Paul Torrens Health Forum speakers discuss health care under Trump administration

Speakers at the Paul Torrens Health Forum made their predictions on how the Trump administration would impact health care and health insurance. (Andrew Diaz/Daily Bruin)
This post was updated Feb.12 at 1:12 a.m.
Speakers at the Paul Torrens Health Forum predicted that the Trump administration’s proposed health care budget cuts could threaten the coverage of millions of Californians and Americans alike.
The Paul Torrens Health Forum – hosted by the UCLA Fielding School of Public Health and the Center for Healthcare Management at UCLA – provides an organized space to discuss public health issues. Three CEOs in the health care industry – Charles Bacchi, Dustin Corcoran and Tom Priselac – were invited to speak at the Ronald Reagan UCLA Medical Center regarding the future of health care under the Trump administration Jan. 29.
Bacchi, the CEO of California Association of Health Plans, said the Trump administration may impact California residents with different health care plans – including Medicare.
The chances of President Donald Trump cutting Medicare is low, considering how he did not cut the health insurance program during his first term, Bacchi said. The 22 million California residents on Medicare and similar commercial group insurance plans are less likely to be impacted, he added.
Trump, however, is more likely to alter the Medicaid program that covers around 15 million low-income Californians, Bacchi said. This number includes 40% of children born in the state of California, the homeless population and childless adults with specific income threshold matches, Bacchi added.
Subsidies for people purchasing coverage through exchanges could also be impacted, Bacchi said. The lack of reconciliation by the Republican Congress may result in loss of subsidies in the state of California, impacting around 1.8 million Californians who receive coverage through Covered California, Bacchi added.
“It’s concerning what could happen to your health care,” Bacchi said. “The real risk to California is that we could lose (coverage for) a million people, two million people.”
Corcoran, the CEO of California Medical Association, said the proposed Medicaid budget cuts could total about $2.3 trillion over the next 10 years.
“I would not think it a hyperbole that it’s a devastation for our health care system, certainly for those 15 million Californians on Medicaid,” he said.
Corcoran said the Affordable Care Act, the Prevention and Public Health Fund, and the Supplemental Nutrition Assistance Program-Education, along with many other health-related services, are also at risk of major budget cuts. The effects of these reductions will likely disproportionately fall on central and northern California, as those populations are reliant on these services at higher rates, he added.
“How does that hospital stay open? How does a physician stay in practice?” Corcoran said. “How does the clinic continue to provide those services? Those are the stories that we have to tell and we have to talk about.”
The health care delivery system in Los Angeles is precarious, said Tom Priselac, the president and CEO emeritus of Cedars-Sinai Medical Center.
Over half of state hospitals lose money on operations, Priselac said. Two-thirds of hospitals in California have negative Medicare margins already, resulting in closures and capacity reductions, he added.
The Trump administration may also exercise significant reductions in the Medicaid Section 1115 demonstration waiver that provides health care services for justice-involved individuals, Priselac said. While the commercial market is not subject to significant impact, other potential ideas include expansion of association health plans, increased use of health savings accounts and promotion of high deductible health plans.
The forum ended with questions from the audience, many of which related to the future of health care for undocumented individuals.
Bacchi said California is currently funding coverage for the entire undocumented adult population with state dollars. If the federal government does reduce funding for Medicaid, California will likely consider reallocating the funds for undocumented individuals to help cover the loss, he added.
“We’re back to where we were a decade ago, where you have a significant part of our population that is not getting treated,” Bacchi said. “That’s bad for them, and it’s bad for all of us as a community and as a state.”
Corcoran added that many undocumented individuals are now afraid to even access health care services because these programs require the names of all users to be recorded on a governmental list.
Wren Keber, a longtime attendee of the forum, said his biggest takeaway from it is that chaos is not a bug of the Trump administration but a feature.
Chandra Broadwater, a UCLA alumnus and event attendee, said the numbers provided in the forum displayed how the new administration’s budget cuts in health care could impact community members. It successfully dissected some of the proposals made by the new administration with data, she added.
Corcoran said this is a moment where hospitals, physicians, health plans and others need to be working together, as the things that unite the health care community are far greater than those that divide it.
“The stakes are so, so high,” he added. “Millions of not just Californians’ – but Americans’ – health is at risk and at stake based on what happens in reconciliation and in the years coming.”