The second Issue in the series provides information and analyses on the independent, nonpartisan Congressional Budget Office (CBO) review of the American Health Care Act (AHCA). The GOP proposed AHCA would dismantle significant portions of the federal Affordable Care Act. This ACA Watch describes key provisions of the AHCA and highlights the CBO’s most significant findings. Notably, CBO projects dramatic increases in the number of uninsured nationwide.
|March 16, 2017||Posted by ITUP under Latest ITUP News|
|January 21, 2016||Posted by ITUP under Blog, Special Features||
The Affordable Care Act (ACA) created a hybrid with many moving parts: incorporating employer mandates, individual responsibility and refundable tax credits (shared responsibility), and a Medicaid expansion. It is unclear which parts over time will give way to others. Some predict the demise of employment-based coverage; there is no evidence that is happening. Others predict death spirals in the individual market where only the very ill participate; there is no evidence of that either. So far there appears to be a steady equilibrium between employment-based coverage, the Medicaid expansion, and the individual market Exchanges; employment-based coverage is holding steady while the Exchanges and Medi-Cal grow to cover the uninsured. Both the young and middle aged are participating in the Exchanges.
The ACA shifts the delivery system away from the hospital emergency room towards primary care and prevention. It builds incentives for plans and providers to improve quality and outcomes. It creates important incentives to restrain the growth in health spending. In the following report, we highlight where we should be going with health reform implementation and where we are at in the present.
Download the full report here: Where Should We Be Going?
|November 25, 2015||Posted by ITUP under Delivery Reform, Delivery Systems, Latest ITUP News, Legislation Policy News, State, Waiver Reports||
California’s §1115 waiver recently expired on October 31, 2015, and HHS granted a temporary extension of the waiver until December 31, 2015. On October 31, 2015, DHCS and CMS announced
a conceptual agreement that outlines the major components of the waiver renewal. There are several improvements in the renewed waiver, while also room to continue to improve the MediCal
program. Highlights of provisions in the new waiver, known as Medi-Cal 2020 are included in this ITUP report.
Download ITUP’s full report here: California §1115 Waiver Renewal
|February 14, 2015||Posted by ITUP under Blog||
Open Enrollment closes tomorrow! For those that need a last minute nudge, here are 10 more reason why you should get covered!
1. Because you will need a Doctor’s note when you call into work sick and go fishing instead
2. In case your new belly piercing gets infected
3. Because you need glasses to watch movies on your Iphone
4. So you don’t have to make a choice between setting your broken leg or buying a new snow board after your awesome crash
5. Your asthma is keeping you from achieving the Genius Book of World Record for underwater belching
6. Because giving up your morning triple shot toasted coconut and salted caramel macchiato would make life not worth living
7. You need professional help when your friend refuses to help you put that stuff on your gnarly toenail fungus again
8. When an ambulance ride to the ER cuts into the vacation fund that you saved by eating nothing but ramen noodles (the freeze-dried kind) for the past two years
9. When you eat a habanero pepper (with seeds) that your ex-friend told you was “not hot at all” and now you have a hole in your tongue the size of a jawbreaker!!!!
10. Because all the cool kids have CoveredCA Health Insurance Cards!
The Evolving Safety Net in Southern California: Building New Models of Care for the Remaining Uninsured
|October 9, 2014||Posted by ITUP under Central Valley, Inland Empire, Los Angeles, Orange, San Diego, The Uninsured, Workgroups||
Throughout the summer of 2014, ITUP met with health care leaders in Southern California to discuss caring for the remaining uninsured post-ACA implementation, building consensus and strengthening collaboration. Through one-on-one interviews with stakeholders, county-specific meetings bringing together a myriad of stakeholders, and extensive data analysis, we prepared in-depth reports on organizing care and coverage for the uninsured in Los Angeles, Orange, San Diego, Kern, Riverside, and San Bernandino counties. The project, funded by the California Wellness Foundation, resulted in a summit of key leaders from across the six counties in October.
This page is a resource for participants in the project. The documents below are password protected (participants have been emailed the password), however additional reports available to the public are forthcoming.
For a detailed overview of the remaining uninsured and policy options to cover them, see ITUP’s series on the remaining uninsured.
