Obamacare Met With Confusion, Relief At Start Of New Year

SACRAMENTO, Calif. (AP) — The new year brought relief for Americans who previously had no health insurance or were stuck in poor plans, but it also led to confusion after the troubled rollout of the federal health care reforms sent a crush of late applications to overloaded government agencies.

That created stacks of yet-to-be-processed paperwork and thousands — if not millions — of people unsure about whether they have insurance.

Mike Estes of Beaverton, Ore., finally received his insurance card on Dec. 27 after applying in early November. Still, the family was thrilled to have insurance through the Oregon Health Plan, Oregon's version of Medicaid, because their previous $380-a-month premium "literally crushed our family's finances," Estes said.

Obama administration officials estimate that 2.1 million consumers have enrolled so far through the federal and state-run health insurance exchanges that are a central feature of the federal law. But even before coverage began, health insurance companies complained they were receiving thousands of faulty applications from the government, and some people who thought they had enrolled for coverage have not received confirmation.

Tens of thousands of potential Medicaid recipients in the 36 states relying on the federal exchange also are in limbo after the federal website that was supposed to send their applications to the states failed to do so.

Reports of complications were scattered around the country.

In Burlington, Vt., the state's largest hospital had almost two dozen patients seek treatment with new health insurance policies, but more than half of those did not have insurance cards. Minnesota's health care exchange said 53,000 people had enrolled for coverage through its marketplace, but it was unable to confirm the insurance status of an additional 19,000 people who created accounts but did not appear to have purchased the plans.

In Connecticut, officials were pleading for patience as call centers fielded calls from people who are concerned because they had yet to receive a bill for premiums or an insurance identification card.

"This is an unprecedented time, because there are a record number of people who have applied for coverage with an effective date of Jan. 1," said Donna Tommelleo, a spokeswoman for the Connecticut Department of Insurance.

Don't get too worked up over today's big ObamaCare deadline

Monday is the last day to sign up under ObamaCare for coverage that kicks in January 1... sort of.

Yes, most people must sign up by 11:59 p.m. Monday night to have coverage in place at the start of next year. And as such, the cutoff is being trumpeted as a major hard deadline for the president's health care law.

Yet due to a number of administration-mandated tweaks and delays, the deadline is actually kind of squishy, and thus more symbolic than anything.

Last Thursday, the administration announced that some of the hundreds of thousands of people who had lost their existing health care plans because of ObamaCare could be exempt from the individual mandate's penalty. The "hardship exemption" written into the mandate stipulates that someone may be considered exempt if there are "financial or domestic circumstances…that prevented him or her from obtaining coverage under a qualified health plan."

That means people who have unexpectedly been dropped from their existing plans do not necessarily need to find new ones just yet. And as the Wall Street Journal noted, there are 14 specific ways people can qualify for the "hardship exemption," some of which require little to no documentation to prove. In other words, there are more than a dozen ways around the December 23 deadline, including one specifically made available to a group of people who have become a political flashpoint for the health care law.

In addition to the new hardship exemption, the administration had already this month extended the deadline from December 23 to the end of the year for people to make their first premium payments for new coverage. And more recently, it urged insurers to retroactively extend coverage to people who sing up by the 23rd but do not make their first payment until January 10.

There will also reportedly be a "good faith" exemption for others who try but are unable to enroll by the Monday deadline, something that will further soften Monday's supposedly hard deadline, according to Reuters. As you may recall, the federal exchange marketplace functioned so poorly in the early going that it effectively prevented people from getting coverage even if they wanted to.

Then there's the fact that the original "hard" deadline was December 15. But when Healthcare.gov crashed in the early going, the White House extended the deadline to the 23rd.

The White House had hoped to enroll 3.3 million people in new health plans through the federally run marketplace by the end of the year. They've so far enrolled about one-third that number. And though the pace of enrollments is trending upward, polls continue to find the law deeply unpopular; a CNN survey released Monday found a record low 35 percent of Americans supported the law.

