Full Steam Ahead on Enrollment and Continuing Health Reform in California

On health reform, last night was a missed opportunity in many states, where gubernatorial candidates that would have been open to doing the Medicaid expansion didn’t win, in states like Kansas, Georgia, Florida, Maine, and Wisconsin.

Whatever the election results were across the country, in California supporters of the Affordable Care Act hold onto strong legislative majorities and all statewide offices. This result builds momentum for open enrollment starting in 10 days on November 15th, and for additional improvements in the California state legislature–even including rate regulation, the subject of the defeated Prop 45.

ON THE ACA/OBAMACARE: Patients will be pleased we can shift from the political rhetoric of ‘Obamacare’ and the practical benefits and new options available under health reform, with open enrollment starting in 10 days, on November 15th. With Affordable Care Act supporters winning strong legislative majorities and all statewide races in California, it’s full steam ahead to get people enrolled, and to continue to implement and improve upon the law.

In a handful of places, we were surprised that the political debate about the law seemed so disconnected from the positive results on the ground. For example, if Doug Ose returns to Congress as a Representative for the Sacramento region, it will be interesting to see if he really votes to repeal coverage for so many of his constituents. But the Affordable Care Act isn’t going anywhere under President Obama, and Californians should take advantage of the benefits and options available with open enrollment starting soon.

ON PROP 45: The insurance industry clearly had the money to bury Prop 45, and they did. Even though Prop 45 was overwhelmed by a well-funded assault of misleading ads, it’s notable that the insurance industry didn’t run a campaign against the concept of rate regulation–just to the specifics of this particular proposal. In fact, the opposition campaign to Prop 45 explicitly re-affirmed the Affordable Care Act, health reform, and the need for insurance company oversight.

We expect the rate regulation debate to return to the legislature, possibly with more momentum, Previous health reform initiatives on HMO patient rights (1996) and prescription drug costs (2005) lost by similar margins at the ballot, but were passed by the legislature and enacted soon afterwards. We will continue to advocate the simple point that patients shouldn’t have to pay premiums deemed unreasonable by regulators.

So even as the national debate may continue to be about going backward on health reform, the California discussion should continue to be about moving forward.