPACTED
BY TWO OF THE NINETEEN THE
MEDICAID EXPANSION HAS ALSO
PROVIDED CRUCIAL MENTAL HEALTH
AND SUBSTANCE USE DISORDER
SERVICES TO LOW INCOME WORKING
PARENTS AND ADULTS WITHOUT
CHILDREN AS ALSO WORKERS WE
BELIEVE THAT HEALTH CARE AT
THE RIGHT IN OUR COMMUNITY
ECONOMIC RIDE WITHOUT ADEQUATE
HEALTH CARE WE ARE GRATEFUL
FOR ACTIONS TAKEN BY THE STATE
THAT HAVE PROVIDED HEALTH
COVERAGE FOR CHILDREN AND
YOUNG ADULTS MEMBERS OF OUR
IMMIGRANT COMMUNITY WHICH WILL
HELP TO REDUCE DISPARITIES AND
HEALTH AND MENTAL HEALTH CARE
WE LOOK FORWARD TO EXPANDING
COVERAGE ALL CALIFORNIANS
AND GUARDING AGAINST CHANGES
TO THE THANK YOU THANK YOU
THANK YOU NEXT WITNESS PLEASE
NEXT WE GO TO NUMBER
SEVENTEEN PLEASE GO AHEAD
GOOD AFTERNOON DOCTOR PANEL
MEMBERS MY NAME IS TINA BACON
HERE ON BEHALF OF THE LEUKEMIA
AND LYMPHOMA SOCIETY HE CA
CONTINUES TO SAVE LIVES AND
PROTECT HEALTH CARE EXCEPT FOR
MILLIONS OF PEOPLE INCLUDING
THOSE FACING BLOOD CANCER
AND OTHER SERIOUS MEDICAL
CONDITIONS READ LIKE TO THANK
YOU AND YOUR COLLEAGUES FOR
DEFENDING THESE GAMES AND
BUILDING UPON THEM ELIMINATING
THE ACA WILL FROM AMERICA BACK
INTO A QUAGMIRE OF LOS BENEFITS
LOST COVERAGE LOST PATIENT
PROTECTIONS AND LOST SECURITY
WE CAN'T LET THAT HAPPEN LAST
WEEK MY ORGANIZATION RELEASED
A ONE HUNDRED DAY'S AGENDA
REPORT SIGNED BY THIRTY TWO
OTHER MAJOR PATIENT ADVOCACY
ORGANIZATIONS THE ONE HUNDRED
DAYS AGENDA REPORT OUTLINED
TO KINDA BORED LOOKING A CA
REFORMS WE ALL WANT TO SEE TO
HELP MORE PEOPLE IN CALIFORNIA
AND ACROSS THE COUNTRY GAIN
ACCESS TO QUALITY HEALTHCARE
THANKS SO MUCH FOR YOUR
TIME AND EFFORTS AND I'LL
MAKE SURE TO SEND THE COPY
OF THE REPORT TO THE RECORD
THANKS THANK YOU NEXT WITNESS
NEXT WE'LL MOVE TO NUMBER
THIRTY THREE PLEASE GO AHEAD
GOOD AFTERNOON CHAIRMAN
PLANNING COMMITTEE MEMBERS MY
NAME IS AND I'M REPRESENTING
ESSENTIAL ACCESS HEALTH WE
CAN BE IN A PROMOTE QUALITY
REPRODUCTIVE HEALTH SERVICES
FOR ALL CALIFORNIANS AND WE
APPLAUD CALIFORNIA FOR TAKING
ACTION AND EMBRACING THE ATA
FROM THE OUTSET AS A RESULT
MILLION THE CALIFORNIANS
MOVED INTO COVERAGE AND GAIN
ACCESS TO QUALITY SEXUAL
AND REPRODUCTIVE HEALTH
SERVICES FROM PROVIDERS THEY
