Health Care


Medi-Cal Expansion Floated as New Policy Shift for California

By Christopher Allen
California Progress Report

Yesterday, the Los Angeles Times published an editorial on expanding the Medi-Cal program as a way to help California meet, or exceed, the requirements of the 2010 health care reform law now being phased into effect. Since part of the Affordable Care Act's primary purposes was to extend health coverage to the uninsured, the 2010 law requires states to find a way to add low-income individuals to the rolls of the insured. In most states, this would be done through the federal Mediaid program, with individuals earning less than 133% of the federal poverty line - or, effectively, 138% due to new methods of calculating eligibility - being covered under the new system.

Health Law Doesn't Protect Californians from Rate Increases

By Carmen Balber

Reporters largely missed the point of a Commonwealth Fund study released last week, that looked at consumer savings under Obamacare's 80-20 rule, the rule making insurance companies spend at least 80% of your premiums on health care, not overhead.

The authors started with a fact we already knew - that health insurance companies had to pay $1.1 billion in rebates for missing the MLR requirement in 2011 - and that big shiny number distracted the news media. But the authors zeroed in on a much more important fact. Insurance companies successfully reduced administrative costs by $1.184 billion in 2011, but they used those savings to increase profits instead of passing them on to consumers.

New Legislature, New Year for Health Care in California (and a Special Event)

By Anthony Wright

Yesterday, a new California legislature got sworn in for the 2013-14 legislative session, with new members, new margins, and a renewed mission to implement health reform and improve health care in general.

Both Senate President Pro Tem Darrell Steinberg and Assembly Speaker John A. Perez mentioned health issues in their opening remarks after being formally re-elected to their leadership posts.

In talking about the budget, Senator Steinberg specifically highlighted the cut of dental coverage in Medi-Cal as a major cut that was made in bleaker budget days, and one he will work to restore. He recalled going to a free dental clinic at Cal Expo, and seeing endless lines of people (mostly working families) requiring root canals and dental surgery, who had put off basic care for years.

White House Makes Aggressive Opening Bid in Fiscal Slope Negotiations

By David Dayen

In the context of doing a deficit reduction deal at all, this is an extremely strong bid that Tim Geithner delivered to John Boehner today. Now we know why Boehner whined and cried all afternoon. Let's walk through it.

House Republicans said on Thursday that Treasury Secretary Timothy F. Geithner presented the House speaker, John A. Boehner, a detailed proposal to avert the year-end fiscal crisis with $1.6 trillion in tax increases over 10 years, an immediate new round of stimulus spending, home mortgage refinancing and a permanent end to Congressional control over statutory borrowing limits.

Lincoln, Health Reform, and the Hard Work of Politics

By Anthony Wright

The new movie Lincoln, remarkable in so many ways, is not primarily about Civil War re-enactments, an unlikely election campaign, or a shocking assassination, but about the more mundane work of politics, policy, and passing legislation.

If nothing else, it reminds those of us who work in politics that merely being right is often not enough to make progress. There is perhaps no more clear-cut moral issue than the 13th Amendment abolishing slavery. But passing the amendment took power and persuasion, personality and perseverance.

Restaurant Chains' Obamacare Gripes Are Really About Shortchanging Workers

By Anthony Wright

Since the election, we've heard of fast food and chain restaurant owners protesting the continued implementation of Obamacare, and the costs of having to provide health coverage to their workers. Some have threatened to cut worker hours, or add a surcharge to their meals.

Some of these claims have been walked back once they got media scrutiny, as owners of Denny's or Papa John's or Applebee's have to defend the dubious figures that they initially present. Even Jon Stewart could see their math didn't quite add up.

But the revolt of the chain restaurant owners is real - they have a business model that depends on low-wage workers with no benefits, leaving the cost of care for those workers to themselves, their families, and in many cases, the taxpayer.

It's Official: California Submits Blueprint for New Health Benefit Exchange

By Linda Leu

With last week's election result ensuring the continued implementation of the historic Affordable Care Act, the board of the newly-named "Covered California" Health Benefit Exchange met Wednesday to finalize its start-up operations and roll-out over the next two years.

Covered California will be the new marketplace under the Affordable Care Act to help California families and small businesses shop for health insurance and get subsidies to make such coverage affordable. The expansion of coverage through Medi-Cal and Covered California to millions of Californians starts January 1, 2014, with an "open enrollment" period to sign people up in the third-quarter of 2013.

New Name, Developments for California's Health Benefit Exchange

By Linda Leu

The California Health Benefit Exchange Board, charged with retooling California's healthcare system to comply with parameters for state healthcare exchanges set forth in the federal Affordable Care Act, met on Tuesday in Sacramento to consider a number of weighty policy issues.

The Board heard updates on implementation of California Health Eligibility, Enrollment and Retention System (CalHEERs) and the Service Center Options last heard at the September meeting of the Board. The CalHEERs IT build is well underway, with 71% of 717 requirements completed. The Exchange staff is on track to continue system design through April 2013, followed by system testing, and federal review in December of 2013.

California Health Care Changes Coming, Despite Concerns

By Linda Leu

Last Thursday, the Assembly Health Committee held a hearing on Managed Care Program Initiatives at the Department of Health Care Services - that is, the transitions the DHCS is overseeing - including moving dual eligibles to managed care, moving seniors and people with disabilities to managed care, and moving "Healthy Families" kids to Medi-Cal.

Consumer advocates and legislators have expressed concerns over how well these transitions are going. Particularly, network adequacy and timely access rose to the surface as serious concerns for consumers who may be falling through the cracks in these transitions. Beth Capell of Health Access spoke of the importance of timely access, and that timely access is a good indicator that plans are financially solvent and that networks are adequate to provide care.

Transitioning from "Healthy Families" to Medi-Cal: Too Much, Too Soon?

By Linda Leu

Last week, two California Senate Committees, the Committee on Budget and Fiscal Review and the Committee on Health, held a joint oversight hearing on the transition of the Healthy Families Program to Medi-Cal. Despite the assurances of Administration officials charged with implementing the transition, legislators' questions demonstrated serious concerns with whether the state will really be ready to move forward on the proposed timeline. The California Department of Health Care Services (DHCS) has proposed that the transition begin on January 1, 2013, with "general notices" going out to families imminently, even though many important details remain undecided.