Affordable Care Act


Read Transcript of Today’s Oral Arguments in Supreme Court Obamacare Case

Today’s oral arguments in the latest Obamacare case to come before the Supreme Court are now over. Proponents of the law are worried that if the plaintiffs prevail, canceling subsidies to insurance buyers in the federal exchange, the Affordable Care Act could be heading for a death spiral. The Supreme Court website has put up a full transcript of the proceedings, which you can read here. A report on today’s events from Associated Press follows.

Here is AP’s write-up of today’s events:

WASHINGTON (AP) — The Supreme Court was sharply divided Wednesday in the latest challenge to President Barack Obama’s health overhaul, this time over the tax subsidies that make insurance affordable for millions of Americans.

The justices aggressively questioned lawyers on both sides of what Justice Elena Kagan called “this never-ending saga,” the latest politically charged fight over the Affordable Care Act.

Chief Justice John Roberts said almost nothing in nearly 90 minutes of back-and-forth, and Justice Anthony Kennedy’s questions did not make clear how he will come out. Roberts was the decisive vote to uphold the law in 2012.

Otherwise, the same liberal-conservative divide that characterized the earlier case was evident. Continue reading

Toby Douglas Looks Back at 10 Years Heading DHCS

(Courtesy: California HealthCare Foundation)

(Courtesy: California HealthCare Foundation)

By Rachel Dornhelm, California Healthline

Toby Douglas has spent 10 years at the state’s Department of Health Care Services, the last four as director of the department. He has seen and instituted big changes in the department, changing the way health care is delivered to more than 11 million Medi-Cal beneficiaries.

During his tenure, the Affordable Care Act was passed and implemented; Douglas oversaw the expansion of Medi-Cal as well as a huge shift of more than 80 percent of the state’s Medi-Cal ranks from fee-for-service to managed care plans.

Douglas is set to retire in January. I sat down with him recently to ask about the changes he has seen — and overseen — in his time in office, starting with a look at what struck him as the most important development in health care during his time as the head of the agency.

“When I step back and I think of our time here in the department and what we’ve achieved,” he said, “it really centers around the Medi-Cal program. We have all of our populations now that are in coordinated systems of care.” He called the Medi-Cal managed care approach “a big change,” for all low-income populations eligible for Medi-Cal.  Continue reading

Obamacare: With One-Third of Californians Now on Medi-Cal, Can State Manage?

By Anna Gorman, Kaiser Health News

California is coming face to face with the reality of one of its biggest Obamacare successes: the explosion in Medi-Cal enrollment.

The numbers — 2.2 million enrollees since January — surprised health care experts and created unforeseen challenges for state officials. Altogether, there are now about 11 million Medi-Cal beneficiaries, constituting nearly 30 percent of the state’s population.

That has pushed the public insurance program into the spotlight, after nearly 50 years as a quiet mainstay of the state’s health care system, and it has raised concerns about California’s ability to meet the increased demand for health care.

Even as sign-ups continue, state health officials are struggling to figure out how to serve a staggering number of Medi-Cal beneficiaries while also improving their health and keeping costs down. Many are chronically ill and have gone without insurance or regular care for years, and some new enrollees have higher expectations than in the past.  Continue reading

Signing up the Homeless, One at a Time

Man sits in Skid Row area of Los Angeles. Advocates say homeless people tend to have complex health problems. (Kevork Djansezian/Getty Images)

Man sits in Skid Row area of Los Angeles. Advocates say homeless people tend to have complex health problems. (Kevork Djansezian/Getty Images)

By Anna Gorman, Kaiser Health News

On a recent winter morning, health outreach worker Christopher Mack walked through the streets and alleys of the city’s Skid Row, passing a man pulling a rusty shopping cart and a woman asleep on a crumpled blue tarp. The smell of marijuana wafted through the cold air.

“Do you have health insurance?” Mack, a towering man with long dreadlocks, asked one woman. “Do you go to the doctor?” he asked another.

Homeless men and women who didn’t qualify for insurance in the past now have the chance to sign up, and Mack — who was once homeless himself — is there to help.

The Affordable Care Act allows states to expand Medicaid to include poor people without children or disabilities who haven’t been able to get the free insurance in the past. Experts say determining how many homeless people are eligible for Medicaid is difficult but estimates range from about 500,000 to as many as 1.2 million. California is one of the 25 states (plus Washington, D.C.) that is expanding its Medicaid program, called Medi-Cal here. Continue reading

Just Over 500,000 People Enrolled in Covered California in 2013 — Some Report Problems

Peter Lee, executive director of Covered California, said he is pleased with the number of young people who have enrolled so far. (Max Whitaker/Getty Images)

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

In issuing a final tally of 2013 enrollment, Covered California reported Monday that 500,108 people signed up for one of its health plans. Another 125,000 people enrolled in a health plan during the first two weeks of January, said Peter Lee, executive director of the agency.

“The momentum we have from the end of last year is still going strong,” Lee said in a press conference.

