Governor Jerry Brown gave his State of the State speech today, claiming the California has “confounded its critics,” balanced its budget, and is on the move. He announced big plans in many areas, including in education, transportation, and water policy.
He probably made his most concrete news on health care, citing California’s lead in taking advantage of the benefit of the Affordable Care Act, and officially calling a special session on health care reform implementation. From the speech:
California was the first in the nation to pass laws to implement President Obama’s historic Affordable Care Act. Our health benefit exchange, called Covered California, will begin next year providing insurance to nearly one million Californians. Over the rest of this decade, California will steadily reduce the number of the uninsured.
Today I am calling for a special session to deal with those issues that must be decided quickly if California is to get the Affordable Care Act started by next January. The broader expansion of Medi-Cal that the Act calls for is incredibly complex and will take more time. Working out the right relationship with the counties will test our ingenuity and will not be achieved overnight. Given the costs involved, great prudence should guide every step of the way.
We certainly appreciate Governor Brown’s call for bold action to address longstanding issues–and there is no greater opportunity this year than on health care.
California needs to move quickly on health reform implementation and Medicaid expansion, so we are ready to start enrolling Californians in coverage in October of this year–in less than nine short months. Our understanding is that the Governor is seeking to do some of the implementation in a special session that would act early this year (maybe March or April)–but leave the Medicaid expansion on the budget timetable, that is likely to be passed in June 2013.
Whether in the special session or the budget, California should seek to maximize the benefit of these reform. With relatively small investments, we can get significant matching funds to make big improvements in our health system. California should seek not just an expanded Medi-Cal but an improved one, one that dramatically improves the health system we all rely on. While these investments have always made sense, given the federal matching dollars, there is more incentive now, as the newly eligible are 100% federally funded for the next three years—and with no less than a 9:1 match in 2020 and beyond. California can and should make key decisions in the next few months to maximize the benefit:
The improvements are what we need to make health reform work as successful as possible, to make changes that are not just incremental but transformational. Throughout the speech, Governor Brown cited the history of California’s innovation and risk-taking, and implementing health reform provides great benefit for minimal risk. California can use this opportunity to build a health system for the future, making this as transformational a moment for our state as the railroad or university system.
Here’s the Governor’s official proclamation for the special session:
BY THE GOVERNOR OF THE STATE OF CALIFORNIA
WHEREAS, an extraordinary circumstance has arisen and now exists requiring that the Legislature of the State of California be convened in extraordinary session;
NOW, THEREFORE, I, EDMUND G. BROWN JR., Governor of the State of California, in accordance with Section 3(b) of Article IV of the Constitution of the State of California, hereby convene the Legislature of the State of California to meet in extraordinary session in Sacramento, California, on the 28th day of January, 2013, at a time to be determined, for the following purpose:
To consider and act upon legislation necessary to implement the federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), in the following areas:
a. California’s private health coverage market, and rules and regulations governing the individual and small group markets related to guaranteed issue of coverage, pre-existing condition exclusions, rating restrictions, and any other requirements necessary to conform state law to federal rules.
b. California’s Medi-Cal program and changes that are necessary to implement federal law, including requirements for eligibility, enrollment, and retention.
c. Options that allow low-cost health coverage to be provided to individuals who have income up to 200 percent of the federal poverty level within the California Health Benefit Exchange, to the extent allowed by federal law or regulations.
IN WITNESS WHEREOF, I have hereunto set my hand and caused the Great Seal of the State of California to be affixed this 24th day of January 2013.