WELCOME TO CITY HALL--Hat tip to Lucy Han of Playa Del Rey and her group, FOTJ (Friends Of the The Jungle), for this one. 

The Issue--While both the City and the LAUSD are charged with maintaining a safe environment for our school children, it turns out they don’t talk to each other much, and the safety of our school children can be suspect when it comes to their interactions with the homeless. 

Aside from just living in LA, there are two circumstances under which our children can interact with the homeless -- going and coming to school, and going on field trips within the City. 

In terms of going and coming to school, the City of Los Angeles has a Municipal Code (Section 85.02) which says that the homeless cannot live within 500 feet of a public school or other “sensitive area” like a park. Okay, for the majority of students who get dropped off and picked up by car or bus, that’s fine. 

But it isn’t fine for those k-12 students walking to school across the 500 foot zone. And it isn’t as if the homeless population has any clue about the Municipal Code, or would care if they did know. 

The second major area where school kids can interact with the homeless population just happens to be in the Ballona Wetlands  in Playa Del Rey. 

It’s a major preserve that over 7000 school children visit each year, and the ingress and egress from there just happens to be a place where a large number of homeless hang out, “dwelling”in their vehicles and using the public restroom facilities. 

‘No, No, Not My Problem’--The FOTJ folks have been trying to use the political system to rectify this problem. First they reached out to Councilmember Mike Bonin (CD11), a veritable paragon of probity. He’s been running for re-election, but without any serious opposition, his re-election will be a lock by the time you read this. 

His Chief of Staff, Chad Molnar, did what politicians do -- he blew the issue off on the City Attorney. So there you have it: not Bonin’s problem. This is probably true, since Bonin’s real problem is bending over for every big developer in his District. See my article, It’s Called a Bonin.  Within that context, why indeed would he care about school children? 

Being stout of heart, the FOTJ folks went to the City Attorney’s Office. Since Friends of the Jungle is not the City Attorney’s client, they got what you would expect. A regurgitation of the Municipal Code. Chalk another one up to Feckless Feurer for caring. 

Finally, the FOTJ went to the ultimate power in LA City, Mayor Eric Garcetti who is all over TV and re-election mail, but largely absent in the wetlands. After being directed to the Mayor’s “Homeless Policy Director,” Alisa Orduna, they were told how wonderful the Mayor’s Healthy Streets Program is; she opined that if the FOTJ would just talk to the homeless, these people would say “cool” and leave. 

For the rest of it, she told them they should talk to their Councilmember. Right on. 

Finally, as of the deadline for this article, they have contacted their LAUSD representative, Steve Zimmer, so we won’t know the outcome until after the LAUSD election. For those who don’t know, Mr. Zimmer is under attack by the California Charter School Assn. folks (CCSA), led by none other than our former mayor, Richard Riordan. There are a number of candidates on the ballot, but the runoff will be with Charter favorite, Nick Melvoin – all fueled by millions of dollars spent on the District 4 race instead of education. 

Personally, I hope Zimmer wins. He actually pays attention to his District, and would likely see what he can do to help the school children who visit the Ballona Wetlands. 

The Disconnect--Only in LA do you find dichotomies like this. On the one hand, there are somewhere over 50,000 homeless youths in LA County, which is a scary number. At the same time, the LA Unified School District acknowledges somewhere around 15,000 students who are homeless, and even has a special homeless unit within the District to help them. 

So, on the one hand we have a significant homeless problem, and even the LAUSD student body has one as well. 

On the other hand, the City of Los Angeles and its City Attorney have this weird way of claiming to protect their student population in the LAUSD from adult homeless folks, many of whom have severe mental and physical health issues. 

It is pretty clear that the politicians at City Hall have no clue what they are doing about this, and it is equally clear that the bureaucracies of LA City and the LAUSD don’t coordinate or talk to each other. 

The Takeaway--By the time this column posts, we in Los Angeles will have approved yet another tax to help the homeless, Measure H, a new 1/4 cent sales tax for the County of Los Angeles. This is on top of the $1.2 billion LA City bond measure the voters approved in the November 8 General Election. 