At her first doctor’s appointment, she was told that the practice was not taking any Covered California plans. 

Medi-Cal, California’s public health insurance program for people who are low income or disabled, also showed strong enrollment — 584,000 additional applicants to Covered California appear to be eligible. When adding that number to the 630,000 Californians who transitioned to Medi-Cal from the Low Income Health Program on Jan. 1, more than 1.2 million Californians are newly insured in Medi-Cal. “Powerful numbers,” Lee said. “We are touching millions of Californians.” Continue reading

Anthem Blue Cross, Kaiser Extend Deadline to Pay Insurance Premiums

(Getty Images)

(Getty Images)

By April Dembosky and Lisa Aliferis

If you signed up for a Covered California plan by the Dec. 23 deadline, Wednesday is the official deadline to pay your January premium.

That is, unless you are an Anthem Blue Cross or Kaiser Permanente customer — in which case you have a little more time.

  • If you’re a Kaiser member, you have until Jan. 22 to pay your January premium
  • If you’re an Anthem Blue Cross customer, you have until Jan. 31 (Update: On Jan. 16, HealthNet also extended its deadline to Jan. 31.)

If you’re in one of the other nine plans available statewide, you must pay your premium by midnight Wednesday night. Continue reading

My Five-Week Saga Enrolling in Covered California

(Getty Images)

(Getty Images)

As a journalist I’ve covered the Affordable Care Act on and off since it was a gleam in President Obama’s eye. The melodrama of the fierce legislative fight; the subsequent relentless attacks against it; the Supreme Court case; and the catastrophic rollout of — good times for the news media, though not necessarily the American public.

My first unwelcome surprise came when I input all my information, and the system told me I wouldn’t get a subsidy despite the fact that I knew I was eligible.

But of course, the difference between covering something as a journalist and experiencing it as a citizen is substantial. Last year, in part for health reasons, I gave up my full-time job with KQED News. No more long hours: check. No more crazy deadlines: check. No more health insurance: check … my blood pressure. Because our COBRA costs were going to be astronomical, like 40-percent-of-income astronomical. And my health history rendered me uninsurable on the individual market. At least, on the old insurance market.

All of this made me one of the many poster-children for Obamacare, under which insurance companies, starting Jan. 1, would be required to insure my middle-aged ass, and the government was going to help pay for it to boot. Whether this is a victory for common sense and decency, the end of democracy as we know it, or simply a bad idea, I couldn’t say — and still can’t. I only know that the only rational financial decision, personally, was to try getting an exchange plan through Covered California. Continue reading

Nearly 500,000 Californians Enrolled in Obamacare Plans, Federal Data Show

Screenshot from, the website of Covered California.

Screen shot from, the website of Covered California.

Federal officials reported Monday that 2.2 million people nationwide have selected a plan in the new health insurance marketplaces established under the Affordable Care Act. Nearly 500,000 of them are Californians.

The numbers were released by the U.S. Department of Health and Human Services, which also reported demographics across age groups, gender and tier of plan chosen.

While California makes up about 12 percent of the nation’s population, the state’s enrollment is 22 percent of the national total. Continue reading

No Obamacare Invoice? Keep Trying to Pay But Don’t Worry, Says Covered California

No one knows just how many Californians have not yet received their insurance invoice. Insurers say they have added staff to deal with large volume of new enrollees. (Getty Images)

The deadline to pay your premium for a health insurance plan bought through Covered California, the state’s Obamacare marketplace, has been extended to Jan 15. While insurance went into effect Jan. 1 for those who enrolled, you must pay the first month’s premium by Jan. 15 or you you will not be covered.

“If there was a good faith effort by an enrollee to start an application by Dec 23, everyone is honoring that,”- Covered California spokesperson Anne Gonzalez

As that date fast approaches, some enrollees who are well aware of the deadline and are ready, willing, and able to pay have been experiencing a problem: they can’t because their insurance company hasn’t sent them an invoice yet.

Until this week, this was my situation. I waited well over a month between the time I enrolled in a plan through Covered California and the insurance company I selected — Kaiser — sent me an invoice. I kept checking with Kaiser, and they kept telling me they had yet to receive the information from Covered California. And Covered California kept telling me to keep checking with Kaiser. Continue reading

Many Spanish Speakers Left Behind in First Wave of Obamacare

CoveredCA_SpanishBy Daniela Hernandez, Kaiser Health News

In Silicon Valley, the executives and engineers who’ve helped build the Apple, Google and Facebook empires earn high salaries and enjoy a slew of perks, including stellar health benefits.

The clients of the Ravenswood Family Health Center, a community clinic in East Palo Alto just two miles away from Facebook’s sprawling headquarters, live in a very different Silicon Valley.

They’re the gardeners, nannies, factory workers and service staff who keep Silicon Valley homes and offices humming, the lawns manicured and the families comfortable.

They are also, in many ways, a microcosm of the population the Affordable Care Act was meant to help. Continue reading