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Medi-Cal leader not speculating on repeal of the Affordable Care Act

California Medi-Cal chief: We still have Obamacare

Diana Dooley, secretary of California Health and Human Services Agency, discusses the potential repeal of the Affordable Care Act during her stop at Fresno State on Thursday, Feb. 16, 2017.
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Diana Dooley, secretary of California Health and Human Services Agency, discusses the potential repeal of the Affordable Care Act during her stop at Fresno State on Thursday, Feb. 16, 2017.

Diana Dooley doesn’t like to speculate about a repeal, replacement or repair of the Affordable Care Act, but the secretary of California’s Health and Human Services Agency knows changes are coming.

She’s just not sure when Obamacare, as the Affordable Care Act is widely known, will be cut or modified.

“My message now is that we have a law and we’re operating under that law,” she said Thursday shortly after speaking to students at the Pay It Forward Luncheon Series at Fresno State.

Dooley is chairwoman of the board of Covered California, the state’s health insurance exchange for the Affordable Care Act, and is responsible for California’s Medi-Cal insurance program for low-income people. Republican lawmakers have vowed to create a new health insurance delivery system for the country that could vastly change both programs.

A health care overhaul could take time to create – and more time to win approval of members of Congress. And Dooley said she is in no rush for consensus. “I never thought gridlock would look so good,” she said, getting laughs from the students.

But as Dooley, a Hanford native and graduate of Fresno State, mingled after the luncheon, House Republicans were in Washington, D.C., announcing a plan for the repeal of Obamacare to be introduced after next week’s recess.

I’ve never thought gridlock would look so good.

Diana Dooley, Secretary of California Health and Human Services Agency

One aspect of the Republican plan, according to The New York Times, would sharply reduce payments to states for Medicaid (known as Medi-Cal in California).

State health leaders have been forewarned that a repeal of Obamacare likely would also affect the expansion of Medicaid, which was authorized under the Affordable Care Act. And although the House Republicans had yet to announce their plan Thursday, Dooley expressed concern over a possible repeal.

California chose to expand Medi-Cal to include low-income adults who previously had not been eligible for coverage. The state has added some 3.7 million residents to Medi-Cal under the expansion. And enrollment in the central San Joaquin Valley has been among the most vigorous. Fresno County, for example, has enrolled about 117,000 residents.

A repeal of the Affordable Care Act could cost California $20 billion, Dooley told the students at the Smittcamp Alumni House on campus. “If that is cut, it will have very serious consequences.”

But Dooley said the Affordable Care Act took four years to implement and a new plan could take at least a couple of years to come online, if not longer.

“I’m not so gloom and doom,” she said.

But she is not entirely optimistic either about what she could face in the last two years she will be overseeing Medi-Cal and a dozen other departments in the Health and Human Services Agency. Gov. Jerry Brown appointed her to lead the agency in 2010.

The implementation of the Affordable Care Act has changed health care delivery in good ways, such as hospitals providing outpatient care, including collaborations between hospitals and law enforcement for treatment of patients with mental illness, Dooley said.

“It will break my heart if my last two years I have to start disassembling what we have built in the last six years.”

Barbara Anderson: 559-441-6310, @beehealthwriter

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