Author Archives: Lisa Aliferis

Lisa Aliferis is the founding editor of KQED's State of Health blog. Since 2011, she's been writing stories and editing them for the site. Before taking up blogging, she toiled for many years producing health stories for television, including Dateline NBC and San Francisco's CBS affiliate, KPIX-TV. She also wrote up a handy guide to the Affordable Care Act, especially for Californians. You can follow her on Twitter: @laliferis

Brown on Health Coverage: “Right Thing to Do. But It Isn’t Free.”

Gov. Jerry Brown is sworn in as California governor for the fourth time. (Andrew Nixon/Capital Public Radio)

Gov. Jerry Brown is sworn in as California governor for the fourth time. (Andrew Nixon/Capital Public Radio)

Jerry Brown was sworn into his fourth term as governor of California Monday morning. In a wide-ranging inaugural address (that doubled as a State of the State address), he included some brief remarks about the Affordable Care Act.

Here’s the text of what he said:

Along with education, health and human services constitute a major part of what state government does. And in the past few years we have made massive commitments in this area, which will require increasing levels of spending, the full extent of which is not yet known. For example, two years ago California embraced the Affordable Care Act, dramatically increasing its health insurance coverage under the Medi-Cal program. The state will enroll 12.2 million people during this new budget year, a more than 50 percent increase.

Providing the security of health coverage to so many Californians who need it is the right thing to do. But it isn’t free. Although the federal government will temporarily foot much of the bill, new state costs – now and more so in the future – will run into the billions.

Before we take a deeper look at his statements about Medi-Cal, let’s go back a year ago to last year’s budget. Then, Brown’s budget proposal included an additional $670 million for Medi-Cal, at least in part because of the expected additional costs due the expansion of Medi-Cal under the Affordable Care Act. Perhaps more importantly, “The Medi-Cal caseload is expected to be approximately 24 percent of the state’s total population,” the governor said when he released last year’s budget.

Speed forward a year. Obamacare sign-ups surged in California during 2014 and outstripped all estimates. Specifically in Medi-Cal, it’s not 24 percent of the population that is covered by the program, it’s closer to 33 percent.

While the ACA  pays for 100 percent of the people who are newly eligible for Medi-Cal, many people who signed up in 2014 were already eligible before the ACA expansion. They just had not enrolled. With all the hoopla around the ACA, plenty of those previously-eligible people signed up. Many refer to this as the “woodwork” effect.

Estimates are of the 2.4 million people who signed up for Medi-Cal by Mar. 31, about 800,000 of them were previously eligible. The federal government funds those people at the non-expansion rate of 50 precent. That’s why in the May revision of his budget, Gov. Brown included an additional $1.2 billion to fund the caseload.

Brown closed his brief remarks about health with a remark about the state’s costs “in the future.” The federal government is funding 100 percent of the Medi-Cal expansion only through 2016. Come 2017, the match will start to drift down and ultimately end at 90 percent. Yes, this is still a generous federal outlay. But 10 percent of billions of dollars is a lot of money.

The governor is expected to release his budget proposal on Friday.

Top 5 Stories on State of Health in 2014

President Obama took a victory lap on Apr. 1 as the first open enrollment of the Affordable Care Act came to a close and millions had signed up. A story about the ACA was in State of Health's top five posts this year. (Nicholas Kamm/AFP/Getty Images)

President Obama took a victory lap on Apr. 1 as the first open enrollment of the Affordable Care Act came to a close and millions had signed up. A story about the ACA was in State of Health’s top five posts this year. (Nicholas Kamm/AFP/Getty Images)

It’s been a big year in health: the launch of the Affordable Care Act, an ongoing Ebola epidemic and the first soda tax in the country, passed by Berkeley voters.

Here on State of Health, all those stories got plenty of attention from you, the readers. But the Top 5 might surprise you. We crunched the numbers and here are the posts that netted the most views this year.

1) What Philip Seymour Hoffman’s Tragic Death Teaches Us About Addiction

Philip Seymour Hoffman arrives for the Los Angeles premiere of 'The Hunger Games: Catching Fire' in Los Angeles, California, last November. Robyn Beck/AFP/Getty Images)

Philip Seymour Hoffman arrives for the Los Angeles premiere of ‘The Hunger Games: Catching Fire’ in Los Angeles, California, last November. Robyn Beck/AFP/Getty Images)

We all know the sad details. In February, Philip Seymour Hoffman died of a drug overdose. He had been an addict as a young man, but given up drugs and alcohol at 22. His relapse cost him his life. But what troubled me most after his death were the heartless social media attacks about his “selfishness” and “poor choices.” Continue reading

How Much Drinking Causes A Hangover?

(ckelly/Flickr)

(ckelly/Flickr)

Editor’s Note: this story originally ran Dec. 30, 2013.

Medically, the condition is called “veisalgia” — from the Norwegian kveis or “uneasiness following debauchery,” and the Greek algia, otherwise known as “pain.”

But you probably just call it a hangover.

The helpful PR coordinators at the American College of Physicians resent information about a review, published back in 2000, titled simply The Alcohol Hangover. “More than 4700 articles have been written about alcohol intoxication (from 1965 to 1999), but only 108 have addressed alcohol hangover,” the researchers, all at UC San Francisco at the time, wrote.

But you probably don’t care about how much research has been done, you just want to know how many drinks cause a hangover. Continue reading

New Health Laws Set to Take Effect in California

(Justin Sullivan/Getty Images)

(Justin Sullivan/Getty Images)

The new year will bring in hundreds of new laws in California, including a landmark law that permits undocumented individuals to obtain a driver’s license and another requiring that all eggs sold in California come from chickens living in bigger spaces.