For those who voted for Measure H without reading the fine print, the expenditure of its 1/4 cent sales tax for the next ten years is to “comply with the Approved Strategies to Combat Hopelessness,” a 130 page document that supposedly integrates with the 300 pages of the LA City Bond measure HHH. You can read about the County ballot measure here, including links to the details.

If the early results of the already implemented City Bond Measure (HHH) are any indication, with Measure H we will be once more throw money at a problem without a realistic chance of success in implementing this County measure. Check out this article.  

At a recent LANCC meeting, we were told Assembly Member Sebastian Ridley-Thomas (D-54th AD) that once the number of homeless grows to much over 50,000 in LA, the problem rapidly becomes insurmountable. Well, by the time the November LA City Measure (HHH) was passed, I was told that the real number of homeless in LA was already well over 50,000 and climbing. As of this column, the results of a January recount were not available. 

The $1.2 billion in bonds that you and I will have to pay for are already a fizzle by all accounts. When we throw in the new 1/4 cent tax to address the overwhelming complexities of our homeless, all controlled by over 400 pages of bureaucratic “planning,” does anyone actually believe that the issue will really be ameliorated? 

Pardon my cynicism, but no wonder the City Hall elite can’t cope with helping 7000 school children avoid potential problems when interacting with the homeless parked at Ballona Wetlands. The LA City incumbents have won in a walk, and can now go back to their real business: approving every big real estate development they can find.

On the other hand, maybe Steve Zimmer will win the runoff for LAUSD seat 4. One can hope.

(Tony Butka is an Eastside community activist, who has served on a neighborhood council, has a background in government and is a contributor to CityWatch.) Edited for CityWatch by Linda Abrams.

MEASURE S … A PLANNER’S ANALYSIS--In the past few days the foreign media, like the Guardian, and even most of the U.S. media, have blasted out the story of the 9,000 CIA hacking documents that WikiLeaks made public after redacting critical information. 

Based on press reports, these documents reveal a long list of cyber tools that invade computers, cell phones, and smart TVs. The release’s long-term impact is hard to know, but before WikiLeaks went public with this information, one scholar already concluded that World War III would likely be a cyber-war. 

In the words of the University of Wisconsin historian Alfred McCoy, a WW III conflict between the United States and China will end with an electronic whimper, not a bang: 

As the Chinese virus spreads uncontrollably through the F-6 satellite architecture, while those second-rate U.S. supercomputers fail to crack the malware’s devilishly complex code, GPS signals crucial to the navigation of U.S. ships and aircraft worldwide are compromised. Carrier fleets begin steaming in circles in the mid-Pacific. Fighter squadrons are grounded. Reaper drones fly aimlessly toward the horizon, crashing when their fuel is exhausted. Suddenly, the United States loses what the U.S. Air Force has long called “the ultimate high ground”: space. Within hours, the military power that had dominated the globe for nearly a century has been defeated in World War III without a single human casualty.  

But, without WikiLeaks and Professor McCoy, in Los Angeles we can figure out the city’s deep politics and players without a City Hall deep throat. Even though Measure S, the Neighborhood Integrity Initiative, lost in the March 7 election, it allowed us to learn the following about the inner workings of LA’s urban growth machine:  

• Based on the extensive research of the Los Angeles Times and Patrick McDonald for Measure S, real estate developers and City Hall’s elected officials engage in extensive pay-to-play. We now know who exactly make the payments, who receives the payments, and what goes on between them: money buys discretionary planning and zoning approvals. 

• We also have a better idea of what these many land use entitlements are worth to property owners and investors, although more research would be helpful for the certain planning-related fights to come. 

• We also know who financed the no on S campaign to ensure that the cozy and lucrative status quo continues. The big funders were 10 large real estate companies, who openly contributed $8 to $10 million. Furthermore, their accomplice was Rusty Hicks, the well-paid director of the LA County Federation of Labor, who ponied up more than a $1 million of his members’ dues. According to the LA Times, Hicks is also close to Parke Skelton whose SG&A firm lead the campaign against Measure S. 

