Strategic Planning for Health Access California
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Transcript of Strategic Planning for Health Access California
February 2014February 2014
Strategic Planning forStrategic Planning forHEALTH ACCESS:HEALTH ACCESS:
What’s New, What’s Next, What’s New, What’s Next, and What Do We Need to Do?and What Do We Need to Do?
www.health-access.org
www.facebook.com/healthaccess
www.twitter.com/healthaccess
BFDBFD
Biggest Congressional Action for Consumer Protections; Coverage Expansion; Cost Containment
I t Was Up To Us It Was Up To Us To:To:
““Because of the money and resources, California is frequently touted as Because of the money and resources, California is frequently touted as the state that is implementing the Affordable Care Act most actively and the state that is implementing the Affordable Care Act most actively and aggressively. aggressively. The stakes couldn’t be higher.”The stakes couldn’t be higher.” – POLITICO– POLITICO
““California is a particularly important test for Obamacare. California is a particularly important test for Obamacare. It’s It’s not just the largest state in the nation. It’s also one of the states most not just the largest state in the nation. It’s also one of the states most committed to implementing Obamacare effectively. ... committed to implementing Obamacare effectively. ... If California can’t If California can’t make the law work, perhaps no one can. But i f California can make the law work, perhaps no one can. But i f California can make the law work, i t shows that others can, too.” make the law work, i t shows that others can, too.” –Ezra Klein, –Ezra Klein, Washington PostWashington Post
““The ACA can’t succeed if California fails,” The ACA can’t succeed if California fails,” –Drew Altman, –Drew Altman, president of the Kaiser Family Foundation. president of the Kaiser Family Foundation.
"If this works in California,eventually America will follow your lead… If it comes off the rails here,it will give aid and comfort to everyonewho really just wants to say, 'I told you so.‘”–President Bill Clinton.
California LeadingCalifornia Leadingon Health Reformon Health Reform
Together, we passed several dozen bills to implement and Together, we passed several dozen bills to implement and improve health reform, worked at many agencies, and improve health reform, worked at many agencies, and defended it politically (not one ACA supporter lost).defended it politically (not one ACA supporter lost).
We did this despite a budget crisis (and a Governor We did this despite a budget crisis (and a Governor focused on it)—preventing some cuts, winning revenues focused on it)—preventing some cuts, winning revenues and restorations.and restorations.
California shows the way:California shows the way:
especially among statesespecially among states
with high uninsured rates with high uninsured rates
CALIFORNIA IMPLEMENTSMillions with new consumer protections; financial assistance3.5+ million Californians with new coverage alreadyUninsured cut in half; Average rate hike 4.2%
CALIFORNIA IMPROVESEARLY:Low-Income Health ProgramsChildren with pre-existing conditionsMaternity coverageBETTER:Exchange that negotiates & standardizesMedi-Cal express lane enrollment optionsCoverage of legal & DACA immigrantsLGBT inclusion
CONTEXT: Challenges and CONTEXT: Challenges and Opportunit iesOpportunit ies
POLICY & POLITICSPOLICY & POLITICS HEALTH INDUSTRYHEALTH INDUSTRY
CONTEXT: Challenges and CONTEXT: Challenges and Opportunit iesOpportunit ies
ORGANIZATIONORGANIZATION
ADVOCACYADVOCACY
MEDIA/TECHNOLOGYMEDIA/TECHNOLOGY
THE MOVEMENTTHE MOVEMENT
Policy AgendaPolicy Agenda Expanding Coverage Implementing and Improving Health Reform and the Affordable Care Act Improving the Consumer Experience with Eligibility and Enrollment Extending Help to All Californians (#Health4All, etc.)
Protecting Consumers Ensuring Care and Coverage: Oversight Over Insurers and Health Plans Controlling Costs and Improving Quality: Oversight Over Providers and the
Delivery System Preventing Disparities and Advancing Equity
Encouraging a Healthier California Investing in Public Health and the Safety-Net: Budget Advocacy Promoting Prevention Seeking a Stronger Social Contract Beyond Health Care
“The federal government’s biggest attack on economic inequality since inequality began rising more than three decades ago...” – David Leonhardt, The New York Times, 323/2010
Beyond Preventing Medical Bankruptcy:Progressive Revenue & Distribution * Income SupportAffordability * Health Jobs * On-The-Job BenefitsEconomic and Community Development
Changes to coverage, Changes to coverage, mental health, and mental health, and substance abuse treatment substance abuse treatment can and should have ripple can and should have ripple effects throughout criminal effects throughout criminal justice, policing, county justice, policing, county services, and corrections…services, and corrections…
2015 Legislative Agenda2015 Legislative Agenda
RICH PEDRONCELLI, ASSOCIATED PRESS
The chairman of the California Legislative Latino Caucus plans to propose a new law that would expand access to health insurance for all Californians, including those living in the country illegally.
