The energy was ecstatic on Sunday, March 12th, at the Ed Roberts Campus where over 300 people gathered to #Fight4OurHealth and defend the tremendous health care gains California has made covering over 5 million people.

We remember what it was like before the Affordable Care Act (ACA), close to seven years ago:

• Young adults were kicked off coverage when they were around 23 years old.
• If you were young and healthy and could afford coverage on the private market, access to the services you needed were not a guarantee if you had a certain condition or an expensive illness that meant you could hit a lifetime cap on coverage.
• As a woman you had to pay higher premiums because maternity coverage was not considered an essential benefit.
• If you had breast cancer, or allergies, or diabetes, you had a pre-existing condition and were either considered uninsurable or had to pay much, much more.

The ACA changed those things. Today we have more secure coverage because we are guaranteed a minimum level of benefits, meaning you get what you pay for no matter what happens, and prevention screenings are free. Low income families and individuals have options for coverage, where there were none before through the expansion of Medi-Cal. We strengthened private health care coverage so there are no longer lifetime caps for coverage yet your out of pocket costs are limited. At the town hall on Sunday, we heard courageous stories from Bay Area residents about their journey for health care coverage and what it has meant to their livelihood.

On Monday, House Republicans introduced legislation to gut mental health care for millions of Americans.

For individuals enrolled in Medi-Cal, the legislation will enact a per-capita cap, or a limit on federal spending for each Medicaid enrollee. For enrollees with significant health costs, including prescription drugs, on-going treatments, and hospitalizations, this will mean that costs above the cap must be covered by the state or by the enrollee. California stands to lose at least $20 billion, or one fifth of our Medi-Cal program, which will force the state to make dramatic cuts to eligibility and benefits.

The legislation also dismantles the Medi-Cal Expansion. Thirty percent of those newly eligible for coverage are living with mental illness and/or substance use disorders, the majority previously uninsured. While people who are currently enrolled in Medi-Cal will be able to remain covered, new enrollment will be frozen in 2020. Additionally, anyone with a coverage gap of more than one month will lose his/her coverage.

Additionally, beginning in 2020, the Essential Health Benefits requirement in Medicaid would be eliminated, including mental health and substance use treatment. California will have the option of whether or not to require Medi-Cal Managed Care plans to provide these benefits in light of decreased federal funding for the program.

For individuals enrolled through Covered California, income-based tax subsidies will be eliminated and replaced with an unspecified and discretionary fund for states. Additionally, for commercially insured individuals, the prohibition on discriminating on the basis of pre-existing conditions, including mental health conditions, will be eliminated. Individuals who have not maintained continuous coverage will be required to pay a 30% penalty beginning in 2019.

This past week thousands of constituents showed up at California town halls, vigils, and search parties for Republican representatives back in district but missing in action on health care. Democratic leaders were also drawing crowds. More than 2500 people gathered in Santa Rosa Saturday to hear Congressman Mike Thompson and other lawmakers discuss the effects of repealing the ACA. The press is paying attention to the public outcry, and polling shows that support for the ACA is at an all-time high. The pressure on D.C. lawmakers to come up with a replacement plan for the ACA isn’t just coming from voters. Governors, including John Kasich (R-Ohio), gathered this week, calling for a plan that will protect the millions of dollars in Medicaid expansion their states receive. But a leaked GOP ACA replacement plan did little to assuage their fears. Among other things, the plan would undermine the two main ways Californians get coverage, through Medi-Cal and on the job benefits.

CPEHN is concerned that the Republican proposal for replacing the Affordable Care Act (ACA) will lead to less care at higher cost for communities who least can afford it. After six years of attempting to repeal the ACA without a viable replacement plan, Congressional Republican leadership released another white paper on Thursday, February 16, outlining their ideas. Republicans insist their ideas will be “better” but they are only moving us in the wrong direction.

CPEHN believes a better health care plan must: