Study: Obamacare repeal to cost Sonoma County 2,000 jobs, $200 million

Guerneville resident Alicia Tighe had no health insurance in late 2013 when she fell seriously ill and was hospitalized for about a month.

Tighe, now 26, lost coverage after leaving her retail job to focus on classes at Empire College in Santa Rosa, where she was studying to become a medical assistant. But Tighe said she was able to receive quality care through Medi-Cal coverage she secured because of an expansion of eligibility requirements allowed by the Affordable Care Act, President Barack Obama’s landmark health care law.

“If Obamacare wasn’t around, I don’t know what would have happened to me, or the type of care I would have received,” Tighe said. “I’m just really thankful that it’s there.”

But it may not stay there much longer. The federal health care law has once again come into the crosshairs of Republican lawmakers, who have long sought to repeal the legislation and now have a qualified endorsement from President-elect Donald Trump.

On Friday, the House of Representatives gave final approval to a budget blueprint that will speed Republicans’ plans for repeal.

If lawmakers successfully sink the law, they could eliminate a source of health insurance for more than 35,000 Sonoma County residents - like Tighe - cost the county 2,000 jobs and saddle it with an economic loss of nearly $200 million, according to University of California health care researchers.

Patients would lose access to preventive care, treatment for acute and chronic conditions, as well as mental health services and dental care, local public health officials said.

“Most likely, many would go back to using the emergency room when they were in crisis,” said Naomi Fuchs, chief executive officer of Santa Rosa Community Health Centers, one of the largest primary care providers for Medi-Cal patients in the county.

Medi-Cal benefits

The Affordable Care Act included an expansion of Medi-Cal benefits that enabled 3.7 million low-income adults to gain government-sponsored health benefits, cutting in half the number of uninsured California residents from 6.5 million in 2013 to 3.3 million in 2015, according to researchers at UC Berkeley and UCLA.

Santa Rosa Community Health Centers, which operates eight facilities, got 14,000 people covered under the Medi-Cal expansion, generating about $4 million a year in new revenue for the nonprofit organization.

“It’s a very big economic engine for the county,” Fuchs said, noting the Medi-Cal money pays for the cost of health services, creates jobs and buys supplies.

More insured

In Sonoma County, 35,240 adults - roughly equal to the population of Windsor and Sebastopol combined - obtained Medi-Cal after eligibility was expanded by Obamacare to cover adults, primarily those without children under 18 living at home, with incomes below 138 percent of the federal poverty level.

Overall, the county had 112,732 men, women and children enrolled in Medi-Cal last year.

The increase as a result of expanded eligibility, along with an additional 19,620 residents who purchased government-subsidized health insurance from Covered California, the state’s health benefit exchange, resulted in a 51 percent decline in the number of uninsured Sonoma County residents, from 64,000 in 2013 to 31,000 in 2015, the Berkeley-UCLA report said.

Mendocino County gained 12,275 new Medi-Cal recipients and Lake County gained 8,823.

Statewide, the uninsured rate declined from 17.2 percent in 2013 to 8.6 percent in 2015 - the sharpest drop across the United States. The correlating jump of those now covered by some form of health insurance was unprecedented, said Laurel Lucia, manager of the health care program at the UC Berkeley Center for Labor Research and Education.

The uninsured rate in Sonoma County dropped from 13.1 percent in 2013 to 6.3 percent in 2015, she said.

“That’s fantastic,” said Mary Szecsey, executive director of West County Health Centers, which operates clinics in Guerneville, Sebastopol and Occidental.

More than 1,800 clinic patients were enrolled under the Medi-Cal expansion, which took effect three years ago and prompted the West County nonprofit organization to sign up all its patients who had become eligible, Szecsey said.

More preventive care

For both people and their caregivers, the difference was dramatic.

Szecsey recalled an elderly man who suffered from heart disease and other conditions and hadn’t been able to afford ongoing care. With Medi-Cal, he and other patients can come in for preventive care, tests and prescriptions rather than waiting for a health emergency, she said.

The new Medi-Cal enrollments cut the percentage of West County’s uninsured patients from 40 percent to 6 percent, boosting the average reimbursement per patient visit about 20 percent, Szecsey said.