Still, there's plenty of time for people to find coverage in the new year before they'll be penalized for going uninsured. Due to another extension, the uninsured have until April 1 to enroll in coverage before they'll be hit by the individual mandate's penalty.

So in that sense, the hard deadline for the law itself is April 1 — or, given the numerous delays to date, it's the law's hard deadline for now.

via http://theweek.com/article/index/254543/dont-get-too-worked-up-over-todays-big-obamacare-deadline

This Christmas, give the gift of ... health insurance?

Forget the Xbox One, Ugg boots or that "Keep calm and kill zombies" hoodie.

California officials are urging you to consider gifting that special young adult in your life something a bit less tangible: Obamacare.

Covered California, the state health insuranceexchange, on Thursday launched its "Give the Gift of Health" campaign aimed at families, principally mothers and grandmothers (for the latter, apparently a $5 bill no longer cuts it).

Officials estimate roughly 1.8 million residents aged 18 to 29 are eligible to obtain health insurance through the exchange or qualify for free or reduced Medi-Cal, the government program for the poor and disabled. About 2.6 million Californians - many of them under 30 - will qualify for a federal subsidy reducing their monthly premium.

The holiday campaign - Wednesday was the last night of Hanukkah - includes a website atCoveredCA.com/pledge, where one can "pledge" to cover the cost of insurance; e-cards containing information about covered options and tips for starting a discussion about the importance of getting insured.

Claire Lipschultz, the mother of two twenty-somethings, acknowledged parents can't force medical decisions on their adult children. But they can help get them affordable insurance, said Lipschultz, the state policy advocate for the National Council of Jewish Women-California.

"Young adults tend to think that nothing will harm them," she said. "Moms know you are healthy until you are not. So, be sure your loved ones are covered."

Editor's Note: Post updated at 3 p.m. to reflect the last day of Hanukkah.

PHOTO: Emanuel Jumatate of Chicago, hugs his new Xbox One after he purchased it at a Best Buy in Evanston, Ill on Nov. 22, 2013. Microsoft is billing the Xbox One, which includes an updated Kinect motion sensor, as an all-in-one entertainment system rather than just a gaming console. AP Photo/ Nam Y. Huh

Read more here: http://blogs.sacbee.com/capitolalertlatest/2013/12/this-christmas-give-the-gift-of-obamacare.html#storylink=cpy

All of Us Or None at LA's 2nd Annual Power Festival

Saturday, October 28, 2013, All of Us or None / A New Way of Life Reentry Project shared a table at the South LA's 2nd Annual Power Festival, which was spearheaded by Community Coalition.

Hundreds of people came out to gather more information concerning health care reform, which we all know as Obamacare. The Affordable Care Act (the medical coverage original name) has made it possible for low cost health care insurance to reach folks that normally would have to suffer having no insurance at all.

Much controversy against the bill has created politicians to refuse the ACA, but through it all, President Obama has been adamant to continue to improve the nations health care system, no matter what. 

As the community continues to be informed about the benefits of Obamacare, it seems to bring a particular measure of hope to many that held no hope at all.

LA's Mayor Eric Garcetti came out and shared his support of Obamacare, and the day flowed with the people gathering all the information they could to understand the language of the health coverage that has stirred up a political gang banging fight that truly has another meaning altogether.

Shutdown, or not - California launching health law Tuesday

California will forge ahead with the launch of its health insurance marketplace Tuesday, regardless of whether Congress fails to reach a last-minute deal to avert a federal government shutdown.

A possible shutdown would not stop the state because it has already received federal funding to implement the law. Much of the health care law, including federal subsidies for lower-income customers, was established through mandatory spending and not tied to annual appropriations.

On Friday, President Barack Obama promised that the insurance exchanges would open for business even if there's a government shutdown.

"That's a done deal," he said.

Indeed, Covered California - the state's version of the federal health care law - is preparing to begin enrolling customers in its health insurance exchange on Tuesday. Parts of the government would close on the same day if lawmakers in Washington don't act on legislation to extend discretionary spending.

