By Reggie Ellis
visalia – Huddled under a few pop-up tents, 40 people gathered on the sidewalk in the pouring rain last week in Visalia to protest Congress’ first steps in repealing key portions of the Affordable Care Act (ACA), more widely known as Obamacare. And while the cold rain made it difficult to stay dry and warm and hear what was being said, those leading the protest said the storm was nothing compared to the dark clouds looming over Tulare County if the repeal were to become permanent.
The Jan. 18 rally was held on Church Street in Visalia outside the offices of Congressman Devin Nunes (R-Tulare). The District 22 representative was among 227 House Republicans to vote in favor of a resolution dismantling key provisions of ACA on Jan. 13 with the promise of replacing it with something else. Rep. Kevin McCarthy (District 23) and Rep. David Valadao (District 23) also represent portions of Tulare County and voted in favor of the resolution. The repeal was narrowly passed by the Senate on Jan. 11. Sen. Kamala Harris opposed the resolution and Sen. Diane Feinstein abstained but publicly denounced the repeal on her web site.
Farmersville councilman Greg Gomez, who is also a county employee and a member of the Local 521 of the Services Employees International Union (SEIU), organized the rally because he said the ACA helped restore balance to a health care system that benefitted the few at the expense of everyone else.
The number of uninsured County residents has been cut in half from 15% to 7.4% since Covered California, the state’s health insurance exchange set up under the ACA, opened enrollment in 2013. Nearly 14,000 Tulare County residents were enrolled in Covered California as of February 2015, the most recent numbers available. The expansion of Medi-Cal under the ACA provided coverage for an additional 50,000 adults between the age of 19 and 64, bringing the total number of residents enrolled in Medi-Cal to 258,000, more than half of the county’s total population as of August 2016.
“Now with the repeal of the ACA and no plan to replace it, we are looking at returning to the days of worse health, higher costs, and less access,” Gomez said. “We must stand together; we must call and write our representatives and we must fight for our health.”
Joining Gomez in leading the rally was Graciela Soto Perez, CEO of Altura Centers for Health.
Perez said Tulare County has the highest percentage (53.1%) of residents enrolled in Medi-Cal in California, where one third of residents are enrolled statewide. She said repealing it will open the door to private insurers to go back to the days of denying coverage for pre-existing conditions. Perez said pre-existing conditions include nearly every common ailment in the Central Valley such as asthma, diabetes and heart disease.
“People depend on this coverage for survival and to maintain quality lives,” Perez said. “Without a doubt, [Tulare County] has the most to lose.”
She said single women and men could not afford health care coverage prior to the ACA, but under it many people found a solution to health care coverage problems. She said many of the elderly use it as gap insurance for things Medi-Cal doesn’t cover.
“It’s important to write to your congressman and senators and make sure your voices are heard,” Perez concluded.
Perez said clinics set up to serve the county’s low income residents will also be hurt by the repeal. Altura, formerly Tulare Community Health Centers, benefitted greatly from the Medi-Cal expansion that came on the heels of the ACA’s passage in 2010. She said the payer mix at Altura’s clinics went from 50% to 75% Medi-Cal but the number of uninsured patients dropped from 36% in 2012 to 9% in 2015. Perez said federal money through the ACA helped her clinic hire more staff and buy more equipment to improve preventative care.
“Most of all our patients had access to more than just us. They had access to a hospital, pharmacy, hospice, durable medical equipment and so much more.”