Health Access California has reviewed the draft concept paper on the Medi-Cal Section 1115 waiver offered by the California Department of Health Care Services (DHCS) on October 19, 2009. Health Access California was an active participant in the debate over the previous waiver negotiated in 2005. Health Access California has two primary goals for the Section 1115 waiver: first, to reinvest any savings resulting from improved efficiency in health care and second, to expand coverage as a bridge to implementing national health reform in California. Health Access proposes a number of steps designed to smooth the cost curve of implementation and maximize federal revenue, particularly in 2013 and 2014, through early implementation of federal health reform. In our discussions with the Obama Administration officials, we have learned that the Obama Administration is committed to early implementation of national health reform.