CaliforniaPolicyForumWebinarFirst101DaysoftheTrumpPresidency:How do we approach the future of Health Care, Charitable Tax Law and Immigration?

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TODAY’S WEBINAR

Monday, May 1, 2017

TODAY’S WEBINAR

WelcomeRonGallo,

President&CEOSantaBarbaraFoundation

www.lccf.org @CalNonprofits @NorCalGrant @SDGrantmakers @socalgrantmaker

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Q&A

TODAY’S WEBINAR

Agenda• SessionIntroductions

RonGalloisthePresident&CEOoftheSantaBarbaraFoundation• Immigration:Immigration&theFutureofCalifornia• Daranee Petsod isthePresidentofGrantmakers ConcernedwithImmigrantsand

Refugees(GCIR)• HealthCare: 100Days&Beyond

EllenKugler,Esq.isManaging Partner of Federal AffairsatDeBrunner &Associates• Law:CharitableTaxDeductions/TaxReform

ErikDryburgh isaPrincipalatAdler&Colvin• LegislativeUpdate

NancyBerlinistheDirectorofPublicPolicyatCalNonprofitsClosing

Daranee PetsodPresident

Grantmakers ConcernedwithImmigrantsandRefugees(GCIR)

SPEAKER

+

Immigration and the Future of California

League of California Community Foundations May 1, 2017 Webinar

+Presentation Overview

Snapshot of Federal and State Policies

Why Immigration Matters to California

Imperatives for Philanthropic Leadership

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+Immigration Executive Orders and Other Administrative Actions

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+Sweeping effort to reduce all immigration n Criminalize all immigrants: authorized, unauthorized, naturalized

n Hire 5,000 CBP agents and 10,000 ICE officers

n Make unlawful entry a felony instead of misdemeanor

n Two-year automatic detention for adults apprehended at the border

n Reduce refugee admissions

n Ban Muslim admissions

n Eliminate protections for asylum seekers, including unaccompanied children

n Threaten “sanctuary” jurisdictions with loss of federal funding

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+Influence public perception of immigrants and refugees

n Victims of Immigration Crimes Engagement Office

n Weekly list of ‘crimes’ committed by immigrants

n Report on the cost of the refugee assistance program

n Report on the number of foreign workers in the U.S.

n Report on injuries to American workers caused by employment of foreign workers

n Report on the public benefits used by immigrants and how government funding can be reinvested in inner cities

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+Legislation

n Dozens of bills introduced on refugees, immigrants, and unaccompanied children

n DREAMer legislationn Bridge Act to protect DACA beneficiaries

n Reintroduction of the DREAM Act

n Second push to repeal the Affordable Care Act

+State Policy Proposals

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+ 8

CA Values Act (SB 54)• Bars state or local resources from being used for

immigration enforcement• State and local law enforcement agencies cannot detain or

transfer anyone for deportation without a judicial warrant

Expanding Due Process Act (SB 6)• Finances legal services for immigrants fighting

deportation

Stronger Public Defenders Act (AB 3)• Funds training on immigration law for public defenders’

offices

Privacy: State Databases (SB 244)• Enhance privacy and confidentiality protections in our

state’s databases

+Why This Matters

to California

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+Demographics: State Level

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• Immigrant share of California population• Latin America: 51%• Asia: 39%27%

• Share of children with an immigrant parent50%

• Share of state population with at least one unauthorized family member12%

• Citizens as a share of immigrant population• Unauthorized: 28% • LPR, H1B, student visa, etc.: 22%50%

• Share that arrived before 2000. • Arrived before 2010: 82%49%

Data for all immigrants, regardless of status, unless otherwise noted.

+ Demographics by Region

Immigrant share of

population

Share of children with an

immigrant parent

Top regions of origin

LA/Orange 34% 57% Latin America:56%; Asia: 35%

Bay Area 30% 52% Asia: 55%; LatinAmerica: 32%

Border Region 24% 45%Latin America: 54%; Asia: 34%

Central Valley 22% 43% Latin America: 72%; Asia: 22%

Inland Empire 22% 42% Latin America: 71%; Asia: 21%

Central Coast 22% 45% Latin America: 71%; Asia: 18%

Sacramento Region

18% 35% Asia: 42%; LatinAmerica: 35%

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Data for all immigrants, regardless of status.

