Health Care Is On The Ballot

HEALTH ACCESS UPDATE: Monday, November 3, 2014 


*        Several races, from Governor to state legislators, will have an impact on the future of health reform in California. County Supervisor races will impact your local health care safety-net. Whether to repeal “Obamacare” has been a key issue in some California Congressional races, with stark contrasts between the parties.

*       Some ballot measures also impact on health policy. In particular, Prop 45, supported by several consumer groups, would give authority to the Department of Insurance to approve or reject health insurance rates.  VOTE YES ON 45!

Tomorrow is election day, and health care is on the ballot, along with many other issues. The future of health reform will be decided in both statewide races like that of Governor, Insurance Commissioner, Attorney General, and others, and in local races for Congress, the State Legislature, and County Boards of Supervisors.

Find your polling place here:

In particular, “Obamacare”–and whether it should be repealed–continues to be an issue debated in television ads in key Congressional districts. For example, ads in the 7th Congressional district in Sacramento accuse Rep. Ami Bera of supporting “Obamacare,” even though he wasn’t elected yet when it was passed; counter-ads accused Rep. Doug Ose of seeking to repeal the law and the consumer protections within it, which would leave many without coverage and help in getting health care. That race, and others up and down the state, are seen as closely contested and contentious.

The makeup of the California Legislature will also be determined Tuesday, and with it, the state’s ability to continue its leadership in health reform. The California Legislature has been a leader in implementing and improving upon the Affordable Care Act–passing several dozen laws to improve on, the reforms and protections of Obamacare. How that continues depends on state Senate races from Bakersfield to Orange County, and Assembly races from Southern California to the Central Valley.

County races from Los Angeles to Fresno will also impact the your health care as new faces on a county’s Board of Supervisors will make determinations about the county’s health care safety-net in this time of transition in health care, impacting not just the remaining uninsured, but the health system on which we all rely.

Obviously, the most central position with regards to the future of health care is the Governor, who will determine the next few critical years of health reform, including the new Medicaid waiver being negotiated over the next year and the fate of all future bills and budgets on the topic. Other statewide offices of import include the Insurance Commissioner, which regulates a portion of the health insurance market, and the Attorney General, which oversees hospital mergers among other transactions.

A few ballot measures also focus on health care, including Proposition 45, which would give the Insurance Commissioner the authority to approve all health insurance rates in the individual and small group markets, and reject unjustified rate increases.

YES ON PROP 45: Health Access California supports rate regulation and Prop 45. California’s successful implementation of the Affordable Care Act has shown the progress that can be made in moderating health care premiums in part through more oversight on health insurers, and rate regulation is an important next step. Under the new authority given to state regulators by the ACA, insurers have to file and justify rates. To date, these transparency provisions have led to rate rollbacks and rebates of over $300 million to consumers.

At the same time, there have been other rates deemed unreasonable by regulators that the insurers just went ahead with anyway. California regulators should have the ability to reject unjustified rates, to prevent the current situation where over a million Californians are paying a premium deemed unreasonable by an expert health agency.

Rate regulation is not in conflict with the Affordable Care Act; in fact, 35 states have some form of rate regulation. The ACA’s results in terms of lower premiums and rebates shows proof of concept: that this type of government oversight works and California can and should take additional steps to lower costs and protect consumers. The progress made by Covered California in negotiating rates and benefits shouldn’t conflict with an actuarial review by a regulator who can deny unjustified rates–and is especially needed for individuals and small businesses not buying coverage through Covered California. While ACA supporters have raised legitimate questions regarding timing, jurisdictional, and operational issues, those are resolvable if the Department of Insurance works together with other key agencies like the Department of Managed Health Care and Covered California, and they have indicated they would.

Health Access and other consumer advocates have tried to advance rate regulation in the Legislature for many years, but progress was stalled due to full-court opposition from the insurance industry. Prop 45 provides an opportunity to move forward on this issue.

Remember–up and down the ballot, your health care is on the ballot. So please remember to vote!