HEALTH ACCESS UPDATE:
Tuesday, December 23, 2014
2014 YEAR IN REVIEW: PROGRESS MADE AND PLANNED;
A NEW WEBSITE FOR A NEW YEAR OF CAMPAIGNS
* California leads the nation in not just implementing but improving health reform–with bills and budget efforts–and a new focus on keeping insurers accountable for timely access to care and adequate networks of health providers.
* Health Access launches a new website for the new year, full of new resources for the 2015 reform efforts–click the links to check it out.
PLEASE CONSIDER CONTRIBUTING TO CONTINUED PROGRESS–MAKE A GIFT TO HEALTH ACCESS BEFORE THE END OF THE YEAR!
The year 2014 brought historic advances on health coverage–bringing the promise of health reform home to millions of Californians, while advancing efforts to improve access to care for everyone. After the first open enrollment period at the start of the year, over a million Californians signed up for coverage and subsidies in Covered California, and over two million enrolled for the first time in Medi-Cal. Estimates suggest California cut its uninsured rate in half—a dramatic reduction for a problem that some had considered insolvable.
HUGE PROGRESS, BUT WORK LEFT TO DO: We in California can be proud of our progress, but the work was and is not done. First of all, the rollout was not without problems: Californians signed up in major numbers despite website glitches, an inadequate number of community-based in-person enrollers, long call center wait times and other issues. Perhaps most notably, at one point, over 900,000 Medi-Cal applications were stalled and backlogged—a number that has since shrunk to nearly zero just recently. We worked with community groups to simplify and translate notices and messages to consumers, to educate patients about the new rights and options, and to help improve the processes that connected people to the peace of mind of coverage.
ACCESS TO CARE, ONCE COVERED: Our work continued not just to improve the enrollment experience enrolled, but to ensure access to care once covered. In particular, we’ve honed in on the lingering issue of making sure insurers fulfill their promise of timely access to care and adequate networks of doctors and hospitals. This work has culminated in passage of SB964(Hernandez) to have more aggressive Department of Managed Health Care oversight of so-called “narrow networks” of Medi-Cal, Covered California, and private plans. After getting hundreds of complaints, DMHC’s non-routine survey found two insurers with inaccurate provider directories. The Department of Insurance also initiated rulemaking on timely access standards that will become effective over the next year.
A legislative effort to increase access to care for Medi-Cal patients by restoring Medi-Cal provider rates was not successful this year, but some other budget restorations did succeed, from the Black Infant Health Program to some HIV prevention programs. Pregnancy and autism coverage in Medi-Cal was also augmented.
#HEALTH4ALL: An ambitious #Health4All campaign to cover the remaining uninsured, regardless of immigration status, was launched and advanced this year through its first committee before stalling. Next year’s vehicle, SB4(Lara), has new momentum in the wake of President Obama’s recent immigration order, which will,have the effect of expanding the “deferred action” category that California has historically covered through state-supported Medi-Cal.
We also had wins at the local level, working in Fresno to prevent a rollback of their safety-net services, while seeing progress in other counties that are augmenting their programs for the remaining uninsured. One such effort lauched this fall, My Health LA, already has over 50,000 enrollees–and more efforts are likely in the new year.
NEW HEALTH ACCESS WEBSITE FOR NEW CAMPAIGNS: This effort, one of Health Access’ top priorities, is highlighted on our new website, built to provide the resources you need to help bring the full promise of reform to all Californians. Consider it our holiday present to you—click around for fresh content and tools related to expanding coverage, winning consumer protections, or the broader work for a healthier California. It also has easy ways for you to submit your story to have direct impact on pending issues in 2015–especially on efforts to help address consumers’ costs of care, from co-payments to premiums.
PLEASE CONTRIBUTE: To advance this agenda and protect consumers, we hope you will consider a year-end contribution to the Health Access Foundation (click here to make a secure tax-deductible donation).
With the start of the legislative session and presentation of the Governor’s budget in January, our work moves into high gear and with that comes the need to keep the pressure on meaningful reforms that translate into better health, improved outcomes, lower costs, and health equity (the “quadruple aim”). We made historic progress this year, but need your help to continue the momentum.
THANK YOU for all your focus on activity this year—we look forward to working with you in 2015. May you have a happy holidays and healthy new year!