Congressional Republicans have been working to stop the health law in its tracks.

On Monday, Senate Democrats tabled two House-approved amendments to a spending bill that would delay for one year implementation of the health law as well as repeal a medical-device tax designed to help pay for its implementation. Obama and Senate Democrats are urging the House to pass the Senate-approved spending bill with no provisions on the health care law.

California, one of 14 states rolling out its own marketplace, will mark opening day with a series of events in Sacramento, Fresno, San Francisco, Los Angeles and San Diego. The federal government will oversee the launch in the remaining states.

Photo: Samuel Butler inquires at a Covered California booth last weekend at the George Sim Center in Sacramento. Lezlie Sterling/The Sacramento Bee

Read more here: http://blogs.sacbee.com/capitolalertlatest/2013/09/shutdown-or-not---california-launching-obamacare-tuesday.html#storylink=cpy

Senate moves forward on debate over Obamacare

WASHINGTON — The Senate easily overcame Wednesday’s first hurdle to a fizzling GOP strategy to strip funding for President Obama’s healthcare law in exchange for keeping the government running.

Top Republicans are now for a new — more modest — way to chip away at the Affordable Care Act.
Time is not on their side after Sen. Ted Cruz (R-Texas) monopolized the floor in his lonely filibuster-like campaign. Money for routine government operations is set to run out Oct. 1, unless Congress acts.

The rare 100-0 vote to end this first round of debate showed how eager senators were to move the bill forward.

Republicans realize that because they are in the minority in the chamber, Democrats will eventually be able to eliminate the Obamacare provision to protect the president’s signature law. Republican leaders want Cruz to wrap up his time in the limelight so the Senate can dispatch the legislation back to the House in time to give Speaker John A. Boehner (R-Ohio) ample opportunity to attach new amendments that might have a better chance at eventually ending the healthcare law.

“My own view is it would be to the advantage of our colleagues in the House, who are in the majority, to shorten the process,” said Senate Republican Minority Leader Mitch McConnell of Kentucky, who has distanced himself from Cruz’s strategy. “If the House doesn't get what we send over there until Monday, they're in a pretty tough spot.”

Republicans in the House and Senate believe a do-over in the House could have better results, if they attach a healthcare provision that would be difficult for Democrats to oppose — such as a repeal of the new tax on medical device manufacturers that some Democrats dislike, or a delay of the individual mandate that all Americans carry health insurance in 2014.

After Republican senators convened for back-to-back closed-door strategy sessions earlier this week, many, if not most, embraced the emerging plan. “It seems to some of us the sooner you get it over to the House, the sooner they can address it,” said Sen. John McCain (R-Ariz.)

Cruz initially showed little interest in yielding, promising to use every procedural tool necessary to stop what others in his party viewed as inevitable.


But after finishing is 21-hour talkathon late Wednesday morning, Cruz suggested speeding up the next key vote to Friday, rather than Saturday as scheduled. That vote is viewed as the Republicans’ last chance to stop the bill before the Democrats gut the health provision.

Cruz said he wanted to make sure Americans were tuned in to watch it. Senate Majority Leader Harry Reid (D-Nev.) initially declined the offer, but conversations are expected to continue.

Under Senate rules, the chamber will now spend 30 hours in debate before the next vote, Thursday morning, to proceed to the legislation. Final passage, without the healthcare provision, would not come until Sunday evening — with hours to go before a possible shutdown.