Many of those new laws have to deal with health. Some take effect on Jan. 1, others in July. Here’s a look at some of them:

Assisted Living Homes: A new law increases 100-fold the top fine for violations of state regulations by assisted living facilities for the elderly. The fine is jumping from a mere $150 to $15,000. AB2236 takes effect July 1 and was part of a package of bills signed by the governor that tighten state oversight of the 7,500 assisted living homes in California. It’s the most significant overhaul of the industry in almost 30 years. Continue reading

Dieting Done Right: Healthy Weight-Loss Strategies

(Getty Images)

(Getty Images)

Oh yes, this is it: the last few days of the holidays, meaning that after midnight Wednesday, when the New Year rings in, several tens of millions of Americans will start thinking about how to take off the pounds they started putting on back in November — or before that.

When I googled “diet” just now, I got more results than there are people in this country. No surprise that weight loss is pretty much “everyone’s No. 1 resolution,” said Dr. Jennifer Slovis, who leads the weight management program at Kaiser Oakland. She joined a discussion about weight loss on KQED’s Forum Monday morning.

The first thing they did on the show was dispatch the idea that fad diets can work for you long term. “We really only support evidence-based therapies,” said Katie Ferraro, a registered dietitian and professor at the UC San Francisco School of Nursing. “Unfortunately, those are kind of boring: ‘Eat less and exercise more’ are not the sexiest messages out there.”

While you should avoid fad diets, the Forum guests all agreed that individuals have flexibility in how they get to “eating less and exercising more.” Continue reading

FDA Proposes Lifting Lifetime Ban on Gay Blood Donors

(Getty Images)

(Getty Images)

The Food and Drug Administration is proposing a policy change that would end a 31-year ban on blood donations from men who have sex with men. The ban was put in place at the dawn of the AIDS epidemic when little was understood about the disease. Under the proposed change, gay men who have not had sexual contact in a year would be allowed to donate blood.

In a statement, the FDA said that “it will take the necessary steps to recommend a change to the blood donor deferral period for men who have sex with men from indefinite deferral to one year since the last sexual contact.” Officials say the change is motivated by research. Australia, Japan and the United Kingdom already have similar policies in place.

The FDA has been considering the move for some time. Earlier this month, Ryan James Yezak with the National Gay Blood Drive told KQED that he thought that any ban was discriminatory, but said that the move toward one year, instead of a lifetime ban, was a step in the right direction. Continue reading

Berkeley Recruits ‘Panel of Experts’ for Soda Tax Implementation

(Frederic J. Brown/AFP/Getty Images)

(Frederic J. Brown/AFP/Getty Images)

Last month, voters in Berkeley made the city the first in the country to pass a tax on sugar-sweetened beverages. On Monday, the city moved forward on implementing one of the  requirements of the measure, staffing its “panel of experts.”

Berkeley is soliciting applications for people to serve on this panel, which will advise the City Council on “how and to what extent the City should establish and/or fund programs to reduce the consumption of sugar-sweetened beverages in Berkeley.”

In other words, the panel will advise the council on how to spend the soda tax revenue. Continue reading

Covered California Sign Ups Continue at Strong Pace

Peter Lee, executive director of Covered California. (Max Whitaker/Getty Images)

Peter Lee, executive director of Covered California. (Max Whitaker/Getty Images)

Just over 144,000 new people signed up for health insurance on the Covered California marketplace during the first month of open enrollment, officials said Wednesday.

Peter Lee, executive director of Covered California, noted that the state is now one-third of the way through open enrollment, which ends Feb. 15. At the same point last year, 110,000 people had picked a plan.

Lee said enrollment was going “remarkably smoothly” so far, although there have been “some small glitches along the way.”

Covered California is targeting 1.7 million enrollees for 2015, including renewing 1.2 million current customers and netting half a million new people. Continue reading

Study: Western States Eliminate Race Gap on Key Health Measures

Researchers looked at how effectively patients had their blood pressure, blood sugar and cholesterol controlled. (Getty Images)

Researchers looked at how effectively patients had their blood pressure, blood sugar and cholesterol controlled. (Getty Images)

A major new study looking at health disparities across the U.S. finds that significant gaps in managing heart disease and diabetes persist — except in Western states, where the gap has been eliminated.

‘It’s possible to eliminate deeply ingrained racial disparities.’
Researchers at the University of Michigan and Harvard University looked at 100,000 Medicare patients who were enrolled in HMOs, called “Medicare Advantage” plans, from 2006 to 2011. While management of blood pressure, cholesterol and blood sugar improved overall, blacks “substantially” trailed whites everywhere except the Western U.S., an area from the Rocky Mountains to the Pacific, as well as Alaska and Hawaii.

“We were certainly hoping we would see indications of progress in eliminating disparities in the country as a whole,” said lead author Dr. John Ayanian, who heads the Institute for Healthcare Policy and Innovation at the University of Michigan. He said that while it was “disappointing” that disparities persisted, “it’s also heartening to see that … in the West, the disparities had been eliminated, and that was both surprising and encouraging.” Continue reading

In California, Where You Deliver Your Baby Matters

Two women in California are having a baby for the first time. They are both low risk, having uneventful pregnancies. But how they will deliver their baby — whether they’ll have a c-section, for example — depends dramatically on the hospital each woman chooses when she delivers.

The California Hospital Assessment and Reporting Taskforce, or CHART, crunched the numbers and found wide and, frankly, stunning variation in the rates of four common procedures related to delivery and newborn care: c-section, episiotomy, breastfeeding and vaginal birth after c-section.

The Oakland-based California HealthCare Foundation created this infographic to illustrate what CHART found:

(Courtesy: California HealthCare Foundation)

(Courtesy: California HealthCare Foundation)

Continue reading