State Sen. Ricardo Lara, D-Bell Gardens, is working with a broad coalition of organizations to map out the details of a bill that would cover undocumented immigrants, who are excluded from insurance coverage under the national Affordable Care Act, or ACA.
“Immigration status shouldn’t bar individuals from health coverage, especially since their taxes contribute to the growth of our economy,” Lara said in a news release.
NEWS
State senator wants health care for all immigrantsBy ROXANA KOPETMAN / ORANGE COUNTY REGISTERPublished: Jan. 10, 2014 Updated: 6:04 p.m.
LEGISLATIVE CAMPAIGNLEGISLATIVE CAMPAIGN
2015 Legislative Agenda:2015 Legislative Agenda:Returning LegislationReturning Legislation
SB4: Health4AllSB4: Health4All (was SB1005) (was SB1005)
Prescript ion Drug Cost SharingPrescript ion Drug Cost Sharing : (was AB1917): (was AB1917) Large Employer Junk Insurance Loophole Large Employer Junk Insurance Loophole (was AB2088)(was AB2088) Follow-Up To Outreach of Licensed Occupations Follow-Up To Outreach of Licensed Occupations (was AB792)(was AB792) SB33: Limit ing Estate Recovery SB33: Limit ing Estate Recovery (was SB1124)(was SB1124) All Payer DatabasesAll Payer Databases Continuity of Care Continuity of Care (was SB1100)(was SB1100) AG Review of Nonprofit Hospital TransactionsAG Review of Nonprofit Hospital Transactions (was SB1094) (was SB1094) CHBRP ReauthorizationCHBRP Reauthorization Community Benefits?Community Benefits?
2015 Legislative Agenda:2015 Legislative Agenda:Potential LegislationPotential Legislation
Medicaid WaiverMedicaid Waiver
SB137(Hernandez) Provider DirectoriesSB137(Hernandez) Provider Directories
““ Surprise Bil ls”/Balance Bil l ingSurprise Bil ls”/Balance Bil l ing
Rate Regulation/Review ReduxRate Regulation/Review Redux
Reference PricingReference Pricing
Coverage ExclusionsCoverage Exclusions
Clean-Up Legislat ionClean-Up Legislat ion Other?Other?
Medicaid WaiverMedicaid WaiverGoals:More federal money for a safety-net that survives and thrivesImproved/coordinated access to remaining uninsuredIncentives that work for patients on cost/quality/equityBetter integration with human services
Are these the right goals? The right details? What’s missing?
State BudgetState BudgetGoals:#Health4AllLimiting Estate Recovery in Medi-CalAccess in Medi-Cal: Provider RatesOther Restorations:
– Medi-Cal Benefits– Public Health Programs
Anti-Poverty Agenda/HHS NetworkIssues:Medicaid WaiverMCO TaxCCI
For more informationFor more informationWebsite: http://www.health-access.orgWebsite: http://www.health-access.orgBlog: http://blog.health-access.org Blog: http://blog.health-access.org
Facebook: www.facebook.com/healthaccessFacebook: www.facebook.com/healthaccessTwitter: www.twitter.com/healthaccessTwitter: www.twitter.com/healthaccess
Health Access CaliforniaHealth Access California1127 111127 11 thth Street, Suite 234, Street, Suite 234, SacramentoSacramento , CA 95814, CA 95814916-497-0923916-497-0923
414 13414 13 thth Street, Suite 450, Street, Suite 450, OaklandOakland , CA 95612, CA 95612510-873-8787510-873-8787
1930 Wilshire Blvd., Suite 916, 1930 Wilshire Blvd., Suite 916, Los AngelesLos Angeles , CA 90057, CA 90057213-413-3587213-413-3587