Affordable Health Insurance  in Santa Monica is very much depended on the out come of the Supreme Court ruling and how the states man in California will react to the ruling.

About 21% of the population of the State of California, nearly 7 million people, are uninsured.  Consequently, California is paying close attention to last week’s Supreme Court hearing concerning the Affordable Care Act.  The remarks of the conservative Supreme Court justices raise the concern  that it is very  possible the court will strike the individual mandate to purchase health coverage.  Such a ruling could throw out the entire Affordable Care Act  as unconstitutional.  If the federal law is struck down how will the California insurance commissioner handle health care reform in California?

California’s Insurance Commissioner, Dave Jones, has stated  that he “would work with other state leaders to make sure that California continues to move ahead. We require everyone to have auto insurance in California, and the world hasn’t stopped spinning on its axis. All this political tumult generated by the far right is really ignoring the reality in California and elsewhere”.

Consumer advocates in California also support Jones’ position, as they feel that the current status is untenable for people with and without insurance. The average California family pays an additional $1400 in premiums annually to cover the costs of the uninsured.  In the event that the federal Affordable Care Act is struck down, California would require a two-thirds majority vote in the State’s Assembly and Senate to mandate Californians to buy health insurance.  That task failed in 2008 under then-Governor  Arnold Schwarzenegger.

The health insurance industry warns that if a guaranteed issue policy is mandated, premiums will rise substantially unless everyone in California participates.  And if premium increase furthe, even more Californians would drop their health insurance coverage.

One of the biggest risks is that a ruling from the Supreme Court that strikes down the health reform act could  significantly cut off federal money and reduce the expansion of Medi-Cal, California’s program for the poor and disabled, as well as reduce subsidies for families purchasing private coverage.   Under the current federal law, California could receive up to $ 55 billion in federal funds for Medi-Cal expansion for the years 2014-2019, and a similar amount to help subsidize people who are now uninsured.  According to the Kaiser Commission, it is estimated that 2 million people would be added to Medi-Cal and 2.2 million Californians could be eligible for subsidies toward the purchase of private coverage.

Since the Obama health care law in 2010 has been signed, many significant changes in California have already taken place; examples of these are free preventive health screening, guaranteed issue for children under age 19, and effective July 2012, mandatory maternity coverage on all CA plans.  Furthermore, the mandate that the health insurance companies spend at least 80 % of their funds for medical care on individual policies will still stay intact, even if the federal law is struck down.  California will continue to build the California Health Benefit Exchange for 2014, using about  $40 million in federal funds to set up and market the various plans to consumers.

I have recently been attending seminars with the leading insurance carriers talking about affordable health insurance in Santa Monica.  Many executives believe that the health care reform act in California will stay, even if it is federally struck down.  And no one is stopping any preparations in California for 2014.