Covered California Open Enrollment

News Bulletin Covered California Open Enrollment Begins October 1, 2013 Covered California will begin open enrollment on October 1, 2013, with coverage beginning January 1, 2014. This is an exciting time, as communities of color represent two-thirds of the 2.7 million individuals who will be eligible for tax credits to purchase affordable coverage in Covered California. Additionally, more than one million eligible adults will speak English less than very well, making language access a priority. We need to spread the word about available resources to maximize enrollment among those eligible in our communities: ·         Covered California's website is currently available in both English and Spanish ·         Fact sheets about Covered California are available in 13 different languages ·         Covered California's telephone help line: 1-800-300-1506 will provide interpreters in any language. ·         The new application for coverage will be available in 12 different languages and will have dedicated, toll-free numbers for telephone assistance in each language. If your organization is interested in helping to get people enrolled in either Covered California or Medi-Cal, visit Covered California's Enrollment Assistance Program, where you can complete an online application to become a Certified Enrollment Entity. Upcoming Convening Provides Information on Outreach and Enrollment For more information on outreach and enrollment efforts, be sure to attend our upcoming convening, A New Era of Coverage: Maximizing Participation in the ACA. At this event, you can get updates on the state's outreach and enrollment efforts and hear about how local organizations are enrolling communities of color in available coverage opportunities. Register today and join us in Fresno (10/3), Oakland (10/8), Los Angeles (10/15), or San Diego (10/16). If you have further questions, email Cary Sanders at csanders@cpehn.org. If you would like to change your contact information, please email info@cpehn.org. If you would like to unsubscribe from CPEHN's Action Alerts, please email unsubscribe-actionalerts@cpehn.org. If you would like to unsubscribe from ALL CPEHN email communications, please email unsubscribe-all@cpehn.org. GET INVOLVED ·         Share With a Friend ·         Subscribe to our Newsletter, Action Alerts, or Event Invites ·         Join Our Network ·         Follow Us on Twitter @CPEHN ·         Like Us on Facebook ·         Donate

© 2013 / California Pan-Ethnic Health Network / info@cpehn.org MAIN OFFICE: 1221 Preservation Park Way, Suite 200, Oakland, CA 94612 Phone: (510) 832-1160 / Fax: (510) 832-1175 SACRAMENTO OFFICE: 1225 8th Street, Suite 470, Sacramento, CA 95814 Phone: (916) 447-1299 / Fax: (916) 447-1292

Personal Finance: New federal health care mandates kick in starting Oct. 1

By Claudia Buck

Love it or hate it, the launch date for the country’s sweeping new health care mandates is just around the corner. In 10 days, the essential piece of the federal government’s Affordable Care Act kicks in, allowing everyone across the country to sign up for health care coverage.

Starting Oct. 1, you’ll need to make some choices, whether you’re currently covered at work, have been buying health insurance on your own, or never had it in the first place.

“We’re getting slammed” with inquiries, said Anne Gonzales, spokeswoman for Covered California, the state’s new health care exchange offering policies under the new law. “People are very focused on Oct. 1, but we’ve already been taking phone calls from consumers and people trying to get educated.”

Although health care policies can’t be purchased online until Oct. 1, “We encourage people to call in ahead of time,” said Gonzales, “so they can shop and compare. There’s no reason to wait.”

While there’s been much heated debate over the merits of affordable health care in the last four years, there are some definite positives. Among them: Everyone will be entitled to 10 “essential services” (see box) and you can’t be denied health care for pre-existing conditions, whether it’s diabetes, cancer, AIDS or anything else.

Whether it’ll be cheaper depends on your family circumstances and your health care needs.

“People who’ve been declined (for pre-existing conditions) all these years will be happy. But if you’re a family of four making $90,000 a year, you’re going to see a big increase,” said Carrie McLean, director of customer care at eHealthInsurance.com, an online health coverage comparison site.

That’s due to a combination of lower caps on what everyone has to pay out of pocket for medical expenses, as well as the mandated coverages required of all health care policies. To cover those costs, health care companies are raising rates on certain policies and premiums.

That’s why it pays, more than ever, to spend some time on your health care choices this fall. Here’s a look at some of the basics:

Covered at work

If your employer provides health care insurance, you’re already in the loop. No doubt you’ve been invited to company presentations, directed to websites or received information packets about changes in your company’s health care plan for 2014.

