A nurse checks a patient's blood pressure.

While Republicans in the U.S. Senate continue their efforts to defund the Affordable Care Act, California is moving full-speed ahead to implement the health care law. Covered California, the state health care exchange, is set to launch on Oct. 1. We talk to the director of Covered California, and take your questions on plans and premiums.

Peter Lee, executive director of Covered California
Lisa Aliferis, health editor for KQED News where she edits the State of Health blog
Betsy Imholz, special projects director for Consumers Union and an expert on health policy

  • @-@

    What we have always needed is socialized healthcare and an end to the tyranny of the health insurance industry. But how can Obamacare, the bill for which was written by the health insurance industry, ever possibly provide anything of value? The corporations want to enslave us, and their Uncle Tom in the White House seems eager to assist them in doing so.

  • Beth Grant DeRoos

    Am curious if someone who has Medicare can also under the ACA buy seperate coverage for whatever Medicare doesnt cover.

    Will dental care be offered under any of the ACA plans??

  • RealNurse2

    As a registered nurse I am very concerned about Kaisers view on the affordable care act. They believe more patient’s means less care in the hospital. Which is simply not true. So many of my co-workers leave their shifts in tears because we are so understaffed already we cannot provide the care people so deserve. It’s heart breaking…Our bottom line will always be our patients.

  • Jacquie Proctor

    Kaiser is doubling my premium (from $3500 a year to $7000!_) to comply with obamacare, apparently to provide maternity, dependent, and prescription coverage I won’t use. The minimum requirements for obamacare seem to penalize older middle class adults who buy their own coverage.

    • RealNurse2

      All while they reduce staff so you won’t get the care you deserve and pay for. Breaks my heart.

      • @-@

        In America the do-nothing, blood-sucking middlemen have far too much power. You see it in healthcare, you see it in the music industry, etc. Even in the computer industry, middle management has expanded enormously.

        • RealNurse2

          They have. We need more people providing the care not managing it.

  • USER


    • @-@

      I just checked and coveredcalifornia.com is registered to one David Moore in Tennessee:

      Registrant Name: David Moore
      Registrant Organization: Health Exchange Consulting Group, LLC

      Registrant City: Nashville
      Registrant State/Province: Tennessee


      coveredca.com is indeed the correct site:

      Domain Name: COVEREDCA.COM

      Registrant Name: Scott Howe
      Registrant Organization: Covered California

      Registrant City: Sacramento
      Registrant State/Province: California

  • Trina

    Many people are shocked to learn that my little family of
    three is paying close to 2000 dollars a month in health care premiums. My husband is a teacher and we are enrolled
    in the California state employee CALPERS system. Families enrolled in this get no share of cost for premiums from the state. The aging baby boomer population which makes up a huge proportion of the teaching pool has driven our premium costs up over 100 percent over the past 6 years. We are a GEN X family who are doing everything right to recover from a short sale immediately following the housing crisis. It has felt totally overwhelming to cover these premiums costs. I am a stay at home mom forced to quit my job because our son was once too ill for childcare. My son and I both have pre-existing conditions which make buying our own plans difficult.

    I keep hearing that this plan will offer some kind of relief
    to people like us who are paying exorbitant costs for health care
    premiums. When I contact covered CA however, I get mixed messages. Is this coverage for people like us who are already covered, but paying way too much money each month in premiums? My husband now grosses a decent income, but
    we don’t see over 20,000 of that each year because of the health care premiums that we pay. We are trying to buy another very modest home, and qualify for a loan, but we find we can’t afford our mortgage payments each month because of our monthly health care premiums. We would be head over heels if we could pay even a 1000 dollars a month for our family of 3. We desperately need help to regain some sort of financial security for our family. What is the bottom line for us regarding our eligibility for Covered CA, and when can we expect coverage to begin?