• We also know that the no on S campaign strategy focused on LA’s housing crisis, an approach SG&A gleaned from focus groups. 

• For that matter, reading between the lines, we also know the “economic” theory that the no on S funders wear as a fig leaf to justify their private greed. It is neo-liberalism, especially its belief in trickle-down economics. Its other principles are deregulation of land use and elimination of Federal and CRA urban programs, except for policing. Even though City Hall’s elected officials are nearly all corporate Democrats, they are fully onboard with this once Republican approach to municipal governance. 

• For that matter, without WikiLeaks the no on S campaign also revealed another supporting player for their “urban growth machine.” These are the non-profits that the SG&A campaign operatives drew into their top-down “coalition.” 

• We also learned about the contentious role of the non-profits. They maintain the status quo by (inadvertently) putting balm on the wounds created by their affluent funders and board members, especially those who maximize profits through real estate speculation. 

While the supporters and staff of the non-profits usually have the best of intentions, they rarely examine the cause of the problems they address, such as real estate speculation. Likewise, because of their close relationship to their funders, they have incrementally absorbed their trickle-down theories. As result, the non-profits no longer call for the restoration of slashed urban programs or local laws regulating land use. Even though it is still too early to know which non-profits experienced direct economic pressure to oppose Measure S, the broad outline is already visible. Most of them are ideologically lined up with the large real estate companies and City Hall politicians who ardently campaigned against Measure S. 

How should we now use all of this information? 

One of the most useful long-term lessons from this campaign was, “There are no permanent defeats, and no permanent victories.” I interpret this to mean several things: 

First, the election results are obvious; the status quo prevailed, so the no on S boosters now need to put up or shut up. Based on what we have learned, my crystal ball tells me to expect the following, all of which conflicts with their often-vituperative no on S message. 

• City Hall's soft corruption will hardly miss a beat. 

• Despite a glut of luxury housing, home prices and rents will continue to rise until the next great recession hits and/or rampant foreign speculative investments in local real estate dries up. 

• As for LA’s housing crisis, the city’s inclusionary zoning programs, existing and proposed, will not keep up with the loss of affordable housing through demolitions, displacement, and gentrification. 

• Ditto for Measure JJJ since its loopholes will prevail over it promises. 

• Measure HHH will also prove to be a disappointment. Cronies will get fat contracts through insider deals, followed by relaxed scrutiny. 

• Traffic congestion will worsen because nearly all new projects, both by-right and spot-zoned mega-projects, are automobile-centric. 

• Bicyclists will still face dangerous roads with serious accidents because LA is not following the example of cities, like NYC, where the City builds separated bicycle lanes. 

Second, the resurgent status quo creates enormous opportunities for the organization, energy, and knowledge that the Yes of S campaign mobilized to morph into a permanent organization, such as United Neighborhoods for Los Angeles. Even without a City Hall WikiLeaks, we know more than enough to take on many important tasks, such as: 

• Strategic support for the many future local campaigns against City Council approved but un-planned mega-projects. 

• Networking these local ad hoc organizations together into a permanent, citywide organization focused on good city planning, especially through the (promised) updates of the General Plan’s different elements. 

• Strengthening CityWatch and other alternative news and information outlets so they can engage in relentless exposes of City Hall’s continued skullduggery, including pay-to-play and the exceedingly poor planning outcomes it inflicts on Los Angeles neighborhoods and residents. 

• Developing a progressive planning agenda based on three principles: sustainability, equity, and community-based planning. In future columns I will attempt to flesh-out this agenda, such as a focus on public improvements in lieu of private real estate deals. 

Your help is greatly appreciated in all of these efforts.

(Dick Platkin is a former Los Angeles city planner who reports on local planning issues for CityWatchLA. Comments and corrections invited at [email protected].)  Prepped for CityWatch by Linda Abrams.

LA IS NOT NEW YORK--According to the LA Times, LA Metro ridership is still falling -- even though billions have been (mis)spent on extra capacity over the last 30+ years. By my count that's the second time this year that the Times has broached this tender topic. As a member in good standing of the LA "good government" (googoo) establishment, the paper had for many years chosen to tip-toe around the bad news. 

