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Where Do We Go From Here?

Though his presidency is still a guessing game, Trump’s campaign promised us a post-Obamacare, post-Dreamer, post-Roe world. Below, a look at the three most likely—and most significant—changes on the horizon.

 

Editor’s note: Read more post-election reactions here.


1. What’s going to happen to Obamacare?

With the possible repeal of the Affordable Care Act, over 280,000 Bay Areans could see their health insurance disappear with the evisceration of Covered California. But according to Cynthia Cox, associate director of the Program for the Study of Health Reform and Private Insurance at the Kaiser Family Foundation, people are probably safe for another year. “The most likely scenario is that changes will be made in 2018 or onward,” she says. “People should make their [healthcare] decisions based on the current law.”

Equally significant to losing Obamacare, she points out, is the dissolution of safety net programs that support the uninsured or those who can’t afford copays and deductibles. Since the implementation of the ACA, funding for many of these programs has been reduced, since more people now have health insurance. When it comes to finding post-Obamacare options, healthcare advocates advise getting familiar with (or donating to) local safety net programs such as the Berkeley Free Clinic, the Women’s Community Clinic, and HealthRight 360.

2. What’s going to happen to the Dreamers?

Trump has said that one of the first things to go under his administration will be Deferred Action for Childhood Arrivals (DACA), which grants temporary legal status to people who were brought to the United States illegally as children. Bill Hing, who served on transition teams for both the Clinton and Obama administrations and now directs the Immigration and Deportation Defense Clinic at the University of San Francisco, says that for the nearly 367,000 Californians with DACA, this will mean an inability to renew the permits, which are good for two years. In addition, the current backlog of applications is so great that immigration advocates have advised people to stop applying altogether, since the process requires that applicants provide their home address. Hing fears this could result in raids around the country, including the Bay Area.

Because San Francisco is a Sanctuary City, law enforcement is barred from directly turning anyone over to the immigration authorities, but that doesn’t protect immigrants from being reported by neighbors or other snoops. “Every DACA person should be screened for some other possible type of relief,” Hing recommends, pointing out that about 15 percent of DACA recipients are actually eligible for some other form of legal immigration status. For people who entered the U.S. with inspection (meaning they overstayed a visa rather than sneaked in), he points out that there is always the ultimate solution: “If you overstayed a visa and got DACA, you can still marry a citizen and complete your paperwork here.”

3. What’s going to happen to Planned Parenthood?

With Trump threatening to defund the organization and the possibility of a conservative Supreme Court overturning Roe v. Wade, reproductive health advocates are battening down the hatches and preparing for what could be the biggest fight yet. Still, California is in a better position than other states, according to Heather Saunders Estes, the president and CEO of Planned Parenthood of Northern California, which has 20 health centers scattered throughout the region. “Abortion and reproductive rights are guaranteed in the state constitution, so even if the Supreme Court sends a decision back to the states, California would be covered,” she says.

Changes to the Affordable Care Act could mean some family planning options, like IUDs, are no longer covered by insurance, but Planned Parenthood says it will continue to provide these services to anyone who comes through their doors, regardless of ability to pay. In the event of defunding, the organization will be forced to rely on private donations, so giving even a little bit helps make sure the doors stay open.

 

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