    • erictremont

      If you currently get coverage through an employer and your share of the annual premiums does not exceed 9.5% of your gross income, it is my understanding that you have the option of buying coverage on the exchange, but you won’t qualify for subsidies. Question: is there a less expensive Calpers option that might meet your family’s needs, e.g., an HMO? I sympathize with your frustration.

  • GiorgioOrwell2nd

    As a independant contractor, making very much middle class wages in SF (so no subsidies for me), I just went through all the options on Covered California and the monthly payments on the Bronze plan are more than double what I currently pay on Anthem, and looking through the details of copay, etc. the Bronze plan is significantly less coverage. This isn’t even close to affordable coverage, unless of course you are at poverty level. So once again the middle class is getting screwed.

  • USER

    All the scam sites should be blocked…for example, coveredcalifornia.com, is collecting emails currently. it is a scam site

  • USER

    Dave, please let listeners know: COVEREDCA.COM is the correct site NOT COVEREDCALIFORNIA.COM
    you are saying covered california in your forum, and it makes us think it is the coveredcalifornia.com, which in fact is a scam site

    • Fay Nissenbaum

      yes, and the guest kept saying covered california even after hearing that lead to a bogus site. Why the hell doesnt the govt shut is down? Fraud, misrepresentation – several ways it should be illegal.

  • GiorgioOrwell2nd

    After playing around on the covered CA website for a while, I am quite sure that very few people are going to sign up for this based on the inflated costs/premiums. Even if you get the credits, it is still very very expensive. It will surely make sense for someone with a pre-existing condition, or a very large family living at poverty level…for the other 99% of people this thing is a joke. The problem is the math isn’t going to work on this if only the chronically ill and large families join this. Let’s watch and see how many people sign up for this bloated gift to the health insurance industry, my guess is it won’t be anywhere near the government hopes/projections.

  • Fay Nissenbaum

    What about all the people Unemployed? If one is receiving CA EDD unemployment benefits of $371/per week – the current maximum under the federal sequester – what then?? You can’t get blood from a turnip!

    Thank you,

  • Fay Nissenbaum

    it’s still expensive for the unemployed – crazy! you are gonna have a lot of folks who will sit on the sidelines b/c they cannot afford an extra carton of milk a week, let alone a hundred or more per month.

    Sounds like a windfall for the insurance companies.

  • Aditya Patel

    The information mentioned by you panelist about Medicare for parents over 65 who are new immigrants is not TRUE!!! They ask you if you have paid taxes for 10 yrs. you get rejected and thru medical you cannot have assets or income over 2k per year. My parents are from India? So how can they give up all their assets. They cannot buy insurance in the open exchange?

    • I would like to talk with you about your experience. Can you contact me at laliferis-at-kqed-dot-org? I am the health editor at KQED News.

    • erictremont

      Are you confusing Medicare with Medi-Cal?

  • GiorgioOrwell2nd

    why did no one at kqed actually get on the covered california website to look through these insanely costly policies before they started interviewing the panelist?? Come on, we rely on Public Radio to do some real interviews/reporting. I just donated last week to KQED and am quite frankly disappointed in this kind of interview….luckily your non-news programming is so good, or I would not be a supporter.

  • Raquel Aparicio

    I am at poverty level and I was wondering if its even possible to get subsidies if I enroll under the plan my partner has, Because I wasn’t able to pay for it before. Or does that fall out and I have to get my own insurance.

  • HrtNurse

    As a Nurse, I am extremely concerned with what we are seeing daily at Kaiser. Patients are coming in to our ER very sick, given minimal treatment and sent home only to return the next day or sooner with worsening symptoms. Patients and family members frequently tell us that it took 3-4 times coming back to ER before they were finally admitted to hospital. Many of these patients are now requiring a higher level of care (ICU, step-down) because treatment was delayed by being sent home instead of admitted. They now have life-threatening blood infections (sepsis), caused by urinary tract infections, pneumonia, etc. or require emergency surgery for something that could have been treated less invasive had they been admitted in the first place. Patients in the hospital are also being pushed to go home long before they are medically ready. Doctors bonuses are affected by factors such as admissions, length of stay. Less means more bonus $$! Kaiser is not staffing our units with what our patients require, deserve and pay for! They have just started to involuntarily cancel nurses from regular shifts which for one, is a violation of our contract! Kaiser is increasing premiums for our members at the same time they are decreasing the care and services to our members!! It is disgusting, unethical and unacceptable. We are talking about the lives of people! Kaiser made 2.1 billion in profit, our outgoing CEO salary $77/minute and Kaiser’s profit will increase in the coming years. I want Kaiser to do well financially but come on! Kaiser’s GREED is threatening the lives of our patients.

