Is “Trumpcare = Choice” a Lie?

Of course it is. The true is that Obamacare with Medicaid expansion (called Medi-Cal in California) now covers over 50,000 Humboldters. That at least doubled and close to tripled Medi-Cal coverage before the ACA.

To be eligible to Medi-Cal under the expansion, your current income had to be 138% of Federal Poverty Limit (FPL) for an adult and under 266% FPL for a child. 138% FPL is $1,387 per month.

With these new, simpler, fair and humane rules under Obamacare we as a Humboldt community were able to share first rate health care with 25,000 to 30,000 more of our neighbors.

If you have family in Humboldt, it’s likely some members of your extended family are aided under this program. Remember, with Medi-Cal roles in the 50,000 range we are talking about 38% of all 130,000 Humbodlters aided under this program.

And it’s a good program. We are a wealthy society and all other wealthy societies around the globe have figured out access to preventative and sustaining health care is a right. Medicaid under Obamacare doesn’t reach universal health care levels, but it does give access to the most needy in a conservative, market-friendly manner that does allow choice.

If you are over that 138% as an adult, or 266% as a child, you then get access to private health care plans on the Covered CA marketplace. Up to 400% FPL these are subsidized and thus affordable.

Again, Obamacare was a conservative approach to universal health care coverage, one based on markets and helping individuals to chose the health care they can afford.

But the chosen Republican party line to sell what the rest of us understand is a money and power grab where the rest of us are entirely vulnerable is to contend that Trump Care is about choice in health care.

And for some it is. For those making over 400% FPL, I imagine there may be expanded choices as the insurance industry again returns to you as their main profit center. But for those who were able to gain access to health care under Obamacare, there will no longer be a choice.

Trump Care = choice is a lie because Obamacare proved that we were able to expand the roles of those obtaining health care. This meant that money was a factor and reducing funding to Medicaid will again return us to the bad old days where health care is a privilege to those who are gainfully employed or have made many good decisions or have been fortunate enough to be born to a family with enough money or love to set us on the right path.

This just isn’t acceptable in our country and it would be nice if local Republicans who get this would speak to their friends and business associates and help their leaders in Washington get this.

Trumpcare will reduce the number of people who have access to health care, it does this by removing the cornerstone of a critical federally-funded program called Medicaid satisfying another conservative goal in working to reverse the FDR-Johnson vision of America with a strong middle class and access to basic necessities of modern life to those who live at or below poverty limits. Mainstream Republicans and conservatives, please do not let the Economic Royalists or loony libertarians do this to us. Our lives are in your hands and we depend on you to call a lie a lie. 25,000 to 30,000 of your neighbors and customers now depend on your integrity.


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G.O.P. Health Plan Is Really a Rollback of Medicaid (Margot Sanger-Katz |NYT | 6/20/17)

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(This is the forgiveness factor.  I’m asking for a high amount of forgiveness for editing/content b/c of the short amount of time I was able to dedicate to this post) 🙂 (ty)

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What is Medi-Cal?  A Timely NYT Opinion Piece. (NEWCU)

NEWCU = News Eligibility Workers Can Use

…also… Medi-Cal is what we in California call the federal program Medicaid.

Between posts, I work as county Department of Health and Human Services employee where I help administer Medicaid in Humboldt County by determining eligibility.

I wanted to make a quick post to share Alice Wong’s piece  in today’s New York Times because:

a) is a first-hand account of one person discovering that public assistance is a right that she has as a member of our society and the freedom that understanding allows, and

b) it does a great job of explaining what Medicaid and Medi-Cal are and other important associated programs such as the Medicaid Working Disabled Program and In-Home Supportive Services, and

c) there is a well deserved kudos to California social services as  the writer describes why she had to move from her home in Indiana to come here.

Liberty and justice for all indeed!

My Medicaid, My Life

   by Alice Wong (New York Times | May 3, 2017)

“I graduated from high school in 1992, two years after the Americans With Disabilities Act was passed. Learning about disability history and realizing I was a member of a protected class encouraged me to imagine and create the life that I want. Once I got over myself and realized I had a right to Medicaid, it made a difference immediately.

This past March marked my 25th year of being a recipient of Medicaid. When I was young, I felt shame and embarrassment at being one of “those people” on benefits. Today I am unapologetically disabled and a fully engaged member of society. None of that would be possible without Medicaid.

Every day I resist forces that label me as the Other or a scapegoat for society’s problems. With the disability community, I share our stories and speak out against threats to our future by using my privilege and tools such as social media. I hope my story will continue for decades to come.”

Times Standard Medi-Cal Editorial Cartoon

Fun (sarcasm) editorial cartoon in the Times Standard this morning.  The Pacific Northwest’s Monte Wolverton hits all the fun right wing memes – sexism, government incompetence, welfare entitlement.

So lets take a look at what is actually happening.  From another Wolverton cartoon.

30% of Californian’s insured under Medi-Cal.

From the Kaiser Foundation in March 2015, there were 12,248,555 Californian’s on Medi-Cal or a 34% rise since the Affordable Care Act when Medi-Cal insured 9,157,000.

Medi-Cal is our state’s version of Medicaid.  This is a program that people have to apply for and if found eligible can often have what is known as a “zero share of cost” or 100% of covered medical procedures are paid for.

This is an incredibly important safety-net program for those of us that might be on either temporary or more permanent hard times.  As Franklin Roosevelt might have framed this, freedom from want.

Medi-Cal is now a part of an imperfect but improving attempt national, state and county governments are making to insure all of us are insured.  All other OECD countries outside of Mexico have figured out that universal health care is the way to go.  Because of bad timing, Truman could not convince our national conservatives of this when we had the chance and since then they’ve owned the political discourse.  Result – we are spending way too much to cover way to few with disastrous expectations.  The silver lining is, those with money have the best care money can buy.

There should not be a stigma against Medi-Cal.  It’s an incredible program allowing all of us to enjoy what a society should be able to provide.  Medical coverage for all.  We shouldn’t have to lose our livelihood, our homes, our families if we are unlucky enough to suffer a debilitating sickness or accident.

We obviously have a long way to go to solve these problems and they solutions will necessarily involve politics, government, the medical profession, not-for-profits, consumer activists, etc.  In other words, all of us.  Having the privilege of earning a living being on the front lines of this myself* I can tell you we are making progress.  One of the big ones is for many people Medi-Cal is no longer a property-based program.  This alone is such a big deal that is not being discussed.  The property-based program was (and, ironically, still is for the most vulnerable) a poison pill that only serves to increase those aspects of the program the editorial is criticising.

The irony is, the editorial is fueling the exact attitude that lead to the lawmakers that would make Medi-Cal eligibility a property-based program in the first place.

It’s complicated and that cartoon isn’t helping.  For a large percentage of the people who have been on the other side of that phone call, I’m going to guess they have had the opposite experience, at least here in Humboldt County.  In other words, not only is it not helping, it’s not true.  I’d challenge the T-S to fact check it, but I know they don’t have the budget to do that.

* CAVEAT:  My name is Jon Yalcinkaya.  I am an eligibility worker at Humboldt County’s Department of Health and Human Services.  The opinions expressed here are my own and are only generally associated with day-to-day, client-to-client experiences at the DHHS.


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