READ TRANSCRIPT

SAUL GONZALEZ, correspondent: Hours before it opens each morning, a line forms in front of St. John’s community health clinic in the heart of South Los Angeles. The people who come to this government-supported health center are some of L.A.’s poorest and sickest residents, and most are uninsured. They turn to this place because if they can’t pay they’ll still be seen and treated.

Do you have insurance?

Yvonne Ivory: No, I don’t have any insurance.

Gonzalez: You don’t have insurance?

Ivory: No.

Gonzalez: When’s the last time you had it?

Ivory: Two years ago, when I lost my job.

Oswald McFadden: I don’t have insurance.

GONZALEZ: You don’t have insurance. What’s that like?

McFadden: Just trying to not get sick.

GONZALEZ: If the Affordable Care Act, better known as Obamacare, works, it’s the patients at St. John’s clinic, and millions more like them across the country, who are among those who are supposed to benefit the most.

Jim Mangia is the president and CEO of St. John’s. He says Obamacare’s importance can’t be underestimated.

post02-implementing-obamacare

JIM MANGIA (President and CEO, St. John’s Well Child & Family Center): There’s no doubt in my mind that it’s one of the most significant pieces of social legislation we’ve seen in more than a generation.

GONZALEZ: It’s up there with Social Security?

MANGLIA: Social Security, Medicare, Obamacare.

GONZALEZ: If all goes according to plan, Obamacare will expand health care coverage to over 25 million people over the next decade. It will do that in two ways. First, through a big expansion of Medicaid, the state and federal health coverage program for low income individuals and families. Individuals with incomes up to 133 percent of the U.S. poverty line will now be able to qualify for Medicaid coverage at no cost to them. Second, for those making more, Obamacare creates new health insurance exchanges where individuals and families can purchase coverage from a menu of insurance plans offered by private insurers. People can begin enrolling in these policies on October 1, with the coverage kicking in on January 1 of the New Year. Premium subsidies will be available for those with incomes up to 400 percent of the federal poverty line. Many uninsured who qualify for the marketplaces but don’t purchase a plan will face a financial penalty, or tax. That starts at a minimum of $95 per year in 2014, but will rise to a minimum of $695 in 2016. Obamacare’s many provisions, especially the mandate to buy insurance, have sharply divided Americans for years, including people of faith.

post03-implementing-obamacare

REV. ART CRIBBS (Executive Director, Clergy and Laity United for Economic Justice California): Obamacare makes health care affordable to everyone regardless of income, regardless of wealth, regardless of ability to pay. It becomes affordable.

GONZALEZ: Art Cribbs is the executive director of Clergy and Laity United for Economic Justice (CLUECA), an interdenominational California group supporting Obamacare. Cribbs is such a strong proponent of good health he invited us to talk to him after his morning workout. To Cribbs, supporting Obamacare goes beyond nitty-gritty health and public policy issues. It’s a matter of morality.

CRIBBS: That is what Obamacare is all about: taking care of those who are among us, for whatever reason, who are unable to care for themselves in terms of their physical condition, in terms of their health and their medicine. As a person of faith if I am to turn my back on people who have needs, medical needs, physical needs, I have turned my back on my faith. That’s the bottom line.

GONZALEZ: Of course, many other people of faith don’t share such views on Obamacare.

post05-implementing-obamacare

PROFESSOR SCOTT RAE (Philosophy of Religion and Ethics, Biola University): The parts that make me nervous about it, particularly from an ethical perspective, is the mandate that people have to buy insurance coverage.

GONZALEZ: Scott Rae studies the intersection of Christian ethics, economics, and health policy at Southern California’s Biola University, an evangelical campus. Rae worries about the estimated $1.1 trillion cost of Obamacare as it expands coverage to more of the poor. He also believes Obamacare takes too much authority out of the hands of individuals and gives it to the government.

RAE: Any time government steps in and tells people what they can and cannot produce on the production side, and can and cannot consume on the consumption side, assuming that there is not significant amount of harm coming from those choices I think that is in general, I think, a movement in the wrong direction.

GONZALEZ: As Obamacare rolls out, so too does a big, national, expensive campaign of public persuasion. Its message is pretty simple: health care reform will be good for the country. And when it comes to getting medical insurance there’s no excuse not to get any.

One big target of the effort will be healthy, but uninsured Americans in their 20s and 30s. Dubbed “young invincibles,” their participation in health care reform is considered vital to offset the cost of covering older and chronically ill people buying insurance. To woo them and others, the federal government and individual states will spend hundreds of millions of dollars explaining and selling Obamacare in the coming months, with a variety of different campaigns.

