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California Leads the Way in Health Care Reform Preparation

Patient Protection and Affordable Care Act (ACA) or Health Care Reform

According to a Washington Watch post, California “is one of the most prepared for the next phase of (ACA) implementation coming in January.” Thank goodness, since the article also states that California “has the nation’s largest health insurance market and 5.6 million uninsured, representing 18% of residents under 65, according to federal and state estimates. Up to 4 million Californians are expected to actually get insurance through the provisions of the law that go into effect January 2014, including the health insurance exchange program, Medicaid expansion, and most other provisions anticipated to have the biggest impact on the healthcare profession.”

California’s Health Care Reform Exchange

The article continues to state that “while the federally-run exchanges are behind schedule and some states appear to be too, California’s consumer insurance marketplace, called Covered California, appears to be on target for open enrollment to begin in October.” Specifically, “plans and rates have been published, and hiring has been greenlighted for exchange call centers that will sell coverage. The state has also lined up a massive outreach campaign to promote the exchange. Among the states, ‘California has allocated the most resources at this point,’ Caroline Pearson, a director at the Washington consulting firm Avalere Health, told MedPage Today. The state has set aside about $43 million, whereas Illinois, for example, has budgeted about $28 million, she said… Illinois has opted to let the federal government run its exchange, which brings fewer federal dollars for consumer outreach.”

“Another reason for the extra dollars might be the challenge in reaching California’s diverse population with over 100 languages spoken across the state, noted Jan Emerson-Shea, a spokesperson for the California Hospital Association.”

“The reason California is on the leading edge of preparedness was its support for (health care reform) from the start as a ‘blue state,'” suggested Gerald F. Kominski, PhD, director of the UCLA Center for Health Policy Research.

“There have been growing pains, though, as some insurers have chosen not to participate in Covered California, including UnitedHealth, Aetna, and Cigna. Together those three insurers had accounted for about 7% of the individual coverage in California, based on a 2011 Citigroup analysis.”

Health Care Reform Leads to Innovation

“‘Despite all the complaints of the ACA creating big government, the ACA has created a ton of innovation on the private side,’ commented ACO researcher Elbert Huang, MD, MPH, of the University of Chicago. ‘I think the healthcare providers in California are probably a little bit further ahead in terms of novel organizational structures.'”

According to the article, UCLA and UCSF have been piloting and testing new programs and rolling out new services across the area hospital networks.

“For example, primary care practices now have a comprehensive care coordinator, who helps patients navigate the healthcare system, addressing needs for referrals or equipment like wheelchairs or walkers to keep them healthy and at home and assisting with transitions back home after an inpatient admission,'” explained Robin Clarke, MD, medical director for quality of the university’s faculty practice group at UCLA.

Please share with us what would make you feel more confident in California’s Health Care Reform Exchange (CoveredCA), in the comments section below or on our facebook page.

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