Affordable Health Care Act explained

As key features of the Patient Protection and Affordable Care Act (PPACA) — otherwise known as ACA or Obamacare — continue to go into effect, Shana Alex Lavarreda, a research scientist at the UCLA Center for Health Policy Research, is hopeful. She, more than many, understands the need that Angelenos face.

As Lavarreda told an audience of about 300 people during a Yom Kippur panel discussion at Temple Emanuel of Beverly Hills, there are more than 2 million people in Los Angeles County who are currently without health insurance — a pool that’s “bigger than the population of many states.”

These remarks came as part of the Contemporary Issues Forum, held annually at Temple Emanuel over the High Holy Days. This year’s took place on Sept. 14 and was titled “Shedding Light on Federal Health Care Reform — What the New Law Means for Me, My Family and My Country.” 

Joining Lavarreda in the panel discussion was Herb Schultz, regional director of the U.S. Department of Health and Human Services (HHS), who said the new law requiring everyone to have health care goes beyond politics.

“Health care is not a partisan issue — health care and health care reform affect all of us, as Americans.” 

Schultz drew on previous experience working in the cabinets of former California Govs. Arnold Schwarzenegger and Gray Davis as he spoke about health care in California and how the new federal law will change lives locally, noting that “5.5 million Californians … will be eligible, many of them for the very first time, for comprehensive, affordable health care coverage,” he said.

Meanwhile, Lavarreda spoke as director of the Health Insurance Studies program at the UCLA Center for Health Policy Research, a resource for health insurance information in California. She explained that many factors have contributed to the current state of affairs in the Golden State.

Not only did the recession of 2008 result in fewer people with job-based coverage — “just under half of California has job-based health coverage,” according to 2011-2012 data collected by UCLA, she said — but Medi-Cal, the state’s version of Medicaid, has stringent rules about income that can be a barrier to enrollment, she said.

Not only can private insurance be “prohibitively expensive,” she added, but some people don’t know it exists at all. Their thinking, Lavarreda said, is, “I can get it through my job, or I don’t get it at all.”

Who are the uninsured in Los Angeles County? About 85 percent are either U.S.-born citizens, naturalized citizens or legal permanent residents, despite myths that illegal immigrants make up a disproportionate amount of the uninsured, she said. 

Another commonly heard talking point — that children comprise a sizable chunk of the state’s uninsured — also is untrue, she said. Lavarreda gave credit to both sides of the political aisle for this, explaining that Democratic and Republican officials in California have supported public and private partnerships that have been successful in providing coverage to kids, including those of undocumented immigrants.

Schultz focused on what will happen now that one of the key features of Obamacare — health-insurance marketplaces for individuals — has opened for enrollment. On Oct. 1, 50 health insurance exchanges opened nationwide as part of reforms aimed at increasing access to health care. This includes Covered California (coveredca.com) in this state, where Californians can compare health plans and shop for an insurance provider. Open enrollment continues through March 2014, and those who sign up before the New Year will see their plans going into effect on Jan. 1.

 Because the ACA is funded by mandatory appropriations, it “will be up and running” despite the government shutdown, according to Kate Migliaccio, a public information officer at HHS. 

“A funding lapse does not go into the core of what we are doing,” Migliaccio wrote to the Journal in an e-mail.

During the discussion at Temple Emanuel, Schultz said there’s plenty to be optimistic about in regard to the ACA, which was signed into law by Obama in 2010. Those who are ages 18-34 — a group sometimes labelled as the Young Invincibles, who often believe they can live without health insurance — now will be able to afford it, he said. 

“[They] want to get health insurance and can’t afford it because of the broken health care system,” Schultz said.

Also, seniors already have saved billions of dollars on prescription drugs, due to ACA-instituted Medicare drug discounts that have been in effect since 2011, he said. 

Schultz praised the ACA’s Patients’ Bill of Rights, which guarantees consumer protections, including a provision that makes it illegal for insurance companies to deny coverage to children with pre-existing conditions. It is also illegal for a provider to drop from a plan an individual who has made a technical error on a customer application. These rules have been in effect since 2010.

Schultz and Lavarreda’s presentations, which lasted approximately 60 minutes, took place following Temple Emanuel’s afternoon services. It was followed by a 20-minute Q-and-A. Afterward, congregation members made their way back to Emanuel’s sanctuary for evening Neilah services. 

Temple Emanuel’s Rabbi Laura Geller gave brief introductory remarks kicking off the event. She delivered the Jewish argument for providing health care to the needy at an affordable price.

“It is completely clear that Jewish law and tradition places a high priority on caring for the sick in our midst — Jews and gentiles alike — and demands collective responsibility,” she said.

This year’s talk marked more than 15 consecutive years that the congregation has held a Contemporary Issues forum on Yom Kippur — a day when it is important to focus on both tikkun nefesh (“repairing our souls”) and tikkun olam (“repairing the world”), according to Geller. Previous events have covered topics such as immigration and Supreme Court issues. Last year, California Gov. Jerry Brown spoke during a discussion titled “California Matters.”  

Temple Emanuel board member Diane Vanette — who is active in the congregation’s partnership with community organizing network OneLA — moderated last month’s discussion. Another congregant, Scott Redston, who sells health insurance for a living, spoke briefly. They co-chaired the forum.

And their work isn’t over. On Nov. 3, the synagogue — in partnership with Temple Beth Am and OneLA — will host Schultz again. He will join community outreach and education experts in helping young adults, individuals under age 65 and small-business owners enroll in insurance plans offered by Covered California. For more information about the event, contact Vanette at diane.vanette@mac.com.