Open those packets; attend the meetings; go online to look at your options. During this year’s open enrollment, it’s more critical than ever.

Some companies are changing carriers, offering incentives or switching some benefits. Some are urging employees to consider health savings accounts, for instance. (More on that topic in a future column.) And unlike years past, where employees may have been automatically enrolled in a company’s health care plan, this year’s changes often mean you need to proactively take steps to ensure you’re enrolled. If you forget to sign up, you may be out of luck until 2015.

A recent MetLife study found that a majority of employees “are on autopilot” during open enrollment and don’t really scrutinize their health care choices, which could be especially risky this year. “Employee benefits are not ‘one size fits all,’” said Michael Fradkin, MetLife’s senior vice president for worksite benefits, in an email. To avoid “missing new coverage options and money being left on the table, we encourage all employees to take the time to closely evaluate all of their benefits options.”

If you’re confused or unclear about your choices, contact your company’s HR department for guidance.

Buying it yourself

If you’ve never had health care insurance, either because you were too young, had a pre-existing condition or your employer didn’t provide it, now’s your chance to get coverage and shop for the best rate.

Insurance on the exchanges comes in four levels: bronze, silver, gold and platinum. At the lowest level, bronze, your monthly premiums will be the cheapest, but you’ll pay more for doctor visits and co-pays. The plan will cover about 60 percent of your medical costs. At the higher gold and platinum levels, your premiums are higher but you’ll pay less when you see a doctor or buy a prescription. Those plans will cover 80 percent to 90 percent of your costs.

That’s where doing your online comparisons comes in. “Start playing around with the online computer to look at your coverage options,” said Gonzales. Using the “Shop and Compare” tool on the Covered California website, you type in your age, ZIP code, income and family size. You’ll instantly get a list of the companies offering plans in your county.

For instance, a single, 26-year-old male in the 95814 ZIP code making $25,000 a year could get a bronze-level plan for $75 to $84 a month. That’s with a federal subsidy of $126 a month. A family of four in the same ZIP code earning $80,000 a year could choose from four bronze plans priced at $386 to $417 a month, with a $332 subsidy.

You can purchase health insurance from any local or online broker, but you must go through Covered California if you want to apply for a federal subsidy.

When comparison shopping, have an idea what’s important in your health plan. Do you still want to see your same doctors? Will it cover the prescription drugs you take? How often do you see a physician; do you just need basic coverage? How much can you comfortably afford, both in monthly premiums and out-of-pocket expenses?

“It’s like car insurance. You can lower lower your premium, but if you get in a car accident, you want to be sure you’re covered,” said McLean. “We all hope we won’t get cancer and won’t need the insurance. But if you get seriously ill midyear and originally purchased a bronze level plan, you’ll hit your out of pocket quickly. And you won’t be able to change that until next open enrollment.”

To get personal help, you can call Covered California’s toll-free number or use its online LiveWebchat to speak with a health care insurance counselor in 13 languages. Covered California has hired hundreds of call-center staffers and is training 16,000 enrollment counselors who will be available through community organizations, county offices and nonprofits to help with health care sign-ups.

If you’ve been buying your own insurance on an individual plan, your premium rates will likely go up significantly as companies adjust their costs for mandatory coverages, said eHealthInsurance’s McLean.

But the good news is that for all Americans, out-of-pocket medical expenses will be capped. For a single person, the most you’ll have to pay from your own wallet for prescription drugs and medical care is $6,350. For a married couple with kids, the highest is $12,700. (In some cases, those caps have been delayed until 2015 to give insurers time to comply.)

Options for young adults

Adult children up to age 26 who are covered on a parent’s health care plan can remain so; the new enrollment season does not affect their status. But depending on what your employer charges for dependent premiums, it may be cheaper to have your son or daughter buy a single health insurance plan. It also can make sense if your child lives out of state and has to use costlier, out-of-network doctors and hospitals.