KNOW AND TRUST WITH CONSUMER
PROTECTION THE KNOCKED
OUT BY THE ACA PREVIOUSLY
CONDITION LIKE PREGNANCY AND
SURVIVING DOMESTIC VIOLENCE
ARE NO LONGER BEAR YEARS TO
GAIN HEALTH COVERAGE COVERED
BENEFITS INCLUDE PRENATAL AND
MATERNITY CARE BIRTH CONTROL
AT NO COST THE HPV VACCINE AT
NO COST AND FREE ANNUAL STD
TESTING AND BREAST CERVICAL
CANCER SCREENING WE ALSO
PLOTTERS EIGHT FOUR BUILDING
ON THE SUCCESSES OF THE ACA
BY CODIFYING THE BIRTH CONTROL
MANDATE INTO STATE LAW YOUR
NEW PATIENT CHOICE AND FAMILY
PLANNING PROVIDER FOR MEDICARE
PATIENTS AND ELIMINATING THE
FEDERAL REQUIREMENTS FOR IN
NETWORK REPRODUCTIVE HEALTH
SERVICES IN COMMERCIAL HEALTH
PLANS -- WE DO HAVE SOME
WORK TO DO THAT BRIDGING THE
CONTRACEPTIVE COVERAGE GAP FOR
PEOPLE IN SELF FUNDED HEALTH
PLANS BUT THE OVERTURN OF THE
ACA WOULD RESULT IN MILLIONS OF
CALIFORNIANS INCLUDING ACCESS
TO MENTAL HEALTH BENEFITS AND
DELILLO IN THE FIGHT AGAINST
SEXUALLY TRANSMITTED DISEASE
EPIDEMIC THAT CALIFORNIA HAS
BEEN BATTLING FOR YEARS AND WE
FORESEE IT WILL ONLY GET WORSE
AND THE CALL THE PUBLIC HEALTH
EMERGENCY CONTINUES THANK YOU
FOR HIGHLIGHTING THE IMPACT
OF THE EASY IN CALIFORNIA AND
THE OPPORTUNITY TO SHARE TODAY
THANK YOU NEXT WITNESS PLEASE
NEXT WILL BE NUMBER
EIGHTEEN PLEASE GO AHEAD
THE NEW MY NAME IS I'M NOT I'M
WITH THE CALIFORNIA IMMIGRANT
POLICY CENTER AND HELP FOR
ALL THE MEDICAL ISSUES YOUR
WHOLE CARE ACT HAS PROVIDED A
PLETHORA REPORT AND HANDED BACK
OUR PUBLIC HEALTH EIGHT MEDIC
HEALTH SYSTEM COVERS ROUGHLY
TWELVE AND A HALF MILLION
CALIFORNIANS THE LARGEST
MEDICAID POPULATION OF ANY
STATE IN THE UNION REPEALING
THE ACA MEDICAID EXPANSION
ALONE WHAT COCKTAIL TWENTY OVER
TWENTY BILLION DOLLARS PER YEAR
AND MILLIONS OF WOMEN THEIR
COVERAGE UNDER THE BASIC CHANGE
COVERED CALIFORNIA CURRENTLY
ENROLLED AROUND ONE AND A HALF
MILLION CALIFORNIANS CONTINUE
TO PROVIDE CARE HOW NEARLY
NINE PERCENT OF THE GENERAL
RECEIVE SOME SORT OF THAT
THEY NEED TO LOWER THEIR OUT
OF POCKET COST OR THE MONTHLY
PREMIUM FOR ABOUT WARD OVER
SEVEN BILLION DOLLARS TO THE
STATE PER YEAR LASTLY THE EIGHT
EIGHT OPERATOR PEEL ONE AWFULLY
QUICK MEDICARE BENEFICIARY COST
SHARING FOR PART B.
