CaliforniACA October Newsletter

November 1, 2012

ITUP’s 17th Annual Conference
Registration for our 17th annual conference is now open!  Confirmed speakers include:

  • John Arensmeyer, Founder & CEO, Small Business Majority
  • Kim Belshé, Director, First 5 L.A.
  • Diana Bontá, CEO, The California Wellness Foundation
  • Alex Briscoe, Director, Alameda County Health Care Services Agency
  • Diana Dooley, Secretary, CA Dept. of Health and Human Services
  • Toby Douglas, Director, CA Department of Health Care Services
  • Jon Freedman, Chief of Strategy, L.A. Care Health Plan
  • Dean Germano, CEO, Shasta Community Health Center
  • Howard Kahn, CEO, L.A. Care Health Plan
  • Mitch Katz, Director, L.A. County Dept. of Health Services
  • Peter Long, CEO, Blue Shield of California Foundation
  • Louise McCarthy, President and CEO, Community Clinic Association of Los Angeles County
  • Marian Mulkey, Director of Health Reform & Public Program Initiative, California HealthCare Foundation
  • Katherine Neuhausen, Clinical Instructor, UCLA Department of Family Medicine
  • David Panush, Director of Government Relations, CaliforniaHealth Benefit Exchange
  • Robert Ross, President & CEO, The California Endowment
  • Andy Schneider, Consultant
  • Rusty Selix, Executive Director, Mental Health Association ofCalifornia
  • Marvin Southard, Director, L.A. Department of Mental Health
  • Alan Weil, Executive Director, National Academy for State Health Policy

For more information, please visit our website.

The California Health Benefit Exchange
California’s Exchange Christened “Covered California”
The Exchange board voted to adopt Ogilvy’s recommendations to name the Health Benefit Exchange, “Covered California.”  Other considerations included Eureka and Ursa, but did not test as well among four quantitative focus group sessions; CaliHealth was not chosen due to potential ownership/trademark problems.  Ogilvy’s presentation to the board, which includes focus group results and a tentative logo, can be found online.  The final name, logo, tagline and domain will be announced during the week of November 12, 2012.

October Board Meeting Discusses Branding and User Experience, Revisits Supplemental Benefits and Employer Choice
During the October meeting, the Exchange board discussedbranding/naming and qualified health plan solicitation.  After initially voting against the idea earlier this year, the board voted to allow the sale ofsupplemental dental/vision benefits for adults in the individual exchange.  Regarding the SHOP exchange, the board also voted to adopt staff recommendations for employers to choose the tier of coverage and employees the issuer and/or plan.  All board meeting materials are available online; for more information, click here.

The next meeting has been rescheduled from November 20 in Los Angeles to November 14 in Sacramento.

Support for Proposition 30 Slipping
In the run up to the November election, a Public Policy Institute ofCalifornia (PPIC) poll found that 48% of respondents would vote yes, with 44% voting no and 8% undecided.  The margin has narrowed since July, when a Field Poll showed 54% in favor of Proposition 30; another Field Poll in September showed 51% of likely votes in favor of the proposition.  This ballot measure would temporarily increase sales taxes by 0.25% and personal income tax in excess of $250,000 to fund public education.

Governor Brown Vetoes Health Bills, Calls Special Session in December
Governor Brown vetoed a number of health care bills that reached his desk at the end of September:

  • SB 961 (Hernandez)/AB 1461 (Monning): reforms individual insurance markets to mirror federal rules under the ACA
  • SB 393 (Hernandez): encourages use of patient-centered medical home model of care
  • SB1318 (Wolk): proposes requirement to raise flu vaccine compliance among health care workers to 90% by 2015 instead of 2020
  • SB359 (Hernandez): regulates hospital charges for out-of-network emergency care
  • AB 1000 (Perea): makes oral chemotherapy more affordable and accessible
  • AB 2152 (Eng): requires insurers to give more notice about health coverage changes

Several of these issues, as well as the basic health plan, may be addressed during the special session, which will be held in December or January of next year.

Medi-Cal Faces $85 Billion in Federal Spending Reductions Under House Budget Plan
According to a report by the Kaiser Commission on Medicaid and the Uninsured, California could face $85.3 billion in federal spending reductions over 10 years if the Medicaid program is block granted, as proposed by the House Budget Committee.  This reduction, which is a 22% decrease in projected expenditures, is calculated to be equivalent to 2.1 million fewer beneficiaries.

