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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.

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State Senator Tom Harman (R-Huntington Beach), Vice-chair of the Senate Committee on Health, cautioned for prudence when asked How California Should Respond if Part or All of ACA is Struck Down.

If, as several experts anticipate, the Supreme Court strikes down some or all of the Patient Protection and Affordable Care Act, California will find itself in the untenable position of having promised services it cannot provide without federal funding.

California policymakers, in a rush to lead the nation in implementation, have given little attention to how California will fund the ACA, should it fail the constitutional sniff test. The California Health Benefit Exchange was created in 2010, operating under the assumption that massive federal subsidies will be available for low and middle income earners needing assistance to afford health coverage offered.

It is my belief the Democratic leadership will fully implement legislation concerning the ACA regardless of the court’s decision. As vice chair of the Senate Health Committee, I have heard hours of testimony on legislation seeking to implement facets of the ACA. These measures are irresponsibly moved forward, often in the absence of definitive federal guidance, and without any plan to unwind the implementation should the court reject the ACA.

Just last week a bill dealing with Medi-Cal eligibility was amended to include language stating that it “is the intent of the Legislature to ensure full implementation of the Affordable Care Act … It is further the intent of the Legislature to enact into state law any provision of the Affordable Care Act that may be struck down by the United States Supreme Court and that is necessary to ensure all Californians receive the full promise of the act.”

Previous attempts by some California legislators to move in the direction of single-payer health care have been largely rejected due to the high price tag. Leveraging the ACA as cover to expand state-run health care, the Legislature is moving forward on programs we frankly can’t afford on our own. It appears the Legislature will continue on this path, without a plan in place for funding, regardless of the court’s decision.

The Legislature should slow down and proceed more cautiously on implementation. I intend to introduce legislation that would give the exchange 90 days to submit a plan documenting how it is going to continue operating if the ACA is struck down. In essence, the exchange board will have 90 days to share its “Plan B” — including alternate sources of financing — or implementation grinds to a halt.

ACA implementation has put California on a collision course where no one wins — not the medical community, the people in need of health care or the taxpayers. Let’s get back on the rails.

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

Gov. Arnold Schwarzenegger has signed two key health bills that make California the first in the nation to begin establishing its own health insurance exchange - a key component of the federal health overhaul law intended to widen access to health coverage among the country's millions of uninsured.

"For national reform to succeed, it will be up to the states to make it work, and California is moving forward on reforms that will provide affordable and quality health care insurance," the governor said in a statement.

The bills, Senate Bill 900 and Assembly Bill 1602, would establish the California Health Benefit Exchange and an independent, five-member oversight board that will be tasked with defining how the exchange would operate, in time for the federal deadline of January 2014.

At least 2 million Californians could be eligible to immediately buy insurance from the exchange once it is open for business. The exchange would help funnel billions of dollars in subsidies to help Californians and small businesses obtain health coverage.
The governor's office is expected to hold a signing ceremony in Los Angeles on Friday.

The governor was under pressure by some large insurers and business chambers to veto the bills. The California Chamber of Commerce expressed particular worry about the oversight board, saying that the board would be making key decisions without any accountability to elected officials.

Consumer health care advocates, however, applauded the governor. "We're relieved that we're taking this important next step in improving health care in California," said Anthony Wright, executive director of Health Access California.

Sacramento Bee
By Bobby Caina Calvan
Published: Thursday, Sep. 30, 2010 - 5:58 pm

Read more: http://www.sacbee.com/2010/09/30/3070403/schwarzenegger-signs-landmark.html#ixzz11dVh0sgR

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