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Legislation/Policy

The Patient Protection and Affordable Care Act, the landmark federal health reform legislation of 2010, makes a wide variety of changes to the existing health system in the United States. California is currently implementing the Affordable Care Act and preparing the health system for necessary changes. On this page, you will find information about federal and state health policy and regulations.


ITUP’s February Newsletter

MEDI-CAL Proposal to Transition Healthy Families Children into Medi-Cal On February 9, DHCS hosted a stakeholder meeting on the proposed transition of Healthy Families (HFP) into Medi-Cal. A recently proposed trailer bill would require all HFP enrollees with family incomes up to 250% FPL to transition to Medi-Cal over a […] more

ITUP’s January Newsletter

Medi-Cal Budget Proposal Includes Steep Cuts to HHS Unsurprisingly, this year’s budget proposal is a continuation of a years-long trend that cuts deeply into critical HHS programs. Despite the state’s improving fiscal condition, slow economic growth and lower-than-anticipated General Fund revenues were cited as reasons for the major cuts and […] more

Summary of §1115 Waiver

Introduction The §1115 Waiver provides a bridge or stepping-stones to implementation of the Affordable Care Act of 201o (ACA). The projected value to the state is more than $10 billion in federal match over the next five years. This briefing paper describes the evolution from our current system to the […] more

California’s §1115 Waiver Implementation

Introduction California’s §1115 waiver,[1] approved on November 1, 2010, provides the vital infrastructure to bridge current coverage options into 2014 and offers immediate support and relief to the financially hard pressed[2] safety net system and the individuals they serve.  Local communities face the challenge of implementing three new programs at […] more

ITUP’s December Newsletter

Medi-Cal L.A. Care Will Absorb Costs of Medi-Cal Rate Reduction In October, CMS approved a 10% reimbursement rate cut to certain classes of providers, combined with a plan to monitor beneficiary access to services. Earlier this month, L.A. Care Health Plan, the largest Medi-Cal managed care plan in California, announced its […] more

Summary of HHS’ Final Regulation on MLRs

On Friday, December 2, HHS released the final rule on MLRs, effective January 1, 2012. MLRs, or “Medical Loss Ratios,” are the amount of premium revenues a health plan spends on health care. ACA requires MLRs of 80% and 85% and the small and large group markets starting on January […] more

CaliforniACA November Newsletter Now Available!

Medi-Cal Provider Rate Cuts Approved Despite already having some of the lowest Medicaid reimbursement rates in the country, California was recently cleared by the Centers for Medicare & Medicaid Services (CMS) to cut an additional 10% from many providers’ Medi-Cal reimbursements (including physicians, dentists, clinics, pharmacies, and most nursing homes).  The Medi-Cal program costs […] more

CaliforniACA – October Edition

Update on Health-Related Legislation October 9 was Governor Brown’s deadline to sign legislation into law. Governor Brown signed bills related to MLRs (medical loss ratios), autism coverage, coverage for maternity benefits, standardization of applications, and extensions of Medi-Cal fees for hospitals and Medi-Cal managed care plans. To see a full […] more

Medi-Cal Simplification: Opportunities to Streamline Enrollment Processes

The Patient Protection and Affordable Care Act (PPACA) expands Medicaid coverage to 133% of the Federal Poverty Level (FPL) starting in 2014. As a result, nearly 1.7 million Californians will be newly eligible on January 1, 2014. In its current state, Medi-Cal operates inefficiently, bogged down by excessively complex eligibility […] more

ITUP Comments on Exchange and Medicaid NPRMs

Re: Notice of Proposed Rule Making, CMS-2449-P, CMS-9974-P, and IRS REG-131491-10 Dear Secretary Sebelius Thank you to you and your team for a excellent set of proposed regulations on the Exchange and Medi-Cal program expansions, we would like to offer comments on the following issues: 1) Medi-Cal simplification, 2) the […] more