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California’s health system includes statewide public coverage programs and special county-based programs: Medi-Cal, Healthy Kids/Healthy Families, and others created under Section 1115 of the Social Security Act.

Safety Net Integration – Can it Happen Here?

Download the PDF here:   The ACA requires and rewards integration of services. Accountable care organizations, bundled payments, pay for performance, penalties for excessive hospital readmissions and patient centered medical homes are examples. In California, Kaiser is the best (and only remaining) model of fully integrated delivery system.   Safety […] more

Summary of California Assembly Bill 85

Summary of AB 85: The Budget Trailer Bill Governing County Health Realignment This bill transfers realignment  funds from county health to social services with a 5% CalWorks increase in aid payments on March 1, 2014. It reduces county health realignment funds by an average of 60% beginning in January 1, […] more

Summary of Medicaid Expansion: SB X 1 1 and AB X 1 1

Download the full summary here: Executive Summary Eligibility Coverage of Parents and MIAs up to 133% of FPL (MAGI, Modified Adjusted Gross Income eligibles) MAGI applies to all individuals and families, except the aged and disabled. Consolidation of all income disregards to a 5% uniform disregard for all MAGI eligibles, […] more

The Reckoning

I have been haunted for the last decades by David Halberstam’s book, “The Reckoning” which details the decline and fall of the Big Three Detroit automakers who forgot the basics of design, engineering, and quality while focusing obsessively on “finance”. As a result Japanese automakers flourished while “made in Detroit” […] more

Visions for Reaching an Agreement on Expanding Medi-Cal

California is one of the nation’s leaders in implementing the Affordable Care Act for its 7 million uninsured residents. In December 2012, the Governor’s Let’s Get Healthy California Task Force issued its report delineating California’s goals and steps to improve the health of all Californians, to become the healthiest state […] more

ITUP Analysis of OSHPD Data about Safety Net Hospital and Clinic Utilization and Revenue

This ITUP analysis uses data from the California Office of Statewide Health Planning and Development to asses safety net hospitals’ and clinics’ utilization and revenue. The charts and tables provide data by payer and display trends over the last several years. The data are available for hospitals (inpatient and outpatient […] more

Summary and Analysis of SB X1 3 (Hernandez)

The summary is available for download:   This is the Administration’s effort to authorize bridge plans (i.e. Medi-Cal managed care plans that participate in the Exchange for limited purposes). HHS issued guidance that “bridge plans” could be authorized for two purposes: 1) allow individuals who lost their Medi-Cal coverage to […] more

Redefining the Relationship between California’s State and County Governments: Creating Healthier Communities through Innovative Collaboration and Financing

California is the most populous and perhaps the most diverse state in the nation. To accommodate the needs of its different communities, the state relies on its 58 counties to administer many public and social services. The State formally realigned responsibility for administering certain public programs from the state to […] more

ITUP’s Chart of Small Employer and Individual Underwriting Reforms

The following chart displays the small employer and individual underwriting reforms that are contained the Assembly Bill X1 2 and Senate Bill X1 2. more

Summary and Commentary ABX1 1 (Perez) and SBX1 1 (Hernandez & Steinberg)

The following paper provides ITUP’s Commentary on Assembly Bill X1 1, which was introduced in the California Assembly by Speaker John A. Perez, and Senate Bill X1, which was introduced in the California Senate by Senator Ed Hernandez and Senate President pro Tempore Darrell Steingberg. more