+Economics: State Level

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• Share of labor force35%

• Portion of state’s GDP31%• Share of household

income27%Data for all immigrants, regardless of status.

+Certain industries rely heavily on immigrants (regardless of status)

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Labor force

Construction; transportation

Farming, fishing, and

forestry

Grounds cleaning and maintenance

+Economics by Region

Immigrant share of the workforce

Immigrant contributions

to GDP

Percentage without health

insurance*

LA/Orange 43% 40% / $300B 35%

Bay Area 37% 36% / $39B 19%

Border Region 30% 26% / $27B 31%

Central Valley 31% 31% / $5B 38%

Inland Empire 30% 27% / $30B 38%

Central Coast 29% 27% / $5B 37%

Sacramento Region 22% 20% / $9B 27%

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Data for all immigrants, regardless of status. * indicates prior to ACA.

+Annual fiscal impact of mass deportation in California

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Agricultural output: - $8 billion

Leisure and hospitality industry: - $12 billion

Wholesale and retail trade: - $16 billion

Manufacturing: - $20 billion

Total decline in state GDP: - $103 billion or - 5%

Data for unauthorized immigrants only.

+Annual fiscal impact of ending DACA

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$60,000 in annual GDP lost per worker

216,060 California DACA recipients

$13 billion in annual GDP lost

Data pertaining to DAC beneficiaries only.

+Philanthropy and the

Future of California

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+Efforts to date

Making rapid-

response grants

Mapping strategies, needs, and

gaps

Coordinating with other

funders

Asserting civic

leadership

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+High stakes, treacherous waters

n Anti-immigrant policies will affect a significant number of Californians

n Protecting immigrants is critical to:n Pushing back against attacks on other vulnerable communities

n Ability to advance a broader equity and inclusion agenda

n Philanthropy has an increased leadership role and responsibility

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+

+A few highlights

n Address urgent needsn Know Your Rights, legal services, mental health, anti-hate

n Promote unityn Cross issue, cross-community, cross-movement strategies

n Engage and uplift unlikely alliesn Mayors, universities, law enforcement, faith, business

n Invest in communicationsn Reframe narrative to advance policy, advocacy, and organizing goalsn Avoid ”good” vs. “bad” immigrants and pitting immigrants against others

n Support model policies n Defensive and offensiven City, county, and state level

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+Grantmaking strategies

n Support groups with good analysis and a long view

n Provide general support and flexible project grants

n Make multiyear commitments

n Respond to immediate needs and support long-term strategies

n Coordinate with other funders

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+Assert leadership

n Convene grantees to coordinate, plan, and strategize

n Organize cross-sector meetings that bring together leaders from government, business, faith, law enforcement, etc.

n Educate and engage your donors and donor-advised funds

n Create opportunities to leverage resources from funding colleagues, government entities, business interests, etc.

n Take public stands in support of immigrants and refugees

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+The road ahead

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EllenKugler,Esq. DeBrunner &Associates

SPEAKER

Health Care: 100 Days & Beyond

Ellen J. Kugler, Esq.Managing Partner, Federal Affairs

• Uninsured rate fell from 17% to 9%

• 91% of Californians now have health care

coverage

• Nearly 14 million covered by Medi-Cal, including

4 million covered through Medi-Cal expansion

• 1.4 million insured through Covered California,

the state’s insurance marketplace

California Expanded Health Coverage in Recent Years

2

3

• Repeal of

• individual and employer mandates

• enhanced federal Medicaid matching rate for individuals up to 133% of FPL

• subsidies to help purchase insurance on exchanges

• hospitals’ authority to determine patient presumptive eligibility

• Restricts retroactive Medicaid eligibility

• Would require:

• proof of citizenship or legal status for Medicaid applicants

• redetermination of eligibility every 6 months

• Would replace

• current Medicaid financing with per capita caps

• subsidies with age-related tax credits

• Would allow states to waive the essential benefits and community rating requirements and others

The American Health Care Act: What it Proposes

4

• 14 million would lose insurance by 2018 • 21 million by 2021• 24 million by 2024• Federal funding for Medicaid would fall

$840 billion nation-wide over the next 10 years

CBO Assessment of the AHCA:National Implications

5

• 3 million Californians would lose health care

coverage by 2018

• The state would lose $12 billion a year in

Medicaid funding

• Hospitals could see charity care and bad debt

rise more than $3 billion a year

• Low-income families would be the most affected

CBO Assessment of the AHCA:California Implications

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7

Major Senate Proposals

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Cassidy-Collins Patient Freedom Act• States could choose to:

– keep Obamacare– adopt market-based insurance system with federally funded Roth HSAs– adopt market-based insurance system with no federal support

Senator Rand Paul’s The Obamacare Replacement Act• Repeals ACA• Eliminates essential benefits requirement for insurance plans• Expands use of HSAs• Increases state flexibility through waivers

The Trump Administration & Obamacare

January 20 executive order, “Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal” directs all government agencies and officials with authorities under the ACA to:

• “Take all actions consistent with the law to minimize the unwarranted economic and regulatory burdens of the Act, and prepare to afford the States more flexibility and control to create a more free and open healthcare market”

• “Waive, defer, grant exemptions from, or delay the implementation of” any requirements, including taxes, fees, and regulatory burdens, of the ACA

• Exercise authority and discretion to provide states greater flexibility and control over their health care programs and health insurance markets

• Encourage “free and open markets” and permit the sale and purchase of insurance across state lines

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The Trump Administration& Obamacare

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11

The Trump Administration& Obamacare

• HHS Secretary could:– choose not to fund ACA cost-sharing subsidies– tighten Medicaid rules on presumptive eligibility– grant waivers to states to loosen guidelines for implementing

Medicaid expansion– stop urging insurers to participate in exchanges– limit the individual mandate by granting hardship waivers

• HHS Secretary already has:– proposed relaxing requirements for including essential

community providers in health plans– reduced 2018 open enrollment period 50%– cut advertising for exchanges

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• Medicaid DSH cuts: at least -$90 million in 2018 for CA hospitals and significantly more in later years

• Medicare DSH cuts in 2018: -$27 million in 2018 for CA hospitals and more than $450 million in 2020

• FQHC funding – a cut of $331 million a year to California health centers if not reauthorized– state has 176 FQHCs which serve more than 4 million patients a

year, 22% of whom are uninsured and 63% of whom are on Medi-Cal

• CHIP funding: - over $500 million/year to cover 1.9 million of California’s low-income children if not reauthorized

13

Additional Federal FundingNow at Risk

Questions?

14

Ellen J. Kugler, Esq.

Managing Partner, Federal Affairs

ErikDryburghPrincipal

Adler&Colvin

SPEAKER

© Adler & Colvin

The First 101 Days of the Trump Presidency: Charitable Tax

Deductions/Tax Reform

League of California Community Foundations

California Policy Forum

May 1, 2017Erik DryburghAdler & Colvin235 Montgomery Street, Suite 1220 San Francisco CA 94104(415) 421-7555www.adlercolvin.comwww.nonprofitlawmatters.com

May 2017© Adler & Colvin

3

Tax Reform• Estate tax repeal

• Income tax contribution deduction

May 2017© Adler & Colvin

4

Tax Reform cont...• Bequests of appreciated

property to a private foundation

• Inside the Beltway

May 2017© Adler & Colvin

5

Regulatory Freeze

May 2017© Adler & Colvin

6

Donor-Advised Funds• The IRS finally woke up...

• But hasn’t issued any guidance yet

May 2017© Adler & Colvin

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Endowments• Orrin Hatch writes Harvard a

letter...

