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ITUP Celebrates the Second Anniversary of the ACA

To celebrate the second anniversary of the Affordable Care Act, ITUP will be posting a series of guest blogs by friends and colleagues who have worked to ensure successful implementation of the bill. This week, the blog will serve as a forum to reflect on notable successes achieved under the ACA and as a reminder for the great work that remains ahead.

Today’s guest blog is written by Marian Mulkey, Director of the California HealthCare Foundation’s Health Reform and Public Programs Initiative. The California HealthCare Foundation works as a catalyst to fulfill the promise of better healthcare for all Californians. They support ideas and innovations that improve quality, increase efficiency and lower the cost of care.

As a close observer of the implementation of the Affordable Care Act in California, it’s a pleasure to contribute to ITUP’s blog series marking the second anniversary of the ACA.  This post describes California’s considerable progress to date, identifies some of the challenges ahead, and offers some resources to help inform the policy debate between now and 2014.

A short California HealthCare Foundation summary of the ACA’s impact describes both short-term health insurance changes and new coverage options available to consumers in 2014.  Highlights from California’s progress to date:

  • Launched its Pre-Existing Condition Insurance Plan (PCIP) and enrolled more than 7,000 people with serious health conditions who would otherwise go uninsured.
  • Implemented laws and administrative actions to bring California into conformity with the ACA’s short-term consumer protections (such as assuring that children with pre-existing conditions won’t be denied coverage; expanding dependent coverage to age 26; and the elimination of life-time coverage limits). While the numbers affected by these changes are modest compared to California’s total population, those participating tend to benefit greatly.
  • Established the first post-ACA state insurance exchange. California’s Health Benefit Exchange is hard at work on the operational steps and policy decisions needed to open its doors to enrollment in January 2014.

Some decisions and needs that lie ahead:

  • How will consumers be assured easy ways to determine what program they qualify for?
  • How can consumer choice among health insurance products and plans be streamlined and supported?
  • How will the Medi-Cal program evolve – despite state budgetary challenges – to meet the needs of a greatly expanded eligible population?
  • How can California health care delivery be organized and financed to more consistently provide high-quality, affordable, patient-centered care?

The California HealthCare Foundation has developed many resources to inform and support California’s work to implement the ACA.  These include Enroll UX 2014, a collaboration among many funders, states and the federal government to develop a first-class user experience for enrolling in new coverage options;  alternative visions for the California exchange’s strategic direction; reports and a timeline on the state’s ACA implementation opportunities and obligations with respect to insurance coverage, access to care, and care delivery; and a report on the evolution of payment approaches in California.

California’s public, private, and independent sectors have laid a solid foundation for substantial coverage expansion and meaningful change in the way care is delivered in the years ahead. With a continued commitment to more equitable and efficient coverage and care, the state will be well-positioned to realize the ACA’s considerable potential.

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