Readers may know that some of us began flogging the dead horse in the mid-1970s. Go to the attached proceedings and read the contribution by the late UCLA Prof. George Hilton. He was among the first to write sensibly and clearly that LA is not NY -- and trying to make it so would be a phenomenal waste. But even LA Times’ coverage will be for naught. Billions more will be spent. Pouring good money after bad is what the great and the good in City Hall do for a living. 

We are in the early years Uber/Lyft and all manner of ICT information sharing. These are the game-changers. For the past two months, my wife and I have graduated from a two-car household to a one-car-plus-Uber-plus-walkable-neighborhood HH. The game-changers are here. Conventional transit was never a game-changer.

(Peter Gordon is Emeritus Professor, USC Price School of Public Policy. His current research addresses how the nature of cities impacts economic growth prospects. This perspective was posted first at New Geography.)  Photo by John Schreiber/MyLANews.com   Prepped for CityWatch by Linda Abrams.

SPECIAL TO CITYWATCH … NEIGHBORHOOD INTEGRITY JUST GETTING STARTED--In our huge and wonderful Los Angeles, the "civic conversation" is often said by academics to be weak. And it's true that I can point to only a few times in which LA residents engaged in and led a big, brawling conversation about where the city should head. 

One such brawl was the successful blogger-led fracas (remember bloggers?) over whether the hated Department of Water and Power should control much of the solar-installation industry. Another was the unsuccessful Valley Secession movement, which asked voters whether 1.6 million people should form their own city to free themselves from a City Hall that repeatedly cheated them on services and political clout. 

In both cases, it turned out that the residents were not disinterested or weak. But in our livable LA, made up of many villages and numerous downtowns, residents could not to find a way to be heard. And their frustration finally exploded into healthy ballot box wars that proved, once again, that true democracy is not only crucial, it's messy. 

Measure S, which was defeated at the polls on March 7, falls directly into that category. That's why it has inspired the most robust civic conversation in Los Angeles in years. 

Measure S was soundly defeated — our numbers fell from a neck-and-neck race shortly before Election Day, when billionaire developers poured in a last-minute $5 million to dominate the airwaves, and even Gov. Jerry Brown came out against Measure S. 

But it's clear from post-election media coverage that while our reforms failed, Measure S won the argument.

Mayor Eric Garcetti and the City Council have promised many reforms in reaction to Measure S — almost all stuck in committee or gathering dust on a shelf. 

On Thursday, Garcetti again proposed a vague plan without any deadline for updating the long-stalled Community Plans. He finally signed an Executive Directive enacting a very limited reduction in "ex parte," or backroom meetings, aimed solely at his Planning Commission — and only after a developer formally files an application to get around zoning rules, an action that often happens long after numerous backroom meetings.

Many of Garcetti's planning commissioners deny they hold private meetings. According to city officials who were asked to produce records of the Planning Commissioners' private meetings under the California Public Records Act, none of his planning commissioners bothers to maintain any record of who they meet with.

At his Thursday press conference, under questioning by journalists, Garcetti again refused to adopt the key reform, of ending backroom dealmaking between City Council members and developers and himself and developers. 

Garcetti is no doubt relying on a convenient opinion from the City Attorney last year that developers and their lobbyist are "residents" of LA and elected leaders need to hold private meetings with residents. Aside from the fact that many key billionaires who get backroom deals do not live in LA, it's absurd to conflate these private deals with informational meetings with LA residents. 

As a lifelong LA journalist-now-campaign manager, I was also pleased to read a media report that quoted Michael Weinstein, president of AIDS Healthcare Foundation, the key funder of Measure S, as saying, “This will go down in history as a campaign that didn’t win the vote that had the best results. Nobody in this campaign has defended the current system.” 

The website, known for its "skyscraper porn," and avidly pro-developer bent, then went on: 

That’s true. Even Mayor Eric Garcetti, who handily won reelection Tuesday night, acknowledged that, “the diagnosis is agreed upon by all of us.” But he opposed Measure S, calling it the wrong “prescription.” The election results are not likely to put to rest a heated battle over the future landscape of Los Angeles. 

