Rizwan has just woken up from a nap for his afternoon feeding. He’s only five weeks old and he’s a little fussy.
His dad, Adnan Hussain, tries to comfort him, unzipping his onesie to burp him. “He’s getting calmer. He’s getting calmer,” says Hussain, as though he’s trying to comfort himself just as much as the baby.
Since bringing Rizwan back from the hospital, Hussain says life has reached a new level of chaos for him and his wife — an exciting one.
However, there was one part of becoming new parents that the Westside couple was not excited about. That bundle of dread arrived a few weeks later via the postal service: the medical bills.
“It was kind of amazing,” says Hussain.
The delivery bill alone topped $26,500. But Hussain and his wife will pay only a fraction of that, about $1,400 out of pocket. Their insurance, which they got through Covered California, the state’s online Obamacare marketplace, covered the rest.
Hussain is a freelance visual effects designer and prior to Obamacare he only had emergency coverage. It wouldn’t have covered the new baby.
“We really hesitated before that to even think about having children just because we were afraid we wouldn’t be able to afford it,” Hussain says.
The Affordable Care Act requires all marketplace plans like the one Hussain and his wife have to cover maternity, childbirth and pediatric services. The law also extends those requirements to most individual and small group plans outside the marketplace. Before the health care law, insurers didn’t have to cover those services.
So Hussain is worried that once Donald Trump becomes president, Republicans will make good on their promise to repeal the health care law, just as his family will need to use their plan more.
“It’s challenging to figure out, and this desire on the Republicans’ part to kind of gut the Affordable Care Act is really scary because there’s already enough uncertainty every year in planning for health care, and this makes it far worse,” Hussain says.
Planning for 2017
This week, Covered California extended the 2017 enrollment deadline to midnight Saturday for those who want coverage to start Jan. 1. Agency officials said the deadline extension, moved from midnight today, came amid a surge in last-minute signups.
While enrollments usually increase closer to the deadline, Covered California said more than 25,000 new enrollees signed up for health plans Monday and Tuesday alone. This is almost twice as many new customers over the same period last year.
This year’s enrollment rush comes amid major uncertainty about the future of the law under president-elect Donald Trump’s administration.
Since the law’s passage six years ago, around 4.6 million Californians, including more than a million in LA County, have been able to sign up for health care through Obamacare.
The signups have come both from an expanded Medicaid program and through subsidized private plans offered through Covered California.
No other state has signed up more people for coverage than California, which means it may have the most to lose if the health law goes away.
“There’s so many fuzzy crystal balls,” says Covered California Executive Director Peter Lee. “What we think Californians need to focus on is that insurance is here today. 2017 is locked down, and they should be looking at that,”
He says people should still sign up for plans this open enrollment season, despite concerns about the law’s future.
“Millions have peace of mind that they didn’t have before,” Lee says of the Affordable Care Act. “That peace of mind hasn’t gone away.”
Navigating that peace of mind, though, has become a full-time job for some health care workers.
In East LA, around a half dozen people wait patiently for their names to be called at Via Care, a nonprofit community health clinic.
Dante Carrasco, who helps with outreach and enrollment at the clinic, says Via Care has benefited from the Affordable Care Act because many of the clinic’s patients qualified for Medi-Cal, the state’s Medicaid program for the poor. For the clinic, that meant an increase in insured patients regularly using their services, and a boost to their bottom line.
Asked if the clinic had done any preparation for the prospect of a Trump administration and the possible repeal of the health law, Carrasco is blunt.
“No,” Carrasco says, half laughing.
Carrasco says a lot of patients have been calling and coming in with questions about what is going to happen to their health care next year.
“I really don’t have all the answers, but I try to reassure them, because I really feel like my job is also to keep people calm and make sure they’re able to continue their health care and not live in fear and anxiety of what could happen,” Carrasco says.
But there is one group of people Carrasco is particularly concerned about.
Earlier this year, California opened up Medi-Cal to children under 19 living in the country illegally. Carrasco worries that information could be used against them under Trump, who campaigned on a promise to deport undocumented immigrants.
“I don’t see how they would be able to protect that information from the incoming administration,” Carrasco says, adding that around 75 percent of Via Clinic’s patients are undocumented.
For those families whose kids can or do get health care through Medi-Cal, Carrasco says he now hesitates to push them in that direction.
“I don’t want to tell them to not get the health care or the health insurance that they need,” he says. “I would offer them the other option of not signing up for insurance and taking a look at our sliding fee scale, which is based on income, and if the costs are the same, I’d advise them to do that instead.”
Asked about that immigration status information, a spokesperson for the Department of Health Care Services said, “There are no immediate changes to Medi-Cal, California’s Medicaid program, and DHCS cannot speculate as to any potential changes to the Medicaid program that may occur under a new administration.”
But Carrasco strikes a more optimistic tone when it comes to the state’s ability to protect these individuals, and about the future of the Affordable Care Act in general.
He thinks California could go it alone.
“You know we are like the sixth largest economy in the world,” Carrasco says. “We have the money to do it and we are a pretty liberal state, so I don’t think that’s out of the question.”
According to Covered California’s Peter Lee, it is out of the question.
“I think that’s not a reality. I think the reality is the financial support from the federal government is vitally important,” Lee says. “Can California build on those resources? Absolutely. But we have, in California, a very tight budget.”
Lee says if Republicans are serious about repealing the law, they should consider at least a three-year phase out to help keep things stable in the interim. He says scrapping it without that delay could create even more uncertainty for people.
“Increased Premiums, Decreased Coverage”
For some Californians, navigating the plans on Covered California came with a lot of uncertainty long before Trump’s win, in part because of costs.
“I looked at [the exchange] and I saw, increased premiums, decreased coverage,” says Mar Vista resident Heather Reese.
At 41 years old, Reese says her health plan jumped from about $260 a month just for her to more than $300 next year.
She’s not alone. Monthly premiums on Covered California are set to go up an average of about 13 percent next year.
Reese, who runs a meditation and yoga clinic, says this year she qualified for a small government subsidy, which brought her monthly premium to about $200. But because her income puts her right on the edge of qualifying for financial help, she’s had to pay back those subsidies in previous years.
“Which made me realize this year, well, why am I even accepting a subsidy?” says Reese. “So going into this year in 2017, I just decided to go off the marketplace.”
Reese will pay a little more than she’s paying now for an off-market plan with Kaiser next year, about $250. She says her decision to leave Covered California wasn’t just about the cost.
“I’ve already had an issue where doctors that I’ve seen have gone off Covered California, and I can’t even see them if I want to, and I was like, forget it,” Reese says. “For me, right now, it doesn’t work.”
But even though Obamacare isn’t working for her, Reese says she isn’t opposed to the health law. She just thinks it needs a major overhaul.
Obamacare isn’t working for Congressional Republicans either.
The party is promising to start dismantling the law as soon as Trump takes office.