Obamacare Commercials

In Minnesota, the focus is on humor and turning Paul Bunyan into an Obamacare pitch man.

post06-implementing-obamacare

In Oregon the thrust is folksy and appeals to state pride.

California is taking a more soft-sell approach. California, with the largest population of uninsured in the country, says it will be the most aggressive state when it comes to implementing and marketing Obamacare…

Public Service Announcement in Spanish

...spending $150 million on a multilingual media and outreach campaign.

Peter Lee: (at podium) “We’re now going to see Californians, starting October 1...”

GONZALEZ: California’s also hosting old-fashioned town hall meetings across the state to explain the details of health care reform to its citizens.

Lee: “So rates are based are how old you are, where you live, and your household size. And then the choices you make: Which health plan do I want? That’s how rates are going to be based.”

GONZALEZ: Faith communities are also being recruited to spread the word about Obamacare.

post07-implementing-obamacare

CRIBBS: We’re already doing it. We’re in churches. We’re in mosques. We’re in masjids, temples, and synagogues. We’re in faith communities across the country talking to people about this opportunity to make sure that they and their neighbors have access to affordable health care.

GONZALEZ: Then there’s all the Obamcare-related hiring going on.

Telephone Operator: Oh, no problem, sir. I already found your account here.

HOWARD KAHN (CEO, L.A. Care Health Plan): So we’re staffing up on the members services side. We’re staffing up on the sale side.

GONZALEZ: Howard Kahn is the CEO of L.A. Care, a Los Angeles-based public health plan that expects huge growth under Obamacare as it offers health insurance plans to more people. LA Care’s downtown Los Angeles office tower is filled with floor after floor of operators all trained to sign up new applicants for Obamacare insurance programs.

KAHN: So today, L.A. Care covers about 1.2 million people. Through Obamacare, both the medical expansion and Covered California, I would assume we will serve at least another of a quarter of a million people, another 250,000 people, over the next year and half or so.

post08-implementing-obamacare

GONZALEZ: But even as Obamacare moves closer to full implementation, opposition to it continues. In Congress, many Republicans are still calling for a halt or outright repeal of the law.

Many states have announced they won’t participate in the expansion of Medicaid, and several more are leaning against it.

Crossroads GPS Commercial

And to influence public opinion, conservative political groups have launched their own media campaigns to attack Obamacare. This one, targeting young people, is produced by Crossroads GPS.

Public Service Announcement excerpt: “Yeah, you work out, stay healthy. But come on, bro’, someone’s got to pay for people who smoke, drink 85-ounce sodas, and live in a Barca-lounger.”

GONZALEZ: And even after it’s fully implemented, critics say a public backlash could still kill Obamacare.

RAE: It wouldn’t surprise me if it failed, and we reverted back to market-based solutions either.

GONZALEZ: To what we have now?

post09-implementing-obamacare

RAE: Perhaps even more market-based than we have now.

GONZALEZ: Even ardent supporters of Obamacare acknowledge possible problems with it because of its size.

KAHN: We’re working with 17 to 18 percent of the US economy, the biggest economy of the world. It’s very complicated, and there will be slip-ups.

GONZALEZ: Others worry Obamacare isn’t big enough. For instance, even when fully implemented, an estimated 30 million people in the United States will still be uninsured. They range from the undocumented to people living in states not participating in Medicaid expansion. Finally, there’s a feeling in the health care community itself that there’s much more to learn about Obamacare as the clock ticks down its full unveiling. At St. John’s health clinic, pediatrician and medical director Mimi Choi admits she doesn’t know enough about health care reform.

DR. MIMI CHOI: I would say I don’t know everything; I am learning pieces here and there for sure.

GONZALEZ: It is overwhelming?

CHOI: Totally. Totally. There are so many moving pieces, there are so many arcs and large programs coming into existence that it is overwhelming to try to get a grasp of everything and how it’s going to affect our practice especially.

GONZALEZ: In St. John’s crowded waiting room, there’s little talk about Obamacare and the arguments for and against it. People here just want to know when they do get sick, some place and someone will be there to help and heal them.

For Religion & Ethics NewsWeekly, I’m Saul Gonzalez in Los Angeles.

In This Episode << SLIDE LEFT TO SEE ADDITIONAL SEGMENTS

Implementing Obamacare

“As a person of faith, if I am to turn my back on people who have needs, medical needs, physical needs, I have turned my back on my faith,” says Rev. Art Cribbs, executive director of Clergy and Laity United for Economic Justice. But Biola University religion and ethics professor Scott Rae believes Obamacare takes too much authority out of the hands of individuals.