And that brings us to what happens next. 

Despite public agreement that City Hall's development process is broken, elected leaders continue to let mega-developers, from the Lowy mall billionaires to the Lowe resort billionaires, treat LA communities like pieces on a chess board. The City Council and Planning Commission repeatedly override LA zoning as if the rules are a mere annoyance. 

Important reform sometimes needs more than one cathartic effort. 

Gay marriage took more than one try on the ballot, a fact that is almost impossible to believe today. The far more wonky "redistricting reform" — a statewide vote to stop seat-warming legislators from gleefully custom-drawing the voting district lines around their preferred voters, to ensure their own re-elections — was a robust debate. Until voters approved redistricting reform, few Californians were certain what a "voting district" even was. 

Los Angeles is a great city, and it's worth making sure we get it right. 

Getting it right may mean a second ballot measure. Or it may mean free training so that neighborhood leaders have as many tools to fight City Hall as lobbyists have tools to manipulate City Hall. 

Or it may mean that powerful people who privately agreed with Measure S will now join us in tilting the balance of power. 

"Getting it right" won't be a debate over what types of towering buildings get built where. This is far more fundamental. It's about who decides how and where LA's infrastructure, housing, parks and services are planned and intertwined, as required, to best serve residents. 

That's not radical. It's crucial. 

Getting it right means that the City Council and mayor must relinquish the secrecy to which they are addicted — and which obscures from the public eye LA's wildly non-democratic planning and zoning system. 

More than 77,000 people voted for Measure S because backroom deals cut between our individual City Council members (yes, your City Council member, too), the mayor, and rich developers are repugnant in a democracy. 

Not surprisingly, they are creating an imbalance between what LA really needs, and what it's getting. 

As then-LA City Planner Gail Goldberg famously warned in 2006, "In every city in this country, the zone on the land establishes the value of the land. In Los Angeles, that's not true. The value of the land is not based on what the zone says ... It's based on what [the] developer believes he can change the zone to." 

Gail Goldberg went on: "This is disastrous for the city. Disastrous. Zoning has to mean something in this city." 

We agree. (Please read the Yes on S campaign's report, here, Pay-to-Play in Los Angeles City Government.) The Pay-to-Play report details years of secret meetings between developers and city council members, council staff, city planning officials, and other city staff.  

Under this system, City Hall can only produce more of the mess that Gail Goldberg foresaw: 

-massive traffic backups on our streets, created by bad planning

-pushing out our working families through ill-advised gentrification

-skyrocketing rents set off by a foolish frenzy of approvals of luxury housing that, clearly, does not trickle down. 

We are hearing from residents citywide asking "what's next? How does this get fixed?" 

We will continue to press our elected leaders to reform themselves. But meanwhile, we at Measure S will keep the faith with residents, by tapping their energy and their new awareness. 

Measure S during the past year held dozens of meetings, town halls, debates, rallies and press conferences, from Chatsworth to San Pedro to Baldwin Hills to Westchester to Koreatown to Woodland Hills to Studio City to the Palisades and beyond. 

We made the case that the City Council, by putting our zoning system up for sale, has fueled an unprecedented level of land speculation and greed in LA After the defeat of Measure S, we wrote in an open letter to our supporters:
"The Measure S campaign succeeded, completely, in challenging City Hall to be worthy of LA's residents.

"LA elected leaders now widely agree that wealthy developers should of course not get to write their own environmental impact reports, a glaring conflict of interest, nor should developers hold private meetings to try to influence LA city planning commissioners.

"LA elected leaders also now agree with Measure S, that the City Council must return to its long-abandoned job of updating our 20-year-old General Plan and Community Plans. They also agree that the Council's frequent rewarding of special exemptions that let developers ignore these Plans must be a very rare act.

"It is now up to us, to see that City Hall does not bury these promises in committee, or otherwise delay these reforms. In the wake of this hard-fought election, they know we're watching them."

(Jill Stewart, a former journalist, is campaign director for the Coalition to Preserve LA, sponsor of the Measure S.) 

