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Articles / 2013

Federal health reform draws mixed reviews at Ventura seminar

Ventura County Star
By Tom Kisken

Federal health care reform received kudos for improving access to treatment but criticism for not going far enough at a seminar Tuesday night in Ventura.

Gerald Kominski, director of the UCLA Center for Health Policy Research, praised the Affordable Care Act for providing premium subsidies for low- and middle-income families. But he said while a person covered by an employer with a very good insurance program may pay 1 percent of their income in premiums, a middle-class family in the reform program could pay far more, even if they're covered by subsidies.

"Families in the exchange will be paying up to 9.5 percent of their income," he said, noting that households with lower incomes would pay less.

Enrollment began Oct. 1 in a reform program aimed at the roughly 48 million uninsured Americans. Coverage will begin Jan. 1.

Tuesday night's symposium, organized by Community Memorial Health System, was partly a primer on reform but also assessed strengths and weaknesses.
Gary Wilde, CEO of Community Memorial, which runs hospitals in Ventura and Ojai as well as a network of clinics, praised the law for emphasizing preventive care and attempting to coordinate the health system better.

But he worries about insurance reimbursement to hospitals. He worries, too, about patients covered in the exchange by so-called bronze plans with $5,000 deductibles and sizable co-pays. Even with insurance, they may not be able to pay for their care.

"We think reimbursements are going to go down and our bad debt is going to go up," he said.

The state-run Covered California exchange has avoided many of the online enrollment problems that have plagued the exchange run by the federal government, Kominski said. The state system reported Tuesday its website has received more than 2 million unique visits since Oct. 1.

But the UCLA professor called the problems with an embarrassment and graded the federal rollout of reform with a C at the highest.

"It just feels like there's a lack of preparation," he said of federal online enrollment.

Part of the seminar was spent on explaining the state of health care and the need for some kind of reform.

Wilde talked about the nation's crushing burden of debt and the national costs of health care.

"Almost 18 cents of every dollar we spend is on health care," he said.

Demand for care is growing, but the supply of physicians is thinning, he said. Earlier intervention and preventive care may be a way to control chronic illnesses that bring hospitalizations and large costs.

Kominski said the Affordable Care Act was born as a way to fill cracks in health care by covering more of the uninsured.

The law was designed to keep insurance companies from charging higher rates to people who need care more.

It meant parents could cover adult children on family policies until the age of 26.

It mandated that insurance policies for individuals or small groups no longer can opt not to cover treatment defined as essential, including maternity care, Kominski said.

More than three years after the Affordable Care Act was signed into the law, it remains as divisive as ever. Kominski said he has never seen anything more polarizing.

Asked if he knew of a way to control the partisanship that surrounds the law, he hedged.

"If I knew the answer to that question, I'd be a political wizard," he said.

Community Memorial Health System will hold a second seminar on health care reform Nov. 19 as part of an Ethics of Caring series. Visit for details.