  • Kimberlee

    I have supported the need for healthcare reform in our country since Hillary Clinton made it an issue back when she was First Lady. It failed in Congress then. I support the principles of “Obamacare,” but have had great concern that the funding is just not going to work out as it has been planned; and when the law was passed with so few people reading it, and almost no support from the Republicans, I saw it as another failure. However, I do wish that, instead of spending so much time on opposing it, and so much money trying to sell it, it would just get funded and implemented so we could see if it really can work. On the moral side, I certainly agree we need to look after those who need help. But, I also have a concern with people who knowingly abuse their bodies with alcohol, drugs, and unhealthy lifestyles, don’t maintain health insurance, and then expect the Government (taxpayer) to pick up the bill. Wouldn’t the Government’s resources be best directed to the very young who cannot yet provide for themselves, or the very old, if they can no longer provide for themselves? and the working age folks who are physically or mentally unable to work? Shouldn’t all folks of working age be expected to provide for themselves? I have been very unclear about how the Government will subsidize them under Obamacare, but it seems like it will be huge numbers of people and huge amounts of money… how is that sustainable? It’s been very unclear to me, but I hope it will succeed for our country’s sake..

  • Tony S.

    I’d feel a lot better about the health exchanges if they gave subsidies to the Platinum Plans. Who in the world wants a health plan that only covers 60 or 70 percent of your medical bills? That’s like an exterminator only killing 70 percent of the bugs in your house. Sorry, that ain’t good enough.

  • Wakeup

    So right, the plan people will be able to afford will still bankrupt them.
    70% of a$25,000 leaves $7,500 to be paid.
    Can any one afford an outlay like that?
    All this will do is lowing the rates for the rich, again.

  • Neal Wadeson

    I watched your article on Obama care with dismay.

    How can a country as great as the United States not want to have all it’s citizens covered by affordable comprehensive health care.

    I am an evangelical Christian and find it abhorrent that some Christians are against it.

    It is one of the mandates of the church to help the poor. Furthermore it is a basic human right.

    Why should a person be refused health care because they cannot pay.

    As a Brit living in Canada I concede the Canadian system is far from perfect but it works.

    All I have to do is present my health card at any doctors office, clinic or hospital and I receive excellent care equal to anything in your country.

    Yes it is a big expense for the tax payers, but it is the one area that all citizens and permanent residence here in Canad benefit from directly. Dollar for dollar it is money well spent.

    Were people held hostage by terrorist your government officials would not think of stopping the military going in and rescuing them no matter the cost. They almost certainly would not call on a private company to rescue the hostages.

    Yet when it comes to providing health care to those who need it most they seem to count the pennies and allow private health care providers charge outrageous amounts of money to provide that care. How sad.

    My prayer is that the people of the United States will see the need for Obama care and embrace it.

    And as a side note.

    Remember in Canada it took the Saskatchewan government to implement a health care plan first. Many doctors threatened to leave the province but few did.

    Then when they had shown it was a success, the federal government and other provinces seen the sense in implementing one themselves.

    Today it works very well and no one in Canada has to fear going bankrupt or having a loved one or themselves suffer for lack of funds to go to a doctor.

    Sorry for the long comment

    Neal Wadeson

  • Stewart

    Dear Neal. On the other hand, I have a Canadian friend who lives in the US, and said if her son had the emergency medical needs he did this year back in Canada, he would have died. She was so thankful for our healthcare.

  • prophetic voice

    The takung care of the poor is the first responsibity of a christian and the church . If anyone has problems with that they are an abassdor of Christ plain and simple. I do not care who the claim to be . The fruit of the Spirit is not in them. CHRISTIAN ARE KNOWN BY THE LOVE THEY HAVE FOR THE BRETHEN. everyone who claims to be one and stand against the poor shall no part in the kingdom. Repent for the kingdom of God is at hand. Judgement is about to fall on this nation and is going to start with the so call evangelical church. This the word of the Lord .deliver by a watchman on the wall Repent!!

  • Kimberlee

    Dear Neal, most Americans get health care through their employment and there is no “drain” on the taxpayer. However, our economy has been so bad for the last 5 years that many people have lost their jobs and have been without coverage. In addition we needed reform in several ways, e.g. so that preexisting conditions wouldn’t prevent healthcare coverage, companies would be incentivized to reduce costs, and a family hit with a rare and costly medical issue could still get coverage. I am 60 years old. I’ve had the same healthcare plan since I was in my early 20s and started working, and it has always worked well for me. When I move into a new area, I find my own doctor from the list of participating physicians by reviewing their credentials, patient ratings and recommendations. I just pay a small copay, usually. If I become dissatisfied with the physician’s quality of service, I can look for a different doctor any time. But if I am happy, that doctor becomes our family physician for years and gets to know our medical issues well. Would I have that same ability in Canada?