AND THOSE ON WILL IN PART BE
INTERMEDIATED USER PEEL OR
THROUGH CATASTROPHIC TO THE
STATE OF CALIFORNIA AND ITS
MANY VULNERABLE RESIDENTS
THANK YOU FOR YOUR TIME
TWO THANKS WITH THIS PLEASE
NEXT IS GOING TO BE NUMBER
THIRTY FOUR PLEASE GO AHEAD
THANK YOU DR PAN FOR HAVING
THIS IMPORTANT AND TIMELY
HEARING THIS IS N.
J. DÍAS ON BEHALF OF THE
AYE YOU AND ARE OVER SEVEN
HUNDRED THOUSAND MEMBERS AND
PROVIDERS IT'S PAST MADE TO OUR
INTERNATIONAL UNION WE FILED
AN AMICUS BRIEFS DETAILING
THE DEVASTATING AND LASTING
CONSEQUENCES THAT WORKING
PEOPLE WITH FAITH IF THE EPA
IT DOWN OUR AMICUS BRIEF OFFERS
THE STORY THE WORKING PEOPLE
AND OUR PROVIDERS WHOSE LIFE
HAS BEEN CHANGED AND STATE
BECAUSE THAT THE EIGHTY EIGHT
ADDITIONALLY WE HIGHLIGHTED
THE FOLLOWING HI THE EIGHTY
HAD MADE HEALTHCARE MORE MORE
WIDELY AVAILABLE THAN EVER
BEFORE BY INCREASING THE NUMBER
OF INSURED AMERICANS THROUGH
FEDERAL SUBSIDIES AND THROUGH
MEDICAID EXPANSION WHICH
BENEFITED MANY OF OUR OWN LOW
WAGE AND LOW INCOME MEMBERS
OF THE ATA HAPPY BELIES THE
HEALTHCARE SYSTEM BY CREATING
RELIABLE STREAMS OF FUNDING
FOR SAFETY NET AND THE HOSPITAL
COMMUNITY HEALTH CENTERS AND
ARE HEALTHCARE WORKERS THAT
THEIR COMMUNITIES ESPECIALLY
COMMUNITIES COMMUNITIES OF
COLOR AND OTHER HIGHWAYS AND
VULNERABLE POPULATIONS AS THE
STATE AND THE COUNTRY'S LARGEST
HEALTHCARE UNION AND LARGEST
UNION OF SERVICE WORKERS YEAH
YOU WILL KEEP DEFENDING THE
EIGHTY EIGHT WE LOOK FORWARD
TO FIGHTING ALONG THANK YOU
THE REST OF THE LEGISLATURE
THE AG AND THE ADMINISTRATION
ON MAINTAINING AND PRESERVING
THE EIGHTY EIGHT THANK YOU
THANK YOU THANKS WITNESS
NEXT WE'LL MOVE TO NUMBER
THIRTY FIVE YOUR LINE IS OPEN
GOOD AFTERNOON I'M MICHAEL
DAY AND ON BEHALF OF CHILDREN
NOW NONPARTISAN ADVOCACY
ORGANIZATION WORKING TO ENSURE
THAT ALL COULD DOUBLE THE
POINTS THEY WANT TO THANK
THE PEOPLE HOLDEN JERRY THERE
SHOULD TO STRENGTHEN HEALTH
CARE FOR CALIFORNIA FAMILY
OF THE MANY BENEFITS OF THE
AGA I JUST WANT TO HIGHLIGHT
A COUPLE OF THE IMPORTANT
IMPACT WITH CHILDREN AND YOUTH
IN CALIFORNIA THE RATE OF
UNINSURED CHILDREN DECLINED
FROM OVER TEN PERCENT IN TWENTY
TEN BY ELEVEN PERCENT LAST YEAR
BECAUSE OF MEDICAL INFLATION
PUBLIC CALIFORNIA MORE THAN
TWENTY THREE THOUSAND FORMER
BOSS USED UNDER TWENTY SIX
DONALD MEDI CAL PROVIDING THEM
PROTECTION AND PEACE OF MIND
DURING A CRITICAL TRANSITION
POINTS ALIVE AND ATA ALSO BUT
THE BASIC PACKAGE OF ESSENTIAL
PEDIATRIC PREVENTIVE BENEFITS
ACROSS ALL INSURANCE SO WE