Young adults who don’t have coverage from Mom or Dad or from an employer can purchase individual plans. They’re also eligible for a special, limited category of health insurance called “catastrophic coverage.” Available to those 30 or younger, it doesn’t cover regular medical expenses, such as doctor’s visits, prescription drugs or even an ER visit. Instead, it’s designed to handle “excessive medical bills” that could come with a hospitalization or serious illness.

Compare the “catastrophic” price with the lowest-level bronze premiums to see if the savings are worth the limited coverage.

A little pain: penalties

If you don’t sign up for health care coverage? There are tax penalties, which phase in over three years. In 2014, the first-year penalty for not buying health insurance is 1 percent of annual income or $95 per adult, whichever is greater. The maximum penalty per family is $285.

By 2016, the penalty will be 2.5 percent of income or $695 per adult, with a maximum per family of $2,085. After that, it’s adjusted for inflation.

The penalty is based on the number of days or months you go without coverage after March 31.

Some are exempt from the new health care penalties: inmates, undocumented immigrants, American Indian tribal members and those with religious objections. Also exempted are low-income folks who don’t have a tax-filing requirement.

At least in the first year, it’s expected that many people will make the calculation that it’s worth gambling they won’t get sick. Some may decide they’d rather pay the $95 individual penalty than spend several hundred a month in health care premiums. But that calculation could change in future years as the penalties go up – and if they become seriously ill or hospitalized and are stuck with uncovered medical bills.

A little help: subsidies

To make mandatory health care coverage more affordable, the federal government is providing subsidies, either tax credits (to help cover premiums) or cost-sharing (to help cover out-of-pocket costs), or both. The only way to apply for a subsidy is through a state-sponsored exchange, like Covered California. Its website has a calculator that quickly determines, based on income, if you qualify. (It also determines if you qualify for Medi-Cal or Medicare.)

Generally, if you’re single and make up to $46,000 a year, you will qualify for assistance. For a family of four, you can make up to $90,000 and still qualify.

Note: In most cases, if you’re covered at work by your employer, you won’t qualify for a federal subsidy. The only exception is if your company’s annual health care premiums are more than 9.5 percent of your household income.

Take a breath

As bewildering as some of the choices may be, you don’t have to have everything wrapped up by Oct. 1. “Take a deep breath and know that you have some time to make a decision,” said eHealthInsurance’s McLean. “It’s new for California ... Give it some time. You don’t have to see and shop it all at once.”

You can also post questions about the new Affordable Care provisions to “ Ask Emily,” a new feature that appears weekly in The Sacramento Bee’s Business section. The advice is from Emily Bazar, writer with the California HealthCare Foundation’s Center for Health Reporting. Send your questions directly to her at: AskEmily@usc.edu.

Read more here: http://www.sacbee.com/2013/09/22/5751632/new-federal-health-care-mandates.html#storylink=cpy

HEALTH REFORM: Feminist to address luncheon on Obamacare

For Loretta Ross, health care reform is personal.

The author, feminist and reproductive-rights advocate has insulin-dependent diabetes — and no health insurance. Without insulin, she could die.

Ross is looking forward to Oct. 1, when she and other Americans with pre-existing conditions can buy health insurance on exchanges set up by the Affordable Care Act.

On Thursday, Sept. 12, Ross, 60, of Atlanta, will discuss the importance of the Affordable Care Act at Planned Parenthood of Orange and San Bernardino Counties’ 7th Annual Empowerment Luncheon.

Less than two weeks before the sign-up period opens, many people still don’t understand what the Affordable Care Act means for them and their families, said Robert Armenta Jr., spokesman for the Planned Parenthood chapter.

“In fact, we just received a report that more than four in 10 Americans think the new healthcare law has been repealed, overturned in court or are just unsure whether it remains law,” he said.

That’s why the group invited Ross to speak at the luncheon, which benefits health-education programs in San Bernardino County.

Ross has worked on healthcare reform since the president first proposed it. The plan didn’t go as far as she would have liked, Ross said in a phone interview; she favored universal healthcare. “I will accept half a glass,” she said.

