State of Reform: What Does Universal Coverage Look Like in California? April 26, 2018 Tam Ma Legal and Policy Director
California s Health Care Landscape 93% of Californians have health coverage 39.54 million Californians 50% of Californians have coverage through and employer 1/3 of Californians are on Medi-Cal ~1.7 million Californians in Covered California HEALTH ACCESS health-access.org 2
The Care4All California Campaign A robust agenda to move California s health care forward 1. COVER ALL CALIFORNIANS: Increasing universality and affordability 2. REDUCE HEALTH CARE PRICES: Improving quality & equity through accountability 3. PROTECT PATIENTS: From federal sabotage of our health system HEALTH ACCESS health-access.org 3 3
Care4All California: A Broad Coalition HEALTH ACCESS health-access.org 4 4
Care4All California: Achievable Without Federal Approval California can t wait for a willing Federal government Much of health care is a state-federal partnership, and many health reform proposals require a federal government willing to work together In absence of that partnership, California needs to forge ahead with a plan that can be passed by the Legislature and signed by the Governor in order to protect patients and consumers now HEALTH ACCESS health-access.org 5
Care4All California: Cover All Californians Increasing Universality #Health4All: Ending the unfair exclusion of California s low-income undocumented population from Medi-Cal. SB 974, Lara; AB 2965, Arambula Medi-Cal Aged and Disabled Program: End Medi-Cal s senior penalty by aligning income limits for seniors with younger adults. AB 2430, Arambula Streamline and Encourage Enrollment: Institute express lane enrollment for those in the WIC program. AB 2579, Burke HEALTH ACCESS health-access.org 6
Care4All California: Cover All Californians Increasing Affordability in the Individual Market ACA subsidies have helped millions of people afford health coverage but more help with affordability is needed: Require Covered CA to provide financial assistance for coverage, prioritizing people who currently spend more than 8% of income on premiums (SB 1255, Hernandez) Increase subsidies in Covered California for people between 139%-400% FPL (AB 2565, Chiu) Lower deductibles and cost-sharing in Covered California (AB 3148, Arambula) Provide a tax credit to those who are above 400% FPL so they only spend up to 8% of their income on premiums (AB 2459, Friedman) HEALTH ACCESS health-access.org 7
Care4All California: Federal Resistance Protect Patients, Stop the Sabotage of our Health System Prevent substandard junk insurance promoted by the Trump Administration from being sold in California (SB 910, Hernandez; SB 1375, Hernandez) Require health plans to spend more on health care, limiting administrative costs and profits (AB 2499, Arambula) Prohibit the state from pursuing waivers that make it harder for low-income people to enroll in Medi-Cal (SB 1108, Hernandez) HEALTH ACCESS health-access.org 8
Care4All California: Cost, Quality, Equity Reduce Health Care Prices Contain Costs: Establish and independent Health Care Cost, Quality, and Equity Commission to set reasonable base amounts hospitals, doctors, and other providers of health care can collect from payers (AB 3087, Kalra) Encourage More Options in Covered California: Ensure and encourage public plan and other options for every region of the state, so that no region is left with only one or zero plans (AB 2416, Wood) Ensure Quality in Medi-Cal Managed Care: Ensure the managed care plans that cover nearly one-third of Californians are accountable for improving health care quality and reducing disparities (AB 2275, Arambula) HEALTH ACCESS health-access.org 9
Care4All California: Industry Accountability Health Industry Consolidation, and Prescription Drug Prices Regulate health plan mergers (AB 595, Wood) Prohibit anti-competitive contract clauses by hospital oligopolies (SB 538, Monning) Limit drug company gifts to doctors (SB 790, McGuire) Regulate pharmacy benefit managers (AB 315, Wood) Pool state purchasing power for prescription drugs (AB 587, Chiu) Maintain $250 cap on prescription drug co-pays and other consumer protections (SB 1021, Wiener) HEALTH ACCESS health-access.org 10
Additional Legislation AB 2472 (Wood): Public Option Requires Covered CA to do a feasibility analysis re: public option AB 2502 (Wood): Health care payments database Collect data on health care costs, quality and social determinants of health and require analyses of such data. AB 2517 (Wood): Creates advisory panel to develop a plan to achieve universal coverage and a unified publicly financed health care system HEALTH ACCESS health-access.org 11
For More Information Website: http://www.health-access.org Blog: http://blog.health-access.org Facebook: www.facebook.com/healthaccess Twitter: www.twitter.com/healthaccess Health Access California 1127 11 th Street, Suite 925, Sacramento, CA 95814 916-497-0923 HEALTH ACCESS health-access.org 12 12