ABSOLUTELY AGREE THAT IT IS
IMPORTANT TO FIGHT TO PROTECT
AGAINST YOU BY THE ATA AND
TO FURTHER KEEP DRIVING TO
REDUCE INEQUITIES IN CHILDREN'S
HEALTH ISSUE THAT ALL CHILDREN
ARE ENROLLED IN HEALTH CARE
AND ADDRESS THE PERSISTENT
CHALLENGES THAT YOU FACE
IN ACCESSING THE SERVICES
THEY NEED THANK YOU THANK
YOU THANK GOODNESS PLEASE
NEXT IS NUMBER THIRTY
PLEASE GO AHEAD
GOOD AFTERNOON SENATOR CANNON
MEMBERS MY ORIGINAL PLAN
PARENTHOOD AFFILIATES IN
CALIFORNIA REPRESENTING THE
SEVEN BILLION PROVIDE MORE
THAN A MILLION PATIENTS AND
THAT THE ONLY EIGHTY FIVE
PERCENT OF PLANNED PARENTHOOD
PATIENTS IN CALIFORNIA RELY
ON UNCOMPENSATED CHARITY
CARE MEDIC CAL OR OTHER
PUBLIC BENEFIT PROGRAMS LIKE
FAMILY PACKED AND FOR THEM TO
BALLOT ABILITY FOR PREGNANT
WOMEN THE FORMAL CARE ACT
HAS HAD SIGNIFICANT IMPACT
ON OF THE AFFORDABILITY
AND ACCESSIBILITY OF ACTUAL
REPRODUCTIVE HEALTHCARE NEEDS
IN CALIFORNIA PRIOR TO THE ACA
WOMAN SPENT THIRTY TO FORTY
FOUR PERCENT OF THEIR OUT OF
POCKET HEALTHCARE COSTS ON
CONTRACEPTIVE EIGHTY PERCENT OF
HEALTH PLANS ON THE INDIVIDUAL
MARKET PROVIDED NO COVERAGE
FOR MATERNITY CARE WOMEN WERE
DENIED COVERAGE BECAUSE SOME
PLAN CONSIDERED BEING PREGNANT
ALEX HAD A KEY SECTION OR
BEING A SURVIVOR OF DOMESTIC
VIOLENCE WELL THE PRE EXISTING
CONDITION AND WOMAN PAID AN
ESTIMATED ONE BILLION DOLLARS
MORE IN PREMIUMS ANNUALLY
THE ACLU HAS ENSURED THAT
HEALTH PLAN PROVIDED COVERAGE
FOR ALL FDA APPROVED METHODS
OF BIRTH CONTROL WITHOUT A
CO PAY THE PEOPLE HAVE ACCESS
TO BIRTH CONTROL METHOD OF
THEIR CHOICE IT ALSO IN CHARGE
OUR COVERAGE OF OTHER SEXUAL
REPRODUCTIVE PREVENTATIVE CARE
INCLUDING CANCER SCREENINGS
AND STI SCREENING AND IT MADE
SURE THAT WOMEN WOULD NOT BE
CHARGED HIGHER PREMIUMS FOR
THEIR HEALTH CARE COVERAGE MOST
IMPORTANTLY AS OTHER PANELISTS
AND MENTION THE ACA AND THE
FEDERAL FUNDING THAT BRINGS
CALIFORNIA ALLOWED THE STATE
TO PROVIDE COMPREHENSIVE SEXUAL
AND REPRODUCTIVE HEALTH CARE
SERVICES TO MORE CALIFORNIANS
COVERAGE MANDATES AND MEDICAID
EXPANSION THESE ARE FOR THE
LOSS OF FEDERAL FUNDING WILL
DISPROPORTIONATELY AFFECT
CALIFORNIA CALIFORNIANS RELY
ON THAT ACCOUNT THANK YOU
FOR YOUR TIME AND FOR HOSTING
THIS HEARING TODAY THANK
YOU THANKS WITH THIS PLEASE
NEXT WILL BE NUMBER THIRTY
SIX PLEASE GO AHEAD -- TICKET
ARE GETTING ON THIS IS WHAT
I NEED A RUBENSTEIN FROM THE
NATIONAL MULTIPLE SCLEROSIS
SOCIETY IN A IS IT A CHRONIC
DEGENERATIVE DISEASE I PEOPLE
INVESTED VERY HIGH MEDICAL
