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Covered California News & Commentary

Topics of interest to both consumers and agents related to Covered California and the ACA biased in favor of the successful implementation of the Exchange and deliberately apolitical.

January 2011 Archives

In this Democratic weekly address, Assemblymember Bill Monning (D-Carmel) discusses how partisan attempts to repeal federal health care reform would mean a loss of new health care protections for Californians, including pregnant women, children with disabilities, people with pre-existing conditions, and young people now eligible to remain on their parents' coverage. Monning also notes seniors would lose prescription drug discounts, and face new costs for preventive care to keep them healthy. Monning adds that repeal would also cause California to lose federal funding for our new Health Benefit Exchange, a consumer friendly marketplace where individuals and small businesses can claim federal tax credits and easily understand their insurance choices and costs.

This is Assemblymember Bill Monning, Chair of the Assembly Health Committee.
This week our nation witnessed a shameful political ploy--the attempt by Republicans in Congress to repeal health care reform. Repealing health care reform would be a big, expensive mistake for California and the country. California has been leading the nation on health care reform, and it's no time to turn back now.

Just this month California's own Patient Protection and Affordable Care Act went into effect. That was a law written by Speaker John A. Pérez that my colleagues and I were proud to support and help get signed into law. This law establishes the California Health Benefit Exchange, which will be a consumer friendly marketplace where individuals and small businesses can easily understand their insurance choices and costs and, where they can claim their federal premium subsidies and tax credits to buy affordable coverage. Repealing federal health care reform means we'd lose federal funding for this important tool for families and small businesses.

Repealing health care reform also means young Californians up to age 26 would lose their new eligibility to remain on their parents coverage....pregnant women, children with disabilities and people with pre-existing conditions would lose their new protections... and seniors would lose prescription drug discounts, coverage for check-ups and face new costs for preventive care to keep them healthy.

In California, the federal reforms will save us $200 million in early retiree health care costs - repeal would immediately create an additional hole in our state budget. The Congressional Budget Office says repealing health care reform will cause the national deficit to grow $230 billion over the next decade. The last thing we need is more deficits!
In a state with the most uninsured and underinsured people in the nation, where close to 2 million people lost their job-based health coverage in the last two years because of the recession, repeal of this landmark health care reform is simply not acceptable.

We've made a good start her in California--and we must keep going until every Californian has access to affordable, quality health care. Congress and the President can help us by rejecting the shortsighted political stunt of repealing health care reform.
This is Assemblymember Bill Monning, Chair of the Assembly Health Committee. Thanks for listening.


Assemblymember Monning represents the 27th Assembly District and chairs the Assembly Committee on Health.

Obstacles to Reform Lie Ahead

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California is striving to be a leader in implementing the federal health reform law, but state officials expect to face several challenges along the way, Politico reports.
Diana Dooley, secretary of the California Health and Human Services Agency, said the state wants to be the "lead car" for implementing the reform law. Dooley added, "We are absolutely committed to implementation; we want to move forward."

Leading the Way on Reform

In fall 2010, California became the first state to establish a health insurance exchange under the reform law. Three members already have been appointed to the California Health Benefit Exchange five-member board, and the remaining two appointments are expected to occur in the next month. Officials then will begin searching for the exchange's executive director and move forward on a business plan, community outreach and grant applications. California has reserved $1 million to hire staff for its health insurance exchange.

Expected Challenges

Despite its progress on a health insurance exchange, California is expected to face several challenges as it continues to implement the federal health reform law. Kim Belshé, former CHHS secretary, noted that the size of California's uninsured population will affect how it moves forward with federal requirements to expand Medi-Cal, the state's Medicaid program. California has about seven million uninsured residents and is expected to enroll nearly 15% of them in Medi-Cal, according to the advocacy group Families USA.

The reform law also calls for states to establish a single, easy-to-navigate entry point for health insurance exchanges and public benefit programs. The requirement could pose challenges for California, which currently operates an array of enrollment and eligibility systems for Medi-Cal and Healthy Families, the state's Children's Health Insurance Program.

In addition, California is expected to face financial obstacles as it works to implement the reform law at the same time that it faces a significant budget deficit. Earlier this month, Gov. Jerry Brown (D) proposed a budget plan that would cut $1.7 billion from Medi-Cal.