-cw

CAPITAL & MAIN SPECIAL REPORT--Fernando E. Hurtado scrolled through photos on his mobile phone in a pristine new examination room of South Los Angeles’ federally funded St. John’s Well Child and Family Center. Nearby, his wife, Amy Areli, waited with two of their four children as the younger boy fidgeted nervously. 

“He’s getting his immunization shots today,” Hurtado grinned at the 3-year-old before pausing at a close-up of a woman’s forearm and what looked like a mosquito-bite-sized bump surrounded by a patch of ruddy inflammation. The next image revealed a gaping, half-dollar-sized crater where the bump had been.

“My wife got a tiny cut on her arm that became infected,” Hurtado explained. “It was [Methicillin-resistant] staphylococcus. She spent nine days in the hospital. They told me that if we hadn’t had Medi-Cal, the bill would have been more than $100,000. If this would have happened without medical coverage, there would have been no way for us to afford to pay that kind of expense.” 

On the same day that congressional Republicans set the stage to repeal the Affordable Care Act, the 35-year-old father, who installs artificial lawns, grimly reflected on the shadow that his family and the majority of St. John’s patients have been living under since the election of Donald Trump signaled the coming end of the law that has dramatically transformed California’s health-care landscape. 

“Before my wife got the infection,” Hurtado said, “our 2-month-old baby was also in the hospital, with an infection for [chicken pox], when he got an infection in his head and he was hospitalized for four days for the same [staph] bacteria. I imagine them not having medical coverage. Yes. Of course I’m worried.” 

(Photo: Fernando Hurtado and his wife, Amy Areli, with two of their four children at St. John’s Well Child and Family Center.) 

Though the form that Trumpcare will take remains vague, for Hurtado and his family — and the more than 50 percent of their newly insured South LA neighbors who now rely on the state’s ACA Medi-Cal expansion for their health coverage — the future remains frighteningly uncertain. They are not alone. 

Over five million Californians have received coverage under Obamacare — 3.7 million through Medi-Cal and 1.4 million through Covered California — and the state has logged the largest percentage-point decline in its uninsured rate of any state, dropping from nearly 17.2 percent in 2013 to 8.6 percent in 2015. 

St. John’s alone has enrolled over 18,000 previously uninsured Angelinos, nearly all of them black or Latino, and more than doubled its insured-patient base. The health center has aggressively embraced the new ACA population to dramatically expand preventative and primary care throughout the region, which before the law had been ground zero of California’s uninsured crisis. 

“We provide free medical, dental, mental health and support services, and case management in about 300,000 patient visits a year at 14 sites and two mobile [clinics],” St. John’s Well Child and Family CEO Jim Mangia told Capital & Main. “We provide health-care services to the homeless. We serve thousands of homeless folks through two mobiles that go into the riverbeds and to help buy homeless shelters. And we’re the largest health provider in South LA, which is the largest area of contiguous poverty in the United States.” 

But with Trump now in the White House, those gains are in the crosshairs of the new president and the Republican congress. At stake for Californians is $20.5 billion a year in federal ACA subsidies. The murkiness surrounding what will happen next has left the state’s political and public health leadership with little choice but to brace for the worst and hope for the best. 

“It is almost impossible to develop a contingency without knowing exactly what we are dealing with,” state Senate Health Committee Chair Dr. Ed Hernandez (D-West Covina) told Capital & Main in an email. “A loss of federal funding would be devastating for low-income and middle-class Californians who rely on the ACA for their health insurance. We plan to do everything we can to protect the people of our state and ensure stability in the health insurance market and Medi-Cal program.” 

St. John’s spotlights a lesser-known aspect of the Affordable Care Act — namely, its role as a conduit for $12 billion in construction infrastructure spending and operational funding for the expansion of private nonprofit health centers, which are known as Federally Qualified Health Centers (FQHC). These provide low-income and immigrant communities with quality health care, regardless of a patient’s ability to pay. That makes the center both an exemplar of how much California stands to lose, as well as an unexpected harbinger of what resistance to the abolition of the ACA might look like. 