EXPENSES IT KIND OF ENDED
UP GOING MEDICAL CARE AND
TREATMENT WHICH PRESCRIPTION
MEDICATIONS INTO THEIR HEALTH
AND QUALITY OF LIFE THE ANNUAL
AVERAGE COST OF THAT TREATMENT
CAN BE OF AS MUCH AS SEVENTY
THOUSAND DOLLARS A YEAR BEFORE
THE ACA INSURERS COULD DENY
COVERAGE OR CHARGE DIFFERENT
PREMIUM PREMIUMS THE PERSON
HAD A PREVIOUS INTERPRETS LIGHT
-- DMS AND AS WE DISCUSSED
ACA ELIMINATE THE -- THAT
EXCLUSION ALSO AS YOU DISCUSSED
THE PANEL -- IT THERE BEFORE
THE ACA THEIR WORK TYPICALLY
ANNUAL -- HOW MUCH INSURANCE
COVERAGE PEOPLE PERHAPS GIVEN
THE HIGH COST OF MEDICAL CARE
FOR PEOPLE WITH MS OFFICE IN
DIFFERENT PROBLEM WHICH WAS
ELIMINATED BY THE I.
T. HA -- IT'S TRULY IMPORTANT
DACA'S IMPORTANT BENEFITS FOR
PEOPLE THAT MASS YEAH -- IT
WOULD BE CATASTROPHIC IF IT WAS
A UNLIMITED THANK YOU THANK YOU
THANK YOU NEXT WITNESS PLEASE
NEXT WILL BE NUMBER
THIRTY ONE PLEASE GO AHEAD
AS CHAIR AND MEMBERS THIS
IS BARBARA BLAZER WITH A
CALIFORNIA HOSPITAL ASSOCIATION
ARTICLE CARE ACT HAS BEEN
A LIFELINE FOR MILLION
CALIFORNIANS WHO HAVE LIMITED
OR NO ACCESS TO HEALTH CARE FOR
YEARS CALIFORNIA'S HOSPITALS
ARE PROUD TO BE A LONG TIME
SUPPORTERS OF THIS VITAL LAW
WHICH IS A MAJOR CAUSE FOR
REDUCING CALIFORNIANS UNINSURED
RATE FROM SEVENTEEN PERCENT
TO SEVEN PERCENT SHOULD BE
ON THAT THE ACA HAS HELPED
REDUCE RACIAL DISPARITIES IN
COVERAGE AT THE END ENSURE
GREAT HAS FALLEN ACROSS ALL
GROUPS IN IT IS RESPONSIBLE
FOR PROTECTING SIXTEEN POINT
EIGHT MILLION CALIFORNIANS
FROM BEING REJECTED BY HELP
INSURE DUE TO PRE EXISTING
CONDITIONS IN THE MIDST OF A
GLOBAL PANDEMIC AT THE TIME
OF CALIFORNIANS NEED HEALTH
CARE MORE THAN EVER A LOT OF
THE PROTECTIONS AND COVERAGE
PROVIDED UNDER THE ACA WOULD BE
DEVASTATING IT'LL STAND READY
TO FIGHT FOR THE ACA AND THE
PEOPLE WHO RELY ON HEALTHCARE
THANK YOU FOR HOLDING THIS
HEARING TODAY THANK YOU
THANKS FOR THIS PLEASE
NEXT IS NUMBER TWENTY
FIVE PLEASE GO AHEAD YEAH
I SHOULD SAY I HAVE BEEN
IN THE STUDIO JOINING IN
UNISON WE GOT MAJOR GRAYSON
MERCHANDISING ACCOUNT AND ALL
THE OTHER SOONERS NINETY ONE
SPOKEN I SAID MARIN STRICTLY ON
BASICALLY THE WORLD BASICALLY
THE NEW TOWN TO KNOWLEDGE
I'M GOING TO SPEAK ABOUT HER
CHILDREN AND THEN MEDICATION
BUT FOR SOMEONE TO SAY THAT
I'M AND I THINK REMAINING HERE
I THINK THAT A VERY GOOD JOB
AND I THINK THE FATHERS IN
THE RUMORS OPPOSING SEISMIC
IMMERSION AROUND WHERE WE
SEE HAPPENING WE ALSO HEAR
SOMETIMES YOU'RE DOING A
GOOD JOB THE OPERATOR HERE TO
KNOW AND MARIO A.
