Category Archives: Op-ed

Prop 45 threatens California’s health reform success story

Nearly one and a half million Californians signed up for health insurance coverage during the first year of health care reform. Consumers can now shop on our new marketplace, Covered California, without fear of discrimination based on pre-existing conditions and they receive financial assistance as needed. It is more important than ever to reject proposals that would turn back the clock on the progress our state has made in implementing federal health reform.

And yet Prop 45 — a poorly-drafted November ballot measure that would give one politician sweeping new powers to override decisions made by Covered California’s independent commission — would do just that.

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What needs to be fixed with health care reform

It seems that all we hear about health reform these days is hatred or hype. As usual, the truth is more complicated. We’ve laid a solid foundation for a much-needed national reform, but the challenges to date run deeper than the issues with the website. Successfully creating a functional, universal health care system for our country will require being entirely clear-eyed about what has worked and what needs to be fixed with the Affordable Care Act.

As we reach the end of the first period for individuals to enroll in health coverage, the number of people who have selected a health plan through the public exchanges may top 7 million nationally, more than 1 million in California.

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Update on How Obamacare is Affecting My Family

In July of last year I first began planning to buy insurance for my family under the federal Affordable Care Act. Since then, I’ve reviewed my options on the Covered California website, chosen my plan, paid the insurer, received my card, and have begun accessing healthcare. The process has had some hiccups, but so far the results have been much better than what I anticipated.

Back when I began shopping, I predicted that I would end up purchasing a “silver” Blue Shield PPO product to cover my family of three in Sacramento for $997 per month. The actual prices when they came out were much lower. So we bought a “gold” level product for $972 per month. Continue reading

My Family’s Obamacare

Forget the Talking Points. Health Reform’s Impact Will be as Varied as We Are.


How will the Affordable Care Act affect my family and me? The answer, like the law itself, is complicated. There will be as many stories about health reform as there are families. But I’m confident that most of these stories will be good.

I say this both as a health-policy wonk, with my own health policy consulting firm, and as a husband and father. My wife and I live in Sacramento, California, and we have a five-year-old son. My wife also happens to have a pre-existing health condition. It’s nothing life-threatening but it’s just serious enough that she has been turned down for regular health insurance coverage. Up to a third of Americans face a similar issue, according to the Government Accountability Office. Continue reading

Decisions critical to make health reform work

The hope of health reformers, myself included, is that putting the Affordable Care Act into place will resemble the end of “It’s a Wonderful Life.” After a bumpy transition, everything will be just as it was but better. Zuzu’s petals will be in our pockets, and the whole neighborhood will have shown up to help those in need.

This happy ending would be virtually guaranteed if Congress had passed the law Democrats originally introduced. The wild political process that created the law, though, led to the weakening of the supports that help keep the current system in place. So the future is uncertain, and we need to be extremely careful about the decisions we make if we want to fulfill the promise of reform. Continue reading

Why arena deal makes sense


As Sacramento moves forward with a downtown redevelopment project centered on an entertainment and sports center, it’s important to tune out the ideology both for and against the project. Our actions should be based on a clear-eyed account that weighs the potential benefits and costs for the city.

Arena construction projects generally make economic sense for cities when they do three things: catalyze additional investment that would not have happened otherwise, minimize the downside risk, and preserve other elements of the civic infrastructure. Continue reading

Basic Health Plan numbers do not add up

One of the most hotly contested issues for the end-of-year special session called by Gov. Brown on healthcare is whether California should create a “Basic Health Plan.”  This proposal would take away subsidies for the purchase of private health insurance from an estimated 800,000 lower-income Californians.  It would require them to enroll instead in a program run by the state’s Medicaid department.

The proponents of the Basic Health Plan claim that it will be vastly more affordable for Californians.  But their numbers do not add up. Continue reading

California health reform threatened by bill for basic health plan

California’s work to create a more affordable and fair health care system is threatened by legislation in Sacramento that would create a Basic Health Plan. This plan poses a grave threat to the California Health Benefit Exchange, which is the linchpin of federal health care reform.

When launched in 2014, the exchange will provide a new competitive marketplace for as many as 2 million consumers and business owners. Californians with incomes up to four times the federal poverty level — more than $90,000 for a family of four — will receive subsidies to purchase insurance. Continue reading

Discussion of health care should focus on lowering prices

The clock is ticking for health care reform, but not for the reason that you may think. It is quite unlikely that the law will be overturned next year even if Mitt Romney is elected president. But the Affordable Care Act must make good on the promise of its name and deliver affordable health care for consumers and businesses. Otherwise, the whole political conflict will be moot, and we’ll have to do something truly radical.

The reason that there is little political risk for health care reform is that we have a very conservative governing system in the United States. Because of checks and balances, the filibuster and federalism, it is very hard to do anything in this country and even harder to undo it. Though it would be technically possible for the Republicans to overturn much of the law, it would be a bare knuckle brawl that would exhaust all of Romney’s political capital. Continue reading