Health

Coverage Worries Persist Amid Relief Over Health Care Ruling

Published

10 years ago

June 26, 2015

Affordable Care Act participant Kim Jones poses for a photo in her home in Wake Forest, N.C., Thursday, June 25, 2015. Jones said the Affordable Care Act has been a blessing to her who could not have otherwise afforded the medical care she has received during treatment for a tumor on her brain. The Supreme Court decided Thursday to uphold the Affordable Care Act subsidies. (AP Photo/Gerry Broome)

CARLA K. JOHNSON, Associated Press

CHICAGO (AP) — Throughout the country, relief was the dominant emotion among consumers who get help from the government to lower their health insurance costs following Thursday’s Supreme Court ruling upholding the subsidies underpinning President Barack Obama’s health care overhaul.

Many consumers expressed somewhat conflicting views: They were happy their monthly premiums would continue to be affordable but exasperated by the coverage the policies purchased on the new health care exchanges provide.

“I don’t particularly care for Obama. I didn’t vote for him,” said Salt Lake City resident Paige Preece, whose subsidy allows her to buy insurance for $137 a month. “But, honestly, if it weren’t for this, I would be absolutely lost.”

The court’s 6-3 ruling upheld the federal financial assistance to millions of low- and middle-income Americans to help pay for insurance premiums regardless of where they live. An estimated 6.4 million people in the 34 states that used the federal health care exchange were at risk of losing the subsidies because their home states did not set up their own insurance exchanges.

The case turned on just a few words in the mammoth Affordable Care Act that suggested the federal subsidies could go only to consumers in states that operated their own health insurance marketplaces. Consumers in those states or in ones that fell back on the federal exchange when their own exchanges faltered were not affected by the case.

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Chief Justice John Roberts declared in the majority opinion.

Polls taken before Thursday’s ruling suggested that most Americans wanted the court to uphold the subsidies. In an April Associated Press-GfK poll, 56 percent preferred that the court rule in favor of the Obama administration, while 39 percent wanted the court to rule for the other side.

Lydia DeJesus, who helps people sign up for coverage in Dickinson, North Dakota, said she has noted that division among consumers concerning the health care law, even among those receiving significant subsidies that make their policies more affordable.

“There are people who have services who never had services,” she said. “But there are people who were forced to have insurance and really don’t consider it affordable. Some people have told us they’d rather pay the fine as opposed to having health insurance.”

In Gresham, Oregon, Anna Mar, 28, said she is still no fan of what she calls “Obamacare.” She is a stay-at-home mom with two young boys. Her husband works in construction.

“The plan hardly covers anything, so I avoid going to the doctor,” Mar said. “I love the idea of everyone having health care, but it’s not affordable for us.”

For herself, Mar bought the cheapest plan on the exchange she could find: $134 a month, with a high deductible and high co-pays. Her government subsidy is $40. The couple’s children qualify for Medicaid, the state-federal health program for those with lower incomes.

Other consumers said they were grateful for the health care reforms and for Thursday’s ruling allowing the subsidies to continue.

Kim Jones, a substitute teacher in Wake Forest, North Carolina, said she once used the emergency room for her care. With the health insurance plan she purchased on the federal exchange, she now can afford follow-up treatment after surgery last summer to remove a brain tumor.

Jones, 60, said she was without health insurance for about a decade because of the part-time jobs she took to allow her to care for an elderly parent. Her current coverage costs her about $27 a month, after the government subsidy of more than $500. She continues to take medication and had worried about losing coverage.

“I know it helped so many people, and a lot of folks like myself who had fallen through the cracks were finally getting some kind of help with health issues,” Jones said after the ruling.

In Norman, Oklahoma, Kelli Nicole Smith, a 26-year-old baker who earns $11 an hour at a candy shop, said she was relieved to learn she would still receive the $99 monthly subsidy that she used to purchase a health plan. Without it, Smith said she probably would have considered buying less healthy food or downgrading her mobile phone plan.

“I would have choices, but they wouldn’t be comfortable,” said Smith, who ends up paying about $60 a month for a plan with relatively high co-pays, including $500 for an emergency room visit. “Or I would have to consider finding a job that maybe pays more that I don’t really want to do.”

Advocates such as Walter Davis of the Tennessee Health Care Campaign, used the Supreme Court decision to urge lawmakers in Tennessee to increase Medicaid access, an expansion that was made optional by an earlier Supreme Court ruling.

“Tennessee has failed to expand Medicaid and is falling further behind, leaving thousands of people unnecessarily uninsured and without access to affordable health coverage,” he said in a written statement. “Now Tennessee policymakers should recognize health reform is working, abandon efforts to undermine it, and instead take advantage of the opportunities that health reform offers to improve lives.”

Those with medical issues took the most comfort in the Supreme Court’s ruling and Obama’s assertion afterward that “the Affordable Care Act is here to stay.”

“I’m starting to cry just talking about it,” said Susan Halpern, a 55-year-old breast cancer survivor from Columbus, Ohio, who immediately posted the news to Facebook.

With an irregular income as a freelance contractor, she said the subsidy makes a huge difference. Without it, she said the only way she could continue to pay the premium would be to drain her retirement savings.

“This has saved my ability to retire someday,” Halpern said. “I know tens of thousands of Americans were looking at it the same way.”

___

Associated Press writers Emery P. Dalesio in Raleigh, North Carolina; Travis Loller in Nashville, Tennessee; James MacPherson in Bismarck, North Dakota; Sean Murphy in Oklahoma City; Michelle L. Price in Salt Lake City; and John Seewer in Toledo, Ohio, contributed to this report.

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OPINION: California’s Legislature Has the Wrong Prescription for the Affordability Crisis — Gov. Newsom’s Plan Hits the Mark

Last month, Gov. Newsom included measures in his budget that would encourage greater transparency, accountability, and affordability across the prescription drug supply chain. His plan would deliver real relief to struggling Californians. It would also help expose the hidden markups and practices by big drug companies that push the prices of prescription drugs higher and higher. The legislature should follow the Governor’s lead and embrace sensible, fair regulations that will not raise the cost of medications.

Published

2 days ago

June 18, 2025

Oakland Post

Rev. Dr. Lawrence E. VanHook. Courtesy of Rev. Dr. Lawrence E. VanHook.

By Rev. Dr. Lawrence E. VanHook

As a pastor and East Bay resident, I see firsthand how my community struggles with the rising cost of everyday living. A fellow pastor in Oakland recently told me he cuts his pills in half to make them last longer because of the crushing costs of drugs.

Meanwhile, community members are contending with skyrocketing grocery prices and a lack of affordable healthcare options, while businesses are being forced to close their doors.

Our community is hurting. Things have to change.

The most pressing issue that demands our leaders’ attention is rising healthcare costs, and particularly the rising cost of medications. Annual prescription drug costs in California have spiked by nearly 50% since 2018, from $9.1 billion to $13.6 billion.

Some lawmakers, however, have advanced legislation that would drive up healthcare costs and set communities like mine back further.

I’m particularly concerned with Senate Bill (SB) 41, sponsored by Sen. Scott Wiener (D-San Francisco), a carbon copy of a 2024 bill that I strongly opposed and Gov. Newsom rightly vetoed. This bill would impose significant healthcare costs on patients, small businesses, and working families, while allowing big drug companies to increase their profits.

SB 41 would impose a new $10.05 pharmacy fee for every prescription filled in California. This new fee, which would apply to millions of Californians, is roughly five times higher than the current average of $2.

For example, a Bay Area family with five monthly prescriptions would be forced to shoulder about $500 more in annual health costs. If a small business covers 25 employees, each with four prescription fills per month (the national average), that would add nearly $10,000 per year in health care costs.

This bill would also restrict how health plan sponsors — like employers, unions, state plans, Medicare, and Medicaid — partner with pharmacy benefit managers (PBMs) to negotiate against big drug companies and deliver the lowest possible costs for employees and members. By mandating a flat fee for pharmacy benefit services, this misguided legislation would undercut your health plan’s ability to drive down costs while handing more profits to pharmaceutical manufacturers.

This bill would also endanger patients by eliminating safety requirements for pharmacies that dispense complex and costly specialty medications. Additionally, it would restrict home delivery for prescriptions, a convenient and affordable service that many families rely on.

Instead of repeating the same tired plan laid out in the big pharma-backed playbook, lawmakers should embrace Newsom’s transparency-first approach and prioritize our communities.

Let’s urge our state legislators to reject policies like SB 41 that would make a difficult situation even worse for communities like ours.

About the Author

Rev. Dr. VanHook is the founder and pastor of The Community Church in Oakland and the founder of The Charis House, a re-entry facility for men recovering from alcohol and drug abuse.