ON THE CONTESTANTS I JUST
WANNA SAY THAT ON CERVANTES
MEDICATION HOUSING THING INCOME
ELECTRIC DEVICES IN BLANKS
BECAUSE -- I DON'T USUALLY TELL
PEOPLE THIS BUT I'M I HAVEN'T
HAVE BEEN I'VE HAD A HARD TIME
AND IT'S NOT MY PROBLEM YOU
KNOW MORE FOR ANYONE ELSE'S BUT
FOR SIX MONTHS OR TWENTY FOUR
SEVEN LEOMINSTER TWENTY FOUR
SEVEN AND FOR MUCH TWENTY FOUR
SEVEN BERMAN PEOPLE THREATENING
ME DAY IN OUR INNER CALM
OFFICIALS NAMES AND THREATENING
ALL KINDS OF WINS AND I
HAVEN'T FOUND IT UNACCEPTABLE
SAYS IN HER ANSWER M.
I DON'T KNOW A LOT MORE NOW
ABOUT HER IT'S ABOUT ANYTHING
BUT I'M JUST CONCERNED THAT
SOME OF THIS KIND OF THINK
INDIVIDUAL MAJOR TABLE BUT
I THINK WE ALL KNOW WHAT
YOU'RE LOOKING TO PROTECT
THOSE MINUTES ARE ONLY A
MASSIVE VICTORY LEASE WE
HONOR WELL IN THE BEST
LIGHT POSSIBLE THANK YOU
THANK YOU SO MUCH
THE NEXT WITNESS PLEASE
NEXT IS GOING TO BE NUMBER
FORTY PLEASE GO AHEAD GOOD
AFTERNOON CENTER PAN AND THE
SENATE COMMITTEE THIS IS MARK
SIGMAR WHAT THE PUBLIC LAW
CENTER A NONPROFIT PROVIDING
ACCESS TO JUSTICE FOR LOW
INCOME ORANGE COUNTY RESIDENTS
MANY OF WHOM SUFFER FROM
DISABILITIES SUCH AS HIV CANCER
AND BIPOLAR DISORDER THANK YOU
FOR THE OPPORTUNITY TO BE HEARD
HI I SUBMITS FOR REASONS THAT
MAKE THE FINAL FIRST WE DON'T
WANT TO GO BACK TO THE DAYS
OF HIGH RISK INSURANCE POOL
THEY'RE EXTREMELY EXPENSIVE
FOR INDIVIDUALS WITH PRE
EXISTING CONDITIONS SECOND
MEDICAID EXPANSION HEALTHCARE
MARKETPLACE UNDER THE ACA
HAVE MEANT THAT MANY OF MY
LOW INCOME CLIENTS ARE ABLE
TO ACCESS HEALTH BENEFITS NOW
THEY WOULDN'T BE ABLE TO ACCESS
AND FOR THIRDS ACA GUARANTEE
UNIFORMITY THE QUALITY CONCERNS
PLANS INCLUDING COVERAGE OF
ESSENTIAL HEALTH BENEFITS
SUCH AS MENTAL HEALTH AND
FORD FOCUS ON PREVENTION BY
MAKING PREVENTIVE CARE SUCH AS
VACCINES AND HIV SCREENING FOR
IT WE TRULY CANNOT AFFORD TO
TURN BACK THE TIME I HEALTHCARE
ACCESS FOR CALIFORNIANS
THANK YOU FOR YOUR TIME
THANK YOU NEXT WITNESS PLEASE
NEXT WILL BE NUMBER FORTY
FOUR PLEASE GO AHEAD
