Why It’s Better and Worse Than the President Said…

In San Jose today, President Obama highlighted the success of California’s implementation of the Affordable Care Act (ACA), highlighting the new coverage options that will be available on January 1, 2014–in nearly 200 days. This includes the new choices at competitive rates negotiated by the new state exchange, Covered California, which will start open enrollment this October.

If anything, the President understated the ways the Act has already been successful–but decisions hang in the balance in California’s implementation.

It’s not just that new and competitive options will be available next year, but there are already assistance and improvements today. Today, over one million Californians are already covered through the new options under the Affordable Care Act. California has the one of the few and the largest early expansions of Medi-Cal, covering over 600,000 Californians in county-run low-income health programs.”

A recent report by Health Access, “Counting the Benefits, Countdown to Coverage,” describes California’s leadership role in implementing the law, but also suggests much more is needed to be done to be ready by 2014. The report details how over one million Californians have been able to get coverage due to new options under the Affordable Care Act, including:
* Over 18,000 Californians who were denied for coverage by insurers due to their health status now have coverage through a Pre-existing Condition Insurance Program (PCIP).
* Over 435,000 young California adults up to age 26 have coverage through their parent’s health plan, under the ACA and state conforming legislation.
* Over 600,000 Californians in 53 counties have gotten new coverage through Low-Income Health Programs (LIHPs) − the most expansive early expansion of coverage under the Affordable Care Act in the country.

In addition, millions have new consumer protections and new security that their coverage will be there for them when they need it, and hundreds of thousands of seniors and small businesses in California are getting help with the cost of care. New rate oversight has allowed millions of patients and policyholders to get relief when paying premiums, and there is more California can and should do.

We need to maximize these benefits for our health care system that desperately needs it, and that means making key budget and policy decisions to enhance our ability to do this right.


But there’s a cautionary side to the President’s spotlight on California: As the federal Affordable Care Act is ready to expand coverage and increase investments in our health system, this state budget would seek to cut $300 million immediately and $1.3 billion in 2016–over 75% of the funds to serve the remaining uninsured through the county health infrastructure we have built up over years. California needs a safety-net that survives and thrives, and we should not prematurely reduce the resources already set aside to serve the 3-4 million remaining uninsured.

Decisions made in the next few days may very well reduce our safety-net capacity at public hospitals, clinics, and county low-income health programs. It’s shameful if California policymakers, while the Affordable Care Act is expanding access for so many, actually cuts and curtails access to others. The Governor’s formula to take savings would restrict many counties from providing safety-net care and coverage for many of the remaining uninsured, and the Legislature should not allow that.

At the time we need all the capacity we can get, the current budget would go forward with cuts for both public and private health care providers, which would make it harder for both the insured and uninsured to get the care they need when they need it. The Governor would continue cuts to Medi-Cal dental services to 3 million Californians, and to Medi-Cal provider rates, which prevents many Californians from getting in to see a doctor or specialist when they need it. Cancelling the pending Medi-Cal provider rate cut or restoring dental coverage would bring in one-to-one federal matching dollars for those now in Medi-Cal, but be full federally funded for those newly-eligible under the Affordable Care Act. If California wanted to maxmize the benefits of the law and take a truly leadership position, California should make the investments to get that immediate return for California families, for our health system, for our economy.

Health Access California promotes quality, affordable health care for all Californians.