“I started that literally the day after the election,” Mangia said about planning for the Trump era, “and now I’ve got all of these players. There’s a lot of special interests that benefited from the Affordable Care Act. … We’re talking about, ‘Okay. What’s our advocacy need to look like? Who do we need to be talking to? Who do we need to bring to the table to craft a solution in the state?’” 

(Photo: Jim Mangia, President and CEO of St. John’s Well Child and Family Center.) 

Forty-five percent of St. John’s patients are ineligible for insurance under ACA because of their immigration status. According to Mangia, who was part of President Obama’s health policy committee when the Affordable Care Act was first being drawn up, addressing the plight of those ineligible for Obamacare because of immigration status was always part of the plan. Care for the undocumented is partially paid by My Health LA, a no-cost health-care program run by LA County. Private fundraising makes up the rest. 

The FQHCs have been instrumental in braking the country’s decades-long expansion of America’s health-care inequality gap, which continues to be one of Obamacare’s most significant achievements. 

Even more transformative, perhaps, is the quality of the medical care and the innovations that ACA has delivered. The law reorganized payment methodology and radically re-prioritized the health-care system with pay-for-performance measures that shifted the focus of providers from end-of-life and sick care to prevention and primary care. It encouraged innovations like the patient-centered “medical home” — a holistic delivery model designed to improve quality of care through team-based coordination of care, for the “whole” patient. Tying Medicare payments to the quality, rather than the quantity, of care that characterized the pricey, pre-Obamacare fee-for-service model, created efficiencies and surpluses for health centers like St. John’s that could then be used to serve California’s estimated 3.3 million uninsured, along with its undocumented population. 

“These relatively modest reforms actually ended up being revolutionary in all sorts of different ways,” recalled Anthony Wright, executive director of the advocacy coalition Health Access California. “There was all this really exciting work to provide people medical homes, and have early intervention to keep people healthy before they got sick in the first place. There was exciting work about how to treat issues around substance abuse and behavioral health medically, rather than criminally, which was starting to have profound benefits to not just our health system but to our criminal justice and corrections systems. If we undo the Medicaid expansion, we undo all that progress in one swoop.” 

Preserving that expansion has been the focus of California resistors, including consumer groups, labor unions and Democratic lawmakers, since election day, both in the current campaign by patient advocates, to bring public pressure on Trump and Republicans, and in anticipating the full extent of the damage to California’s Medi-Cal expansion that will need to be controlled. 

Nevertheless, it’s difficult to resist what is still unknown. And the extent of that damage won’t be clear until the plan is unveiled sometime after Trump’s nominee for secretary of Health and Human Services, Georgia Representative Tom Price, is approved by the Senate. 

Recent promises by Trump for a speedy and concurrent repeal and replacement of ACA with “insurance for everybody” that is “much less expensive and much better” have only further muddled the picture. The broad strokes remain at odds with what has been outlined in separate ACA alternatives by Price, who opposed ACA’s fundamental reforms, and by House Speaker Paul Ryan. And Price’s Tea Party antipathy to federal entitlements makes future attempts to cut Medicare and Medicaid likely. 

“Both of [the plans] would repeal most of the regulations under the ACA, but they would restore some aspects of the law, including subsidies for people to buy health insurance,” explained Gerald Kominski, Professor of Health Policy and Management, and director of the University of California, Los Angeles Center for Health Policy Research. “But their subsidies would be substantially lower than those currently available under the ACA, and would [go] back to a market that’s largely regulated at the state level rather than [have] the layer of federal regulations [that has standardized] the individual insurance market. So it’d be a little bit of a free-for-all.” 

California resistors are divided as to whether the state would have the political will or financial wherewithal to make up the federal government’s $20 billion share of the Medi-Cal expansion and Covered California, should it be cut, or to even go it alone with a version of single-payer. 

“I have always believed that health care is a right for everyone in California and the country,” state senator Ed Hernandez said. “The dilemma arises on how to finance it and whether the public supports it. … The state would be unable to backfill the loss of $20 billion in federal funds without massive tax increases or major program reductions.” 