For information on models of financing care for the undocumented, see ITUP’s report.
|October 1, 2014||Posted by ITUP under Special Features||
ITUP’s 19th Annual Conference and Awards Reception were held on February 17, 2015 at the Sacramento Convention Center.
Download the agenda here: Conference Agenda
Conference Evaluation Form
We are all about quality improvement, so please fill out our evaluation form and let us know what you thought went well and what we could do better. We appreciate your feedback!
These photos from the 2015 ITUP Conference and more, are posted on our facebook page.
ITUP has prepared reports in preparation for the 19th Annual Statewide ITUP Conference. Featured topics include important issues like Medi-Cal managed care, the remaining uninsured, premium assistance, Covered California, health care financing, provider workforce, and the future of substance use disorder services. The following reports will be featured at the conference and are available for download:
These reports and the rest of the materials contained in the conference binder are available for download.
Medi-Cal_All Your Questions Answered – Jennifer Kent and Mari Cantwell, California Department of Health Services
Covered California – Peter Lee
National Perspective– Neera Tanden, Center for American Progress
Future of Reform – Massachusetts Panel
Remaining Uninsured – Provider Counties
Remaining Uninsured – Payor Counties
Payment and Delivery System Reforms
Electronic Health Records, Health Information Exchanges, and E-medicine
Future of Reform
ITUP has also started planning our 20th Annual Conference, which will be held on February 8 and 9, 2016. To help us plan another thoughtful and informative conference, we welcome thoughts on speakers and topics of interest. Please email Daphne Radfar at firstname.lastname@example.org. The deadline for all submissions is June 1, 2015.
ITUP’s programs and conference are funded by:
Materials from the 18th Annual ITUP Conference are available here.
|July 28, 2014||Posted by ITUP under Blog||
The ongoing debate of insurance rate review will finally be in the hands of the voters come November 4 when the Insurance Rate Public Justification and Accountability Act, or Proposition 45, will be on the ballot. If approved, the measure would require health insurance companies to justify rate increases, under threat of perjury, and obtain prior-approval by the California Insurance Commissioner. This would only affect health plans in the independent and small group plan, which covers about 16% of the state population, approximately 6 million Californians. Employer-based plans would not be subject to the new rules.
To provide some context of the new rules, in 2011 a health insurance rate review system was created to regulate increases in health insurance rates. Currently, there are two authoritative entities that regulate health insurance including the Department of Managed Health Care (DMHC) and the California Department of Insurance (CDI). Health insurance companies must submit proposed information on rate increases with either DMHC or CDI. These entities review rate increases and declare whether they are reasonable or not. However, the Insurance Commissioner, Dave Jones, has no authority to reject or approve any planned rate increases. Health insurance plans can voluntarily change rates increases if they are deemed unreasonable, however, the plans can also disregard an “unreasonable” ruling and proceed with planned rate increases.
On July 17, the report from the Legislative Analyst’s Office (LAO) analyzed some potential outcomes of the approval of the proposition. First, if approved, the proposition would require future and current rates to be approved. This means that rates filed after November 6, 2012 must also be approved. It is possible that insurance companies would be required to issue rebates to their consumers if rates are retroactively rejected. It is unclear if rebates would be issued for health plans that are no longer active. The California Public Interest Research Group (CALPIRG) reported 14 rate increases since 2011 that have been deemed unreasonable. Consumer Watchdog calculated this has cost Californians approximately $251 million. Therefore, it is possible Californians could receive rebates if they were enrolled in one of the “unreasonable” rate plans as labeled by CDI.
Additionally, the LAO discussed the future role of DMHC if the proposition were to pass. It is speculated that the responsibilities of DMHC could decrease, as the Insurance Commissioner’s authority grows. If the DMHC branch were to downsize, annual savings in the amount of several hundred thousand dollars would result due to reduction in administration costs. However, the LAO also suggested there could be additional regulatory workload, but no specifics were provided.
While rate regulation is an important aspect of affordable health care and cost containment, it is not without controversy. The ballot measure, sponsored by Consumer Watchdog, has the backing of the California Democratic Party, the Insurance Commissioner, other consumer groups (Consumer Federation of CA, Consumer Attorneys of CA), several unions (CA Nurses Association, United Teachers Los Angeles, California Federation of Teachers), and actor Dennis Quaid. Opponents of the measure include the CA Chamber of Commerce, physician/provider/hospital groups (CA Medical Association, CA Hospital Association, etc), CA Association of Health Plans, and some unions (United Contractors, International Brotherhood of Boilermakers, etc).