GOOD AFTERNOON MR CHAIRMAN
MEMBERS MY NAME SELENA SANTA
MARIA WITH NEXT AND POLICY A
NONPROFIT ADVOCACY ORGANIZATION
FOCUSED ON UPLIFTING THE
VOICE OF YOUNG PEOPLE WHO CALL
CALIFORNIA HOME WE'D LIKE TO
ECHO THE SENTIMENTS OF OTHERS
SPEAKERS WHO OUTLINED THE TITLE
PROTECTIONS THE ACA OFFERS AND
THE CATASTROPHIC RAMIFICATIONS
TO REPEAL THE ACA WOULD MEAN
FOR CONSUMERS WOULD ALSO LIKE
TO HIGHLIGHT THAT THERE'S MUCH
WORK TO BE DONE IN CALIFORNIA
TO PROTECT PERSON CONSUMERS TO
PROVIDE EQUITABLE AFFORDABLE
AND ACCESSIBLE HEALTH CARE
FOR ALL ISSUES LIKE SURPRISE
BILLING HOSPITAL CONSOLIDATIONS
AND REIGNING IN THE COST OF
HEALTHCARE AND MAKING SURE THAT
CALIFORNIA'S DIVERSE POPULATION
RECEIVES CULTURALLY COMPETENT
CARE THAT ENSURES THAT THEY
RECEIVE THE GET BEST CARE
POSSIBLE WE LOOK FORWARD TO
CONTINUING THIS WORK WITH YOU
ALL TO ENSURE THE CALIFORNIANS
GET THE HEALTHCARE THAT THEY
DESERVE THANK YOU SO MUCH
THANK YOU NEXT WITNESS PLEASE
WE HAVE ONE MORE IN OUR QUEUE
FOR COMMENTS ABOUT OUR FINAL
COMMENT TO COME FROM NUMBER
FORTY FIVE PLEASE GO AHEAD
SHARE GERMAN PAN MEMBERS OF
THE COMMITTEE NO I BOTTOM ALL
REPRESENTING CALIFORNIA RURAL
LEGAL WITH THE CONSOLIDATION
THANK WIDE NONPROFIT LITTLE
SEARCH THE PROGRAM PROVIDING
-- OUTREACH AND EDUCATION
TECHNICAL AND CLINICAL SERVICES
DEPLORABLE MANAGE FARMWORKER
COMMUNITIES I WOULD APPRECIATE
THE INFORMATIONAL HEARING
AND ALSO ON BEHALF OF THE SAN
JOAQUIN VALLEY HELPLINE WE
WANT TO BUILD ON CALIFORNIA'S
COMMITMENT TO ENROLLMENT
IN TOWARD INCREASED ACTIVE
ALL CARE THAT'S AFFORDABLE
CULTURE NICHOLAS EXPROPRIATE
I REGARDLESS OF RACE ETHNICITY
IMMIGRATION STATUS AGE SEXUAL
ORIENTATION GENDER IDENTITY
OR OTHER SOCIAL ECONOMIC
AND DEMOGRAPHIC FACTORS THAT
EVERY SAN JOAQUIN VALLEY
PERSON AND CALIFORNIANS HAD
THE OPPORTUNITY TO DRIVE AND
HAVE AN ACTIVE HEALTH CARE
IN A TIMELY MANNER APPLE
CHARACTER BEING CHALLENGED
THANK YOU FOR YOUR TIME AND
ENERGY INTO THANK YOU THANK
YOU VERY MUCH MODERATELY PLEASE
CHECK THE LINE ONCE AGAIN TO
