In the last two weeks, two academic reports have been released that detail a number of policy options that California can take to advance state-level health reform.
On March 5, 2018 the UC Berkeley Labor Center released a report that detailed different options for improving affordability and attaining universal health coverage in California.
This new report shows the specific options that California has to improve affordability and further expand and secure coverage for all of our residents—action we can take immediately, without the need for federal approval. The five policy proposals include:
- Adding state premium subsidies to the federal ACA subsidies to further reduce enrollees’ premium contributions;
- Providing financial assistance to further reduce deductibles, co-payments, and other cost sharing for some Californians already receiving ACA cost sharing subsidies, and making more Californians eligible for this assistance;
- Capping the percentage of income spent on premiums by Californians who earn too much for ACA premium assistance by providing state-funded premium subsidies;
- Establishing a state reinsurance program to lower premiums for unsubsidized individual market enrollees; and
- Extending eligibility for state-funded premium and cost sharing subsidies to children and spouses affected by the ACA “family glitch.”
On March 13, 2018 the Assembly Select Committee on Health Care Delivery Systems and Universal Coverage released their report and recommendations based on their months-long hearing process. The Assembly hearings on universal coverage were a substantive and enlightening review of both the problems in our health system and many potential solutions. While the hearings did tease out the obstacles to some types of reform–most notably the lack of a friendly federal partner over the next several years–what’s most important is detailing a number of actions California can take now to expand coverage to those left uninsured or underinsured as outlined in this new report. California can and should seize the moment to take significant, pro-active steps to expand coverage and improve affordability for consumers, in ways that do not run into federal obstacles.
Addressing the real needs of patients and the public on healthcare is not just possible, but urgently needed now. California can secure coverage for all, by opening up Medi-Cal regardless of immigration status and improving affordability assistance in Covered California–neither of which need federal approval.
Health Access and other consumer advocates urge the legislature to take action on this ambitious agenda, that is achievable without federal approval, to improve affordability and universality in health care and coverage. California can take significant steps this year with a part of the budget surplus available, to provide real relief for patients, and as a down payment for further reform. Promoting and organizing for the vision of a universal health care system is a priority, but California should not wait three or more years for a friendly federal partner, when there is real relief we can provide this year and in the next few years.
By implementing and improving upon the Affordable Care Act, California has seen the greatest drop in the uninsured of all fifty states. If we can keep Medicare, Medicaid and the ACA intact from federal cuts and caps, our state can and should build on our progress, and take additional steps to improve access and affordability for all Californians.