The proposition will be on this November’s ballot, and requires a simple majority to pass.
Author: Marina Acosta
|February 5, 2014||Posted by ITUP under Special Features||
ITUP has prepared reports in preparation for the 18th Annual Statewide ITUP Conference. Featured topics include important issues like the future of the Exchange, the remaining uninsured, children’s coverage, payment reform, health care financing, provider workforce, and the future of substance use disorder services. The following reports will be featured at the conference and are available for download:
Successes and challenges that the Exchange has faced so far and will face going forward
Considerations for how to improve Medi-Cal’s substance use disorder treatment benefit
An inventory of payment and delivery system models by payor
A discussion of the health care workforce and strategies for its development
A look at who will remain uninsured, what programs exist to serve them, and what can California do improve access and coverage
An analysis of how children are covered in California and recommendations for the evolution of children’s coverage
Budget and expenditure details for state health care programs
Breaking down the impact of the employer mandate
Additionally, summaries of the ITUP issue and regional workgroups, as well as the Los Angeles Health Collaborative, are available here.
|February 4, 2014||Posted by ITUP under Delivery Systems, Health Financing, The Uninsured||
By 2019, the ACA will reduce the number of uninsured by between 1.8 and 2.7 million people. Despite the significant reduction, between 3.1 and 4 millions of Californians may still lack insurance. There are numerous explanations for why California will have a significant population that will remain uninsured, but this group can be segmented into three categories: 1) undocumented immigrants; 2) individuals who are Medi-Cal eligible but not enrolled, and; 3) individuals eligible for Covered California but not enrolled.
In this series of reports, ITUP identifies who will remain uninsured, what resources are available to them, and how care to the uninsured is financed. The culmination is a set of policy options and recommendations for California to improve and expand access and coverage.
The full report is available for download here:
|January 6, 2014||Posted by ITUP under Conference, Special Features||
18th Annual Conference
Registration for ITUP’s 18th Annual Statewide Conference is NOW OPEN. The conference will be held at the Sacramento Convention Center on February 11, 2014, while the Awards and Networking Dinner will be held at the Citizen Hotel on February 10, 2014 from 6-9pm. (Registration for the Awards and Networking Dinner and the wait list for the dinner are BOTH CLOSED due to capacity)
Confirmed Speakers Include:
John Arensmeyer Founder & CEO, Small Business Majority
Kim Belshé Executive Director, First 5 LA
Diana Dooley Secretary, Health and Human Services Agency
Toby Douglas Director, Department of Health Care Services
Paul Fearer Board Member, Covered California
Jon Freedman Chief of Strategy, Regulatory and External Affairs, L.A. Care Health Plan
Sandra Goodwin President & CEO, California Institute for Mental Health
Scott Hauge President, Small Business California
Mitchell Katz Director, Los Angeles County Department of Health Services
David Lansky President and CEO, Pacific Business Group on Health
Peter Lee Executive Director, Covered California
Peter Long CEO, Blue Shield of California Foundation
Burt Margolin CEO, The Margolin Group
Louise McCarthy CEO, Community Clinic Association of Los Angeles County
David Panush Director of External Affairs, Covered California
Robert Ross President & CEO, The California Endowment
Sandra Shewry Director of State Health Policy, California HealthCare Foundation
Marvin Southard Director, Los Angeles County Department of Mental Health
Alan Weil Executive Director, National Academy for State Health Policy
Lucien Wulsin Executive Director, Insure the Uninsured Project
Download the working draft of the agenda here: Conference Agenda.pdf
$175 due by February 3
Click below to register for the conference:
ITUP has reserved a block of rooms at the following hotels:
Hyatt Regency Sacramento – Reserve Here by January 20, 2014 to secure the rate at $179.
Citizen Hotel – Reserve Here and enter the group code 1402INSURE by January 22, 2014 to secure the rate at $179. You can also contact the Citizen Hotel at (916)492-4460 and request the Insure the Uninsured Project rate.