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Obamacare Baffles Mendo

On Monday, April 8, the Mendocino Board of Supervisors listened to two and a half excruciating hours of impenetrable insurance jargon. If you're inclined to rhetorical self-abuse you'll be ecstatic at “exchange reinsurance program fees,” cost increases, “the healthcare marketplace,” “workforce analysis,” legal and illegal coverage methods, and so on.

Our stalwart leaders seemed so overwhelmed by the barrage of charts, graphs, slides, and monologues consisting entirely of technical jargon, that they had trouble even forming questions. What few questions they did ask were answered with “I don’t know,” “I’m not certain,” “That’s still open,” “that’s possible,” “that wouldn’t make any sense,” “there are many other things you might want to do,” “that could make a big difference,” “we still don’t have a good picture of that,” “this is just a beginning of a dialog,” “this is the kind of thing we have to begin to look at.”

In short, although there’s lots of information, nobody but the consultants seemed to have any real grasp of it.

At one point Supervisor Hamburg, who seemed to be trying his best to understand the ununderstandable, asked, “I’m still kind of stuck on this $3 million penalty. That’s a penalty that the County would have to pay…”

Health insurance consultant Peter McNamara: “That’s correct.”

Hamburg: “If we did what?”

McNamara: “Let’s say come October you have open enrollment for your regular plan and for whatever reason every employee in the county says, ‘You know what? I’m going to the exchange because I want this plan or that plan and it’s not offered by the employer.’ For every employee who does that it’s gonna cost you $3,000 because you currently offer insurance to your employees. But as an employer the federal government is saying the penalties for your employee who has coverage through you and comes to the exchange that’s $3,000.” (Times 1,000 employees comes to $3 million.)

Hamburg: “I don’t understand the logic of that. Why penalize the employer for a decision by the employee?”

Mr. McNamara shook his head. “I don’t work for the federal government. I don’t know.” Then he threw up his hands, shrugged his shoulders and added, “There has to be a way to pay for the healthcare, right? And this is… all of these taxes and fees and penalties and call them what you want, they are all meant to provide the revenue in order to cover the uninsured.”

And, he could have added, to guarantee high profits for private insurance companies, the basic point to Obamacare.

Then there was a discussion of whether the $3,000 per person penalty had to be paid each year or one time. Different people had different answers. As far as we could tell it’s probably charged for each year an employee opts out.

Later in the presentation, when a chart of insurance rates for various plans and coverages was displayed, Supervisor Hamburg explored another subject: “What is the projected stability of these [insurance plan] rates going forward?”

Another consultant named Lee Kemper replied, “To be honest, I’m not in a position to say other than what Covered California would tell you and that is that those are the rates that they project in the first year. They will be negotiating the rates in the subsequent years and everything becomes a part of the risk mix and the total size of the population that comes in to be enrolled.”

Hamburg: “I remember a speech given by the— what do we call the health commissioner of California?

Kemper: “The Health and Human Services agency secretary.”

Hamburg: “No, I think this is an elected…”

Kemper: “The insurance commissioner?”

Hamburg: “The insurance commissioner! Yeah. And he was explaining that because he has no authority over the rates that are charged by health insurance companies. He wasn’t expressing a lot of confidence that these rates will be held down. I think there are other states that give that power to that elected insurance commissioner but California is not one of those states.”

Kemper: “That’s correct. We also have another variant. That is that our insurance function is actually provided by the department of managed care which oversees health plans like HMOs and the department of insurance which oversees indemnity plans, regular insurance and a variety of other insurance products. So it’s a little bifurcated.”

Hamburg: “Who benefits from all this diffuse responsibility?”

Kemper: “Well, I’m not sure that you can say who benefits. What I can say is that historically it’s been that way and one of the realities is that overtures to block it, or rather to change it and provide rate-setting approval authority, have been blocked in the legislature.”

Hamburg: “Yeah. Gee — I wonder why.”

Toward the end of the presentation a clearly exasperated Hamburg summed up: “Anyone else who would like to bring up a question or…, or, um… end up an advocate for Single Payer? [Laughs] It would be WAY more simple than this! Oh, god! … Is that somebody in the back or is that just another Single Payer advocate? If nobody else has a question… Maybe we’re all just kind of bleary-eyed (squints) with all this information. Thanks a lot Peter [McNamara] and Lee [Kemper]. [Laughs.] No, I mean it! Thanks a lot.”

Several county staffers repeated that this mind-numbing presentation was “just an introduction,” and there are “lots of decisions to make.” CEO Carmel Angelo noted that the County’s “health working group” was working on implementation with “our community partners.”

Supervisor Pinches finally spoke up: “Has there ever been a federal law that was this hard to implement?”

Hamburg: “I’m sure. I’m sure that there was.”

Maybe, but we sure don’t know what it would have been. And Mendocino County is just getting started.