NancyBerlinDirectorofPublicPolicy,

CalNonprofits

LEGISLATIVE UPDATE

GovernmentinTransition;NonprofitsinTransition

CalNonprofitssurvey/nonprofits-rethinking-their-future-under-trump-administration

Playing Defense:

• SB54– CaliforniaValuesAct• SB6– LegalHelpforImmigrantsFacingDeportation

• AB378– Greenhousegases,criteriaairpollutants,andtoxicaircontaminants• SB10andAB42-TheCaliforniaMoneyBailReformAct.

On the Offense:

ResourcesAnyCaliforniabill:leginfo.legislature.ca.gov

CalNonprofitsLegislationTracker:http://calnonprofits.org/public-policy/bill-tracker

• June2nd - lastdayforbillstopassoutoftheirhouseoforigin.• MayRevise• June15th – deadlinetopassthebudget

Important Dates

CaliforniaPolicyForumWebinarFirst101DaysoftheTrumpPresidency:How do we approach the future of Health Care, Charitable Tax Law and Immigration?

TODAY’S WEBINAR

Monday, May 1, 2017• Visitourwebsitesformoreinformationand

forarecordingofthiswebinarandslides• Therecordingandslideswillalsobegiven

toparticipants24-48hoursafterthewebinar

calnonprofits.orglccf.orgncg.orgsdgrantmakers.orgsocalgrantmakers.org

1

Q&A

First 101 Days of the Trump Presidency May 1, 2017

1. Q: What is the cost of all this immigration to California? Do you have any

data on that? A: Please check this reference page: http://www.ppic.org/main/publication_show.asp?i=258

2. Q: Because unauthorized immigrants are a portion of all CA immigrants, when you use the term immigrants in this presentation, are you referring to all immigrants, those that are unauthorized, or is it mixed? It would be helpful to know for statistics presented. A: Answered during the webinar. Please listen to the recording.

3. Q: This seems to focus on all immigrants. Is this data broken into legal and

illegal status? A: Answered during the webinar. Please listen to the recording.

4. Q: I am interested in hearing more about what the Trump administration

has shared about his plans regarding DACA and what we can expect on the federal level. I would also love to hear whether CA has seen any reduction in the number of students who are applying for Dream Act funds due to insecurity around DACA repeal. A: The future of DACA is uncertain, especially with DACA beneficiaries who have either been detained or deported. There was concern that the number of applications to the CA Dream Act would be significantly reduced,

2

but due to aggressive outreach, the number this year has actually increased over last. The state is working now to ensure that data collected on students who lack social security numbers will be protected.

5. Q: What are "the exchanges"?

A: The exchange is another term for the ACA health insurance marketplace. Under the Affordable Care Act, each state was charged with setting up an organization aka exchange to facilitate the purchase of individual insurance products and the ACA subsidies. States that would participate in the federal exchange. In California, the exchange is called Covered California

6. Q: Is that medicare or medicaid DSH cuts in 2018? A: In my presentation, I referred to both. Medicaid DSH cuts are scheduled to begin in FY2018. Nationwide cuts are slated for approximately $2 billion. Regulations are not yet available to firmly state California’s share of those cuts. Medicare DSH cuts began in FY2014, new proposed regulations may mean hundreds of millions of dollars in additional cuts to California hospitals in FY2018.

7. Q: Is that 6000 per year in CA or US? A: US Help Links and Contact Information

• National Immigration Law Center: https://www.nilc.org/

• California Immigrant Policy Center: https://caimmigrant.org/

• Grantmakers Concerned with Immigrants & Refugees: https://www.gcir.org/

• Nonprofits Rethinking Their Future Under a Trump Administration (CalNonprofits Survey: http://calnonprofits.org/publications/article-archive/529-nonprofits-rethinking-their-future-under-trump-administration-new-survey-reports

• CalNonprofits Legislative Tracker: http://calnonprofits.org/public-policy/bill-tracker