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Oak Temple Hill Hosts Interfaith Leaders from Across the Bay Area

Distinguished faith leaders Rev. Ken Chambers, executive director the Interfaith Council of Alameda County (ICAC); Michael Pappas, executive director of the San Francisco Interfaith Council; and Dr. Ejaz Naqzi, president of the Contra Costa County Interfaith Council addressed the group on key issues including homelessness, food insecurity, immigration, and meaningful opportunities to care for individuals and communities in need.

Published

6 days ago

June 14, 2025

Oakland Post

Troy McCombs (from the state of Washington), Elder Mark Mortensen (from Irvine, CA), Michael Pappas, Rev. Ken Chambers, Dr. Ejaz Naqvi, Elder Sigfried Nauman (from the state of Washington), and Richard Kopf. Courtesy photo.

Special to the Post

Interfaith leaders from the Bay Area participated in a panel discussion at the annual meeting of communication leaders from The Church of Jesus Christ of Latter-day Saints held on Temple Hill in Oakland on May 31. Distinguished faith leaders Rev. Ken Chambers, executive director the Interfaith Council of Alameda County (ICAC); Michael Pappas, executive director of the San Francisco Interfaith Council; and Dr. Ejaz Naqzi, president of the Contra Costa County Interfaith Council addressed the group on key issues including homelessness, food insecurity, immigration, and meaningful opportunities to care for individuals and communities in need.

Chambers, said he is thankful for the leadership and support of the Church of Jesus Christ Latter-Day Saints’ global ministry, which recently worked with the interfaith congregations of ICAC to help Yasjmine Oeveraas a homeless Norwegian mother and her family find shelter and access to government services.

Oeveraas told the story of how she was assisted by ICAC to the Oakland Post. “I’m a Norwegian citizen who escaped an abusive marriage with nowhere to go. We’ve been homeless in Florida since January 2024. Recently, we came to California for my son’s passport, but my plan to drive for Uber fell through, leaving us homeless again. Through 2-1-1, I was connected to Rev. Ken Chambers, pastor of the West Side Missionary Baptist Church and president of the Interfaith Council of Alameda County, and his car park program, which changed our lives. We spent about a week-and-a-half living in our car before being blessed with a trailer. After four years of uncertainty and 18 months of homelessness, this program has given us stability and hope again.

“Now, both my son and I have the opportunity to continue our education. I’m pursuing cyber analytics, something I couldn’t do while living in the car. My son can also complete his education, which is a huge relief. This program has given us the space to focus and regain our dignity. I am working harder than ever to reach my goals and give back to others in need.”

Richard Kopf, communication director for The Church of Jesus Christ in the Bay Area stated: “As followers of Jesus Christ, we embrace interfaith cooperation and are united in our efforts to show God’s love for all of his children.”

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“Unnecessary Danger”: Gov. Newsom Blasts Rollback of Emergency Abortion Care Protections

Effective May 29, CMS rescinded guidance that had reinforced the obligation of hospitals to provide abortion services under the Emergency Medical Treatment and Labor Act (EMTALA) when necessary to stabilize a patient’s condition. Newsom warned that the rollback will leave patients vulnerable in states with strict or total abortion bans.

Published

6 days ago

June 14, 2025

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By Bo Tefu, California Black Media

Gov. Gavin Newsom is criticizing the Centers for Medicare & Medicaid Services (CMS) for rolling back federal protections for emergency abortion care, calling the move an “unnecessary danger” to the lives of pregnant patients in crisis.

Newsom warned that the rollback will leave patients vulnerable in states with strict or total abortion bans.

“Today’s decision will endanger lives and lead to emergency room deaths, full stop,” Newsom said in a statement. “Doctors must be empowered to save the lives of their patients, not hem and haw over political red lines when the clock is ticking. In California, we will always protect the right of physicians to do what’s best for their patients and for women to make the reproductive decisions that are best for their families.”

The CMS guidance originally followed the 2022 Dobbs decision, asserting that federal law could preempt state abortion bans in emergency care settings. However, legal challenges from anti-abortion states created uncertainty, and the Trump administration’s dismissal of a key lawsuit against Idaho in March removed federal enforcement in those states.

While the rollback does not change California law, Newsom said it could discourage hospitals and physicians in other states from providing emergency care. States like Idaho, Mississippi, and Oklahoma do not allow abortion as a stabilizing treatment unless a patient’s life is already at risk.

California has taken several steps to expand reproductive protections, including the launch of Abortion.CA.Gov and leadership in the Reproductive Freedom Alliance, a coalition of 23 governors supporting access to abortion care.