Medi-Cal Reimbursement Rates Only 43% of Medicare Rates in 2010
An analysis of the Urban Institute’s data shows that Medi-Cal providers received only 43% of Medicare rates in 2010, the second lowest in the US.  This is a decline from 2008, when California reimbursed its Medicaid providers 47% of Medicare rates.  Low reimbursement rates have been tied to poor provider participation in the Medicaid program.  The ACA will increase primary care reimbursement rates to Medicare levels for two years, but it is unknown if California will be able to sustain these rate increases.

§1115 Waiver
Low Income Health Program Enrollment Nears 500,000
The Department of Health Care Services (DHCS) released new Low-Income Health Program monthly enrollment data by county during August 2012.  Total LIHP enrollment was 487,324, with over 200,000 Los Angeles LIHP enrollees.  CMSP, Alameda and Orange counties had the next highest enrollment at 55,685, 44,464 and 42,291 enrollees respectively. For more information, click here.

Sacramento County Announces November Launch of LIHP
Sacramento County announced plans to launch a low income health program (LIHP) in November. The county initially planned to operate a LIHP in August, but negotiations with participating hospitals caused a delay.  Up to 14,000 adults whose incomes are less than 133% of the federal poverty level could be eligible for the program. Sutter Health and Dignity Health have contracted to provide services to LIHP participants, and Kaiser Permanente is expected to enter contract negotiations this month.

Information Technology
UnitedHealthcare to Provide Critical Access Hospitals $20M for IT
UnitedHealthcare will provide $20 million in grants to help 11 critical access hospitals in Central and Northern California implement electronic health records (EHR).  The California State Rural Hospital Association, the California Critical Access Hospital Network and the California Rural eHealth Information Network helped identify eligible hospitals and the funding amount for each.

Long Term Care
CalPERS Approves Long Term Care Premium Increases
The California Public Employees’ Retirement System’s (CalPERS) Board of Administration unanimously approved a plan to raise long-term care insurance premiums by 85% for 114,000 state workers and retirees.  This rate hike is higher than the 75% increase that was considered earlier this month. CalPERS’ long-term care policyholders currently pay $1,400-$2,400 annually in premiums; the rate increase will take effect in 2015 and will be phased in over two years.

Prison Health System
CA to Start Regaining Control of its Prison Health System
Federal officials will begin transferring administrative functions for CA’s prison health care system to state officials.  U.S. District Judge Thelton Henderson had appointed federal receiver J. Clark Kelso to oversee the state’s prison health care system after determining that an average of one inmate per week died as a result of malpractice or neglect.  According to Kelso, the state will be given a few administrative responsibilities to demonstrate if state officials have “the will and capacity to maintain improvement” and eventually assume full control of the prison health care system.

Managed Risk Medical Insurance Plan
MRMIP to Cut Premiums in 2013
The Managed Risk Medical Insurance Board voted to decrease MRMIP premiums by an average of 12% next year.  MRMIP is a state insurance plan for those who cannot obtain health insurance due to pre-existing conditions.  Program officials were considering a 10% rate increase, but the passage of AB 1526 (Monning) this year allowed the program to subsidize rates for members at no less than 100% of comparable rates for the individual insurance market. The bill also prohibits any subsidy provided to the subscriber to affect the calculation of premiums.

1.2M Californians Lost Job-Based Insurance from 2009 to 2011
A study by the UCLA Center for Health Policy Research found that about 1.2 million CA residents lost their employer based health insurance coverage from 2009 to 2011; the percentage of employer coverage dropped from 56.4% I n2011 to 49.7% in 2011.  Conversely, the percentage of state residents enrolled in public safety net programs (Medi-Cal and Healthy Families) increased from 15.7% in 2009 to 19.1% in 2011.  The percentage of uninsured state residents remained largely unchanged at 21% of population under the age of 65 – almost 7 million Californians.

CA Had Second-Highest Count of Uninsured Children in 2011
According to a report by the Georgetown University Health Policy Institute’s Center for Children and Families, California had the second-highest count of uninsured children in 2011 with 745,000.  Only Texas had a higher number of uninsured children at 916,000.  The report found thatCA ranked 35th in percentage of uninsured children at 8%, which was below the national average of 7.5%.  The state, however, also had a significant decline (1.5%) in the rate of uninsured children between 2009 and 2011.