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Joint Senate and Assembly Hearing: Implementation of Federal Health Care Reform

Yesterday, the California Senate and Assembly Health Committees held a joint hearing to discuss the opportunities and challenges that will be presented during the next few years of reform’s implementation. The session exhibited the proactive mindset that California is taking in regard to the new law, and is a promising reiteration of the commitment put forth last week by the Governor.

In the second panel, Alan Weil, Executive Director of the National Academy for State Health Policy, stressed that in order to truly reduce costs, patient-centered efforts must be the focus. Specifically, this includes new pilots for chronic disease management and using the purchasing power of the state to drive payment reform models. In order to address a certain increase in health care demand, Weil suggests that we must change our delivery capacity by developing telemedicine and augmenting scope of practice as our current payment and credentialing systems are rooted in an outdated mentality.

Jon Kingsdale, Executive Director of the Commonwealth Health Insurance Connector Authority, presented on a number of findings since initiation of Massachusetts’ successful health insurance exchange. Central, he said, is the need to communicate in these initially uncertain times in order to break through the miscommunication, anxiety, and confusion and act as a trusted source of info. The core mission of the Connector is to sell insurance, so as to reduce the need for administrative expenses from the private market. He urged the importance of an exchange as a commercial enterprise, one that should be set up as an experiment with (at least initially) many plans involved in order to see what works, and to introduce the idea of co-ops and ACOs to the public. Established and well-recognized plans should immediately be on the exchange’s shelf, and plans should compete for this ‘shelf space’. He stressed the the CA Exchange should not turn into the state’s third insurance regulatory body, and needs to be run by people with real experience in the insurance market (and as such, offer salaries outside the civil service pay scales in order to attract competent administrators). He then described the Connector’s IT system, which contains 330 virtual gateway terminals to assist persons with enrollment and the Connector’s extremely user-friendly web portal that California should try to mimic. He also urged for the creation of an automated eligibility system that transfers data across the Exchange, Medi-Cal, and the IRS.

David Maxwell-Jolly of our DHCS ended the session by discussing how to bridge the gap to 2014 through the 1115 Waiver and Coverage Initiatives (CIs). He stressed the importance of engaging the uninsured now in order to mitigate the ‘impact and demands’ of 2014, with a focus on better-organized delivery for seniors, the disabled, and the dual-eligible population.
Here is a link to the recently-released Waiver Implementation Plan.

Watch the full hearing here.