    • Long time Kaiser nurse

      As a 20+ year Kaiser med/surg RN, I concur. My concern is also the growing greed–the massive amount of monies taken in, and the rationing of care when it comes to admitting people into the hospital, whether they are admitted to the correct area such as ICU or kept in a less costly area, whether they are sent home too soon, with resulting poor outcomes or wind up just being readmitted. If you choose Kaiser, you MUST demand to receive the care you are paying for. They should not be sending nurses and other staff home to save money, while those who are left struggle to provide SAFE CARE to those in need!

      • erictremont

        The average salaries for hospital RNs in the Bay Area now exceeds $100,000 per year (plus a generous benefits package), and highly specialized RNs like ICU nurses can make over $150,000 per year. I can’t take seriously nurses’ claims about “greed” when you folks aren’t exactly earning poverty wages. You folks are part of the health care cost problem. If you want to see what real economic hardship looks like, talk to one of the 30,000 + public school teachers in California who have lost their jobs since the beginning of the recession. Hospital nurses have nothing to complain about.

      • Long time Kaiser nurse

        I do believe you missed the entire point, erictremont, of both posts. (Nurses are professionals, and wages are in line with what professionals earn in the Bay area, by the way). This is about providing safe care for the patients.

        • erictremont

          No, I think you missed the point. Nurses are indeed professionals and they deserve to be fairly compensated. But their union reps have no right to impose ridiculous work rules, make it impossible to restructure care more efficiently, or make recklessly false claims about the health care industry (particularly Kaiser which is generally one of the better actors in the industry).

    • Chemist150

      Out of curiosity, how are the expenses on everyday items such as chairs, bandaids?

      One concern I have with the new healthcare system is the $700 hammer syndrome.

      It seems that it will favor HMO type operations because of the 80% expenditure has to go to healthcare. One way to increase cost is increase the cost of goods. Side businesses will spin off to sell themselves items at “retail”.

      For example, a board member starts a warehouse buying bandaids in bulk and factory floor prices. Then they turn around and sale retail to, let’s say, Kaiser. Not only is it retail, it’s 20% higher than you’d buy it from Target.

      Any hints of this?

      I get charged $150 per x-ray at the hospital but the airport does it free. I understand that some of it is labor but it does not seem right.

    • erictremont

      Your assertions about poor quality of care at Kaiser are contradicted by rigorous quality metrics compiled by independent organizations such as the National Committee on Quality Assurance (NCQA). The fact is that Kaiser has a pretty darn good track record when it comes to the quality and safety of the medical care it provides. Furthermore, you are wrong about Kaiser’s incentive payments for its physicians. A large majority of physician compensation at Kaiser comes in the form of an annual salary, and the portion that represents incentive payments is driven mostly by quality targets, NOT by utilization or financial targets.

  • Marty Susman

    This whole health car mess in America can only be fixed when first we all except that health care is a right & that every single American deserves it & when we have National Health care for EVERYONE…

  • Matthew Reiser

    Classic KQED. The host unilaterally blows off a key question of any congressional move, especially this one: How is it funded?

    I’ve been listening for years, but would respect you further if you’d please address fiscal mechanics. Have the courage to report that this Act will be funded by fees and higher taxes on the general public.

    Seeking answers? Consider starting with the facts: http://www.alignamerica.com/node/62

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