County CEO Carmel Angelo included some remarks on the local economic impact of the filming of “Need For Speed”:

“CEO Report, April 9, 2013: Need for Speed Filming: Dreamworks Pictures has begun filming for their motion picture ‘Need for Speed’ within the County’s borders. The production will mostly be focused within and around Anderson Valley, with encroachment permits recently being granted by CalTrans for filming near Mountain View Road and Lighthouse Road today, April 9, and tomorrow, April 10. Upcoming encroachment permits are likely to be granted for extended filming needs the company may require for the film. The County is happy to host this event, as it is estimated to bring in more than $1 Million in revenue, in addition to providing funding for the Boonville Apple Fair this year. The Executive Office hopes to continue bolstering a positive working relationship with the movie industry to bring repeat filming opportunities here locally that can provide jobs and economic growth.”

Need For Speed representatives claimed that they planned to spend $3 million to perhaps even $6 million in Mendocino County. Supervisor Hamburg said at the meeting in Anderson Valley that he thought that the movie would bring in $3 million.

We’ve done our own back-of-the-envelope calculations, pointing out that most of the money the Film Production Company was spending was on their own production costs, not on local employment, lodging or food — although there certainly was some money spent locally.

We're pleased to hear that Supervisor Hamburg and the County intend to do an assessment of the film project’s economic benefit to Mendocino County.

Hamburg: “I wanted to pick up on again with the Need For Speed issue. I think a lot of people out there are curious about how much revenue is actually going to be derived by the county. There’s all sorts of numbers out there that are really not backed by facts. I've thrown around a few numbers myself and I regret that I've done that. But I think, or I know that there will be a report made to the County at the conclusion of the filming, some kind of economic impact report to try to track how much revenue actually did come into the county. It's a hard thing to do because there are so many little transactions and things that happen that have economic impact but are not easy to quantify. But I think it is important that after we do have a major film like this made in Mendocino County that we have an idea of what the benefit is for the obvious costs that are involved for individuals. I just want to say that the feedback that I've gotten from constituents in the Fifth District which is where the filming is happening have been I would say overwhelmingly positive, although there certainly are people who have been inconvenienced and who let me know that.”

No deadline for the Need For Speed Economic Impact Report was mentioned.

* * *

Supervisor John Pinches gave a short report on construction in the Third District: “The Willits Bypass project is moving forward it seems to me without a hitch. I don't see any protesters out there this week, or at least as of this morning when I came by. Also, the brand-new Willits Hospital is getting well under way. If you ever go by there you can see the construction is going up. And also the college expansion project. So there's a lot of construction work going on in the spring and summer in the Third District.”

* * *

Supervisor John McCowen reported on the status of the Mental Health Court implementation that began in the aftermath of the Aaron Bassler case in the fall of 2011. Some people had advocated that the County implement Laura’s Law, a “court coercion” form of steering mentally ill people into treatment but which the Board decided was too expensive to implement and which wouldn’t help very many of Mendoland’s sizable number of persons with mental handicaps, whether genetic or drug-induced. Instead, McCowen and the rest of the Board chose to see if some kind of Mental Health Court could be introduced without the large cost or legal mandates of Laura’s Law.

McCowen: “With regard to what most participants call Mental Health Court or what the Judge Moormon more modestly calls the Thursday 11am Calendar, we have had referrals to that calendar. There have been I think two court hearings so far. So we do have participants. It's a modest beginning. It is moving forward. The larger group involved in planning for this continues to meet. It's really very exciting that we actually have people participating in the program now — with of course the cooperation not only of Judge Moorman, but District Attorney Eyster, Public Defender Thompson, the Probation office, and Mental Health. So that's good news.”

But they obviously have a long way to go because by the County’s own public health report, Mendocino County has more than it’s share of possible candidates for Mental Health Court.

* * *

Supervisor Hamburg also reported on a recent trip he took to the South Coast as the feds are expanding the number of government-protected acres on the Stornetta lands at the mouth of the Garcia via taxpayer acquisition, with significant taxpayer funds going to the Stornetta family themselves.

Hamburg: “On the 29th I was in Point Arena, and former supervisor Kendall Smith was there as well, in addition to Congressman Huffman. This was a dedication for the next portion of the Stornetta lands. Amazingly in Point Arena there was just a gorgeous, gorgeous day. There had been an electrical outage earlier in the day and the schools were closed so they got a bevy of schoolchildren out there on the bluffs. It was a very beautiful day. I think the real question about the Stornetta lands out there is whether use by human beings is going to do more damage than the use by cattle over the last century. Because if you look at the way that land has been preserved while it has been used by the livestock industry, it's absolutely gorgeous. I think the concern is whether human beings will treat it as well as the cows did all those years.”

Supervisor Carre Brown: “I'd like to add to that that the Stornetta family was very good stewards of the land. They were cattle ranchers, and sheep, and they also do the sweet peas and they plant peas and what have you. I know that Millie [Stornetta] who passed away just before the lands really changed [into government control], she was very concerned because the family used to protect that coastline. They would open so many days a year to local abalone hunters; it wasn't a greater public but they really preserved those lands and we should give a tribute to them for doing such.”

Pinches: That's the bigger issue, and there's a big movement for running all of our livestock grazing off our public lands and they are doing a pretty good job of that and it's a real question now that if we replace it with people we are not going to take near as good care of it.”

Hamburg: “It's a real concern. It sounds kind of funny at first, but I don't think it's funny any more. It's real.”

Pinches: “We are preserving ourselves right out of business in this county.”

Hamburg: “We've heard that speech before.”

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