BE SURE WE'VE HEARD FROM ALL
THE MEMBERS OF THE PUBLIC
ABSOLUTELY ONCE AGAIN LEADING
GERMAN PLEASE PRESS ONE ZERO
IF YOU'D LIKE TO PROVIDE
PUBLIC COMMENTS AGAIN ONE
THEN ZERO TO PROVIDE COMMENTS
AT THIS TIME THERE ARE NO
FURTHER COMMENTS FROM THE
PHONE LINES THANK YOU SO VERY
MUCH MODERATOR HAVING HEARD
ALL THE PUBLIC TESTIMONY
ARE THERE ANY FINAL COMMENTS
FROM MEMBERS OF THE COMMITTEE
C. NO HANDS UP SO I WANTED JUST
AGAIN THANK ALL THE WITNESSES
WHO TESTIFIED IN THIS VERY
INFORMATIVE HEARING AND AGAIN
WHY THANK ALSO ALL THE PEOPLE
FOR TO PROVIDED A PUBLIC
COMMENT AS WELL -- YOU KNOW IF
I THINK WE ARE WAITING TO SEE
WHAT HAPPENS AND I CERTAINLY
HOPE WE DON'T FIND OURSELVES
-- NEXT YEAR ESSENTIALLY TRYING
TO BUILD THE LIFE BOATS OFF THE
TITANIC THAT'S THINKING I THINK
IS ANALOGY OF ONE PERSON PUT
TOGETHER THERE'S TO BE FRANK
IT BE VERY DIFFICULT FOR THE
FOR CALIFORNIA STATE TO MAKE
UP FOR THE ACA AND -- SO --
BUT -- NO WE WILL DO WHAT WE
CAN TO TRY TO PRESERVE HEALTH
COVERAGE FOR CALIFORNIANS BUT
WE NEED -- THE SUPREME COURT
AND THE FEDERAL GOVERNMENT
TO -- TO SUSTAIN THIS VERY
IMPORTANT INFRASTRUCTURE THAT
THEY PROVIDED -- PARTICULARLY
NOW DURING A PANDEMIC BUT EVEN
BOTH BEFORE AND AFTERWARDS
SO WITH THAT I Y.
AGAIN THANK EVERYONE FOR THEIR
PARTICIPATION THIS HEARING
AND -- REVIEW CAN REALLY WHAT
APPRECIATE ALL THE PEOPLE WHO
ARE WHO WERE ABLE TO -- TO
TESTIFY VIA TELECONFERENCE
SO I THINK THE MEMBERS OF THE
SENATE HEALTH COMMITTEE WHO
PARTICIPATED AS WELL AND --
FOR THOSE WHO WERE NOT ABLE TO
EITHER FINISH YOUR TESTIMONY
OR WAS PROVIDE ADDITIONAL
COMMENTS -- YOU CAN PROVIDE
COMMENTS OR SUGGESTIONS IN
WRITING OR VIA OUR WEBSITE AT
FOR THE SENATE COMMITTEE ON
HEALTH -- YOUR COMMENTS IS YES
INS ARE IMPORTANT TO US AND
WE WANT TO KLUGER TESTIMONY
INDIVIDUAL HEARING RECORDS SO
AGAIN MY THANK YOU FOR YOUR
PARTICIPATION AND WITH THAT
WE HAVE CONCLUDED THE AGENDA
OF THIS INFORMATIONAL HEARING
ON THE AFFORDABLE CARE ACT --
THIS HEARING IS NOW ADJOURNED
THANK YOU