Health insurance can be much cheaper if it does not pay for health care — taking the health out of health insurance! Real solutions are about cost-effective care, not about shifting costs and risks to the consumer. Phony Solutions: Taking the Health out of Health Insurance The first question to ask in debating cost containment in health care is: affordability for whom? Will it provide better access to more affordable care? Phony solutions bring down the sticker price of health insurance by shifting more costs or more risk to consumers, including high-deductible plans and Health Savings Accounts, bare-bones and skeleton health plans, restrictions on the ability to get care, and the removal or pre-emption of consumer protections and mandates on insurers.

Immigrants are an essential part of California’s economy, a key presence in our communities. They should therefore be fully included in our health care system. We all benefit when all Californians have access to primary and preventive care and affordable health care coverage. For this reason, Health Access California, together with a broad and diverse coalition, has made SB4 (Sen. Ricardo Lara) a top priority for the 2015 Legislative Session.

An important element of the national health reform proposals is the role of public programs, including both Medicaid and CHIP. Governors of many states, facing difficult budgets, have raised questions about the impact on state budgets. This fact sheet estimates the number of Californians eligible and the number likely to be covered under different levels of enrollment (“take-up”) as well as the state budget impacts. It is first important to note timing: Medicaid doesn’t get expanded until 2013 or 2014, and for first 2 or 3 years the Medicaid expansion is 100% federally funded. It is only by 8 or 9th year and beyond that there are any costs to states, with an 82.3% (4-1) match in the Senate and a 91% (9-1) match in the House.

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.

Below is a list of health consumer bills introduced in the 2009 session of the California State Legislature that have passed both houses of the Legislature by September 11, 2009, the last day of the regular legislative session. The appendices contain a list of stalled legislation, which could be available for passage when the Legislature reconvenes on January 4, 2010.

About one in every five Californians goes without health insurance, millions more have inadequate insurance, and countless more struggle with accumulating medical bills and discriminatory practices by insurers. The health reform bill in the House of Representatives, H.R. 3962, Affordable Health Care for America Act of 2009, would provide virtually every Californian with affordable health insurance, either on the job, through a newly created Health Exchange, through a Public Option, from Medi- Cal or improved Medicare benefits. Preliminary analyses of H.R. 3962 indicate that most Californians would keep the coverage they currently have, almost 2 million (mostly low-income adults without children under 18) would become newly eligible for Medi-Cal, and over 4 million Californians would be able to purchase coverage in the newly-created Health Insurance Exchange (most with the help of affordability credits).

The U.S. Senate will make a choice this month between two health reform options that affect the affordability of health coverage for America’s families. One bill does not require employers to contribute to the cost of employees’ health insurance but requires a typical family in California to spend an average of 17.1 percent of family income for health insurance premiums and outofpocket costs. Another bill requires shared responsibility from employers and asks a typical middleincome family in California to contribute $2,196 less each year toward their family’s coverage than the alternative.

Comparing the Employer Requirements in the Congressional Health Proposals Ken Jacobs, UC Berkeley Center for Labor Research and Education Requiring employers to provide health care coverage or contribute to its cost is essential if Congress seeks to encourage employers to continue to offer health insurance under the proposed reforms. An employer requirement: • Levels the playing field between employers; • Reduces the incentive for employers to drop coverage and shift costs onto the public (“crowd-out.”); • Provides revenue to pay for the coverage expansion.