CIRS Blog about Rural California

By Ron Shinkman

Amidst great uncertainty about federal health policy, Covered California announced Tuesday that insurance premiums on the state-run exchange will rise on average 12.5 percent next year, an increase that is slightly lower than in 2017. The agency reiterated that it has a containment plan should the Trump administration cease to provide cost-sharing subsidies for lower-income exchange enrollees.

All 11 insurers currently offering coverage on the state’ exchange will return in 2018, although Anthem Blue Cross will withdraw from Southern California.

The premium hike for 2018 is down from the 13.2 percent average increase for this year, but still much higher than the low single-digit rate hikes announced for 2015 and 2016.

Covered California Executive Director Peter V. Lee noted that if consumers shop around for different plans in each tier of coverage, they could keep their rate increases down to 3.3 percent.

“For consumers, no increase is a good increase, but Covered California did a good job in these uncertain times,” said Betsy Imholz, director of special projects for Consumers Union in San Francisco.

Imholz credited the exchange for taking a tough negotiating stance with the health insurers and ensuring that competition remains in place in most of the state. According to Lee, 82 percent of Covered California’s enrollees will have three or more health plans to choose from.    

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By Claudia Boyd-Barrett

The future is hot.

As climate change heats up the globe, Californians can expect to face longer and more extreme heat waves like the ones sweeping through parts of the state this summer, experts warn.

Seniors, who are more prone to heat stress than younger adults, will be among those most affected by rising temperatures. With the over-65 population projected to expand rapidly in the coming decades, the accompanying hotter weather could place an enormous burden on emergency and health care infrastructure.

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June 23, 2017

After reflecting on this topic, I realized that the best summary available is the paper which Profs. Marc B. Schenker and Stephen A. McCurdy wrote with Heather E. Riden and myself titled Improving the health of agricultural workers and their families in California: current status and policy recommendations, published by the University of California Global Health Institute in February 2015.

 

Instead, I’ve decided to focus today on how Marc’s leadership and influence broadened the scope of research at the California Institute for Rural Studies (CIRS). In turn, the ultimate impacts of CIRS became greater than any of us could have ever imagined.

 

Prof. Marc Schenker and I met for the first time on June 6, 1990, at a Conference on Health Concerns of Living and Working in Agricultural California, sponsored by UC Cooperative Extension and the School of Public Health, UC Berkeley. CIRS was asked to bring community folks to the conference as panelists to discuss specific topics of current concern, and, as well, contribute an overview presentation about rural California. CIRS arranged for farm worker advocates, leaders from predominantly Mexican-American rural areas, and staff of agencies providing health services for farm workers to participate in the conference.

 

As a few who are here today were aware in 1990, it was risky of Marc to seek to engage me in his new initiative. Some eleven years earlier, I was part of an effort led by California Rural Legal Assistance, inspired by the late Ralph Abascal, to sue the Regents of the University of California for ignoring the needs of a great many rural Californians, most importantly, farmworkers, but also small-scale producers, organic farmers and the rural poor. We were not seeking monetary damages, rather we wanted major changes this public institution’s priorities.

 

Although we prevailed in Alameda County Superior Court, the lawsuit was thrown out by the California State Supreme Court ten years later. But, from the filing of the lawsuit, very quietly, the University of California helped to start or support the Small Farm Center, the Sustainable Agriculture Research and Education Program, and the Student Experimental Farm. Moreover, the controversial Alternatives in Agriculture course, begun in 1977, was added to the formal curriculum of the College of Agriculture.

 

It was in this context that Marc’s invitation was most welcome. Bob Spear had let it be known that one of the purposes of the conference was to scope the possible creation of a Center for Agricultural Health and Safety at UC Davis as part of the newly authorized Agricultural Worker Safety program of the National Institute for Occupational Safety and Health. After the conference, Marc asked CIRS to become a coinvestigator of the new Center and prepare a research proposal as part of his grant proposal for which he was Principal Investigator.

 

Quite frankly, in 1990, I could never have imagined what the relationship with Marc’s initiative would eventually yield. When the first NIOSH grant was awarded to the Western Center for Agricultural Health and Safety, in one of the very first discussions with him, we agreed to collaborate in undertaking a population-based survey of farmworker health that would include a modest physical examination.

 

We approach a farmworker clinic in Parlier, a well-known farmworker community. Joined by a few folks from Marc’s research group, and by Dave Runsten from the CIRS staff, we went to Parlier where Arcadio Viveros, Executive Director of the United Health Centers clinic, and Mayor of Parlier, welcomed us and agreed to cooperate.

I clearly recall one of the first comments Marc made to me about our work.

 

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By Hannah Guzik

If Washington, D.C. legislators approve cuts to government health care, California’s rural counties are among those who will suffer most, according to a new report.

Those who live in the state’s rural counties—which are largely in Northern California—are more likely than urban residents to be enrolled in the low-income health program called Medi-Cal, according to the report released June 6th from the Georgetown University Center for Children and Families and North Carolina Rural Health Research Program.

Medi-Cal covers 28 percent of adults and 54 percent of children in California’s rural counties, researchers found. Meanwhile, in the state’s metro areas, 21 percent of adults and 44 percent of children are enrolled in the health program.

Before the federal Affordable Care Act and state reforms opened the gates of Medi-Cal to most low-income adults and children, a quarter of the state’s rural residents under age 65 were uninsured. But by mid-2015, that uninsured rate had fallen to 11 percent.

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By Hannah Guzik

Amidst anxiety about potential federal funding cuts to health programs, California has one bright spot. The state’s new tobacco tax is expected to generate about $1.2 billion next fiscal year for the state’s low-income health program.

Now, California legislators and Gov. Jerry Brown are battling over how to spend the money.

Immigrant rights’ advocates are asking the state to use a portion of the Proposition 56 funding to expand health coverage to undocumented young adults.

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