Wright illustrated California’s difficulty in translating a moral imperative into a health-care entitlement by pointing out that the recent passage of Proposition 56, the two-dollar cigarette tax that, beginning in April, will generate a billion dollars annually for Medi-Cal, had faced three ballot fights — and $200 million in opposition spending by tobacco companies — to become law. 

“Before we get to what California does,” he cautioned, “we all need to be focused on the federal fight. The framework and financing that they provide is going to be very determinative about what is possible for California to do, whether it is an Obamacare lookalike or single-payer or anything else.”

Mangia expressed what might be the ultimate vision of California resistance. “I think it would make a very, very strong political statement across the country if the Republicans repeal [Obamacare] and California says, ‘Okay. Well, we’re going to keep it.’ Democrats control two thirds of the legislature. There’s a Democratic governor. I think we have a real opportunity.”

(Bill Raden is a freelance Los Angeles writer. This article was first posted at Capital & Main.)  Illustration by Lalo Alcaraz. Prepped for CityWatch by Linda Abrams.

MY TOWN--One upside to the acrimonious debate over the ill-fated Measure S is the number of people who have been pulled into the discussion over the future of our City. Of course, this new engagement didn’t seem to translate into actual voter turnout, but … baby steps, right? 

The resounding victory of the No on S campaign – even without the benefit of a catchy, rhyming slogan – places the burden squarely on that unlikely coalition of billionaires, Berniecrats, bankers, and bicycle advocates to come up with solutions to the various crises we face as a result of the status quo.

After all, Measure S sought to change that status quo – the opponents fought to keep it in place. And by status quo I mean the longstanding practice of granting zone changes to specific projects contrary to the language of the City Charter. I don’t mean to imply opponents of Measure S want to keep the City as it is.

To the contrary, the No on S crowd seems to want a development-driven Utopia, where housing is cheap and abundant and the homeless cease to exist. If you, like me, actually kind of like Los Angeles as it is – you are in a distinct minority. Apparently, a majority of the ten percent of registered voters who actually vote in Los Angeles would prefer LA to be more like Houston – where the absence of zoning laws have kept rents low and developers happy. 

We know what Rick Caruso, CIM Group, and Wells Fargo want: more development. And for the armchair activists so recently engaged in local politics, that should be good enough. With each new glitzy skyscraper, the pro-development-at-all-costs people can pat themselves on the back secure in the knowledge that they’ve done their part for the poor, the displaced, and the homeless. Well done people!

But for those of us more engaged in the actual struggle of the poor, undocumented, and homeless in our communities, we all should be able to agree that Phil Anschutz has not exactly been waiting for an excuse to ride in on a white horse and save us.

Nonetheless, the No on S coalition have pointed to several specific actions designed to help the poor, the young, renters, and the homeless that otherwise would have been stymied by passage of Measure S.

For example, the opponents of Measure S argued that many essentially shovel-ready affordable housing units would have been stopped by Measure S. Since Measure S no longer poses an obstacle to those projects, we should be able to track their progress. 

The same can be said for rising rents and home prices as well as loss of rent-controlled units and displacement of long-term low-income residents – all of which the opponents of Measure S told us would be increased by the measure’s passage. The removal of Measure S from that equation should be expected to result in a decrease in that type of activity around the City. Let’s see how that works out.

Finally, we’ve been told that the City has committed itself to updating the zoning laws on a regular basis in order to respond to the changing needs of our communities. In fact, the City has recently passed an ordinance requiring update of the community plans every six years. Let’s see if the City Council lives up to that commitment.

Since the opponents of Measure S consistently told us that updating the zoning laws was a long, onerous process – and, therefore, we couldn’t afford Measure S’s moratorium in order to pressure the City to update its plans – this particular goal should be something we see progress on fairly quickly. We shouldn’t need to wait six years, in other words, to know whether the City is going to update its community plans.

Although every ounce of optimism has been wrung from my soul by the long slog to make some positive change in this City, those who opposed Measure S seems fairly giddy at the sea change this election has brought. Let’s see if they can deliver.

(David Bell is a writer, attorney, former president of the East Hollywood Neighborhood Council and writes for CityWatch.)