Forging Ahead

Despite the possible obstacles ahead, Dooley, Belshé and other state leaders say they expect California to continue making progress by maintaining an aggressive pace in implementing the reform law (Kliff, Politico, 1/18

California HealthLine

Survey shows tax credits and the California Health benefit Exchange make one-third of employers not offering insurance to workers more likely to do so.

Small business owners say key provisions of the Affordable Care Act will make them more likely to provide health insurance to their employees, according to a poll by Small Business Majority, a national nonprofit small business advocacy organization. Small Business Majority's national survey of 619 small business owners with fewer than 50 employees shows how entrepreneurs view two critical components of the healthcare law, small business tax credits and insurance exchanges. It found that one-third (33 percent) of employers who currently don't offer insurance said they'd be more likely to do so because of the tax credits. Another 33 percent of respondents not offering insurance said they'd be more likely to because of insurance exchanges. The results for employers already providing benefits are almost identical.

"These findings are very encouraging," said John Arensmeyer, CEO of Small Business Majority. "Once small business owners learn about the tax credits and insurance exchanges, they realize these provisions will help them provide insurance to their workers, many for the first time ever. However, many employers don't know these provisions exist, so it's imperative to continue getting the word out so they can take advantage of these benefits."

Among the survey's other findings:

  • n average of 31 percent of respondents--including 40 percent of businesses with 3-9 employees--who currently offer health insurance said the tax credits will make them more likely to continue providing insurance.

  • Nearly one-third (31 percent) of respondents already offering insurance said the exchange makes them more likely to continue offering it.

  • Only 31 percent of small business owners are very or somewhat familiar with the exchange, and 67 percent are a little or not at all familiar with it.

  • The margin is smaller when asked about the small business tax credit: 43 percent of respondents are very or somewhat familiar with it, and 56 percent are a little or not at all familiar with this provision of the law.

The small business tax credits allow businesses with fewer than 25 employees that have average annual wages under $50,000 to get a tax credit of up to 35 percent of their health insurance costs beginning in tax year 2010. Insurance exchanges, which go into effect in 2014, are online marketplaces where small businesses and individuals can band together to purchase insurance.

The survey results and methodology are available online at http://www.smallbusinessmajority.org/small-business-research/small-business-healthcare-survey.php

Implementing Health Care Reform

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Key Points from an Interview with HHS Secretary Kathleen Sebelius

Published by the New England Journal of Medicine

NEJM: You said recently "there is no turning back" from implementation of the Affordable Care Act (ACA), despite Republican resolve to kill the measure. The court suits that state attorneys general have joined notwithstanding, are most states on board with ACA's implementation?

Sebelius: I have been doing a lot of outreach to the nation's governors. States are really in the driver's seat of implementation unless they decide to step out of the way. Governors understand, whether it is creating an insurance exchange, setting up a high-risk pool, reviewing proposed increases in private insurance premiums, or any number of other opportunities, the federal government provides the backstop. People who say this is a federal takeover are simply misinformed. So in some states, the legal folks are pursuing court suits at the same time governors are moving forward to create a new insurance marketplace.

NEJM: Given the new political divide, how do you see 2011 unfolding in Washington in terms of implementation?

Sebelius: We have a law, and we will continue to implement it. With President Obama in the White House, efforts to repeal the ACA will not succeed. While the question of constitutionality will continue to travel through the courts, most people believe that the Commerce Clause covers the questions surrounding the coverage mandate.

NEJM: Since Massachusetts enacted health reform, the state has had its challenges in providing all its citizens with ready access to primary care. What message has the Obama administration taken from the primary care shortage, and how is it being implemented by the ACA?

Sebelius: Unfortunately, the shortage of primary care providers has been ignored for a decade or more, along with the fact that doctors whose practices are devoted to primary care are underpaid compared with specialists. So starting with the stimulus law and continuing in the ACA, there has been a significant focus on expanding the pipeline of primary care practitioners, gerontologists, and general surgeons. As a consequence of the stimulus money, an estimated 16,000 additional primary care providers will come through training pipelines over the next 5 years. We have also put more money into nurse training and education, and into mental health.

I believe that refocusing health interventions at an earlier stage, placing more focus on health and wellness strategies, would help reduce demand and promote population health. Recently, the Institute of Medicine released a report on the future of nursing and [nurses'] scopes of practice. The report includes a whole series of recommendations, but the key one says states should allow nurses to practice up to the skill level of their training. . . . We could put some incentives on the table to encourage that discussion.

NEJM | January 5, 2011 | Topics: Reform Implementation

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