Most important to her was keeping abortion restrictions out of the plan and retaining access to contraception, she said. “We have not completely succeeded.”

Her home state, Georgia, resisted implementing the act and tried to roll back reproductive and contraceptive rights, she said.

But the efforts to undo reproductive rights have triggered a resurgence of feminism among younger women, awakening them from complacency, Ross said.

Inspiring young women to get involved and advocate for their rights is now the focus of Ross’ work. She retired last year after 38 years of managing and organizing feminist nonprofits.

Ross’s feminism dates to the 1970s when she was the director of the nation’s first rape crisis center.

Working there saved her life, she said. It helped her overcome the trauma of being kidnapped and raped at age 11 after she got separated from her Girl Scout troop at an amusement park.

She didn’t tell anyone at the time, she said, internalizing the crime and blaming herself for getting lost.

I asked her if an 11-year-old girl today would be more able to report being raped. Ross said it depends on whether there’s someone she can tell without fear of being punished.

Whenever Ross speaks publicly of the rape, women come up afterward and reveal their own sexual assaults they’ve kept secret since childhood, she said.

Educating and empowering girls to protect themselves is vital, Ross said: Even today, health classes focus on preventing disease and pregnancy rather than avoiding sexual assault.

The luncheon is at 11:30 a.m. at the Hilton Hotel, 285 E. Hospitality Lane, San Bernardino. Tickets are $45.

Cassie MacDuff

Press-Enterprise

CALIF. OKS EXPANDED MEDI-CAL TO 1.4 MILLION UNINSURE

Sacramento — The Legislature passed a major piece of the federal Affordable Care Act on Saturday, opting to expand Medicaid to 1.4 million low-income Californians, as it rushed to meet its deadline to complete a state budget.
The action came a day after lawmakers passed the main budget bill outlining a $96.3 billion spending plan for the fiscal year that starts in July.

Saturday’s votes were on a handful of targeted bills. They included ones that would provide college scholarships for middle class families, increase grants for those in the welfare-to-work program, restore dental care for low-income adults, distribute money for school energy projects, and strengthen oversight of the California Public Utilities Commission.

The centerpiece legislation was the expansion of Medicaid, which is called Medi-Cal in California. Broadening the entitlement program to reduce the number of uninsured people in the country is one of the cornerstones of President Barack Obama’s national health care reforms.

Several Democratic lawmakers called Saturday’s vote historic. “We don’t know for certain that this will contain the costs; that’s certainly the goal. But … we also make sure health care is not considered a privilege of the fortunate few but as a basic human right,” said Sen. Mark Leno, D-San Francisco. “That’s what we’re implementing today. This is a big deal.”

Republicans raised concerns about whether California can afford the expansion over the long run, especially once the federal government drops its commitment from 100 percent to 90 percent.
Democrats included a provision in the bill that allows for future lawmakers to reconsider the expansion if the federal government’s share drops below 70 percent.

The federal government will pay the full cost of expanding the low-income health program for the first three years. It’ll reduce payments to 90 percent starting in 2020, putting the rest of the cost on the states that adopt the expansion.

Legislative Analyst Mac Taylor has estimated that by taking on new enrollees, the state could be responsible for between $300 million and $1.3 billion a year starting in 2020. “I worry about expectations that we set out for individuals with ACA in California and having the rug pulled out from underneath us without a funding mechanism,” said Sen. Ted Gaines, R-Rocklin.

Democrats said the expansion would help save lives, keep workers healthy and attract billions of dollars from the federal government into the state. Senate President Pro Tem Darrell Steinberg, D-Sacramento, noted taxpayers and those who have health insurance are paying for the medical care of those who go without insurance. The Medicaid expansion will cover many of those who now receive uncompensated care, he said.

By LAURA OLSON Associated Press 12:01 A.M.JUNE 16, 2013Updated8:04 P.M.JUNE 15, 2013