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CaliforniACA June Newsletter

Executive Director’s Note
Supreme Court Upholds ACA
In National Federation of Independent Business v. Sebelius, 567 US – (2012), the Supreme Court ratified the Affordable Care Act to assure that every American has access to medical care. After 100 years of efforts the US now joins every other developed country in offering coverage for all its citizens.  How should California proceed?  We must use the ACA as a dynamic building block, not a stopping point, towards the affordable and effective health system that all Californians need.  More thoughts are available online.

Budget
Gov Brown Signs State Budget Plan
Governor Brown signed a FY 2012-13 budget plan that helps close the state’s $15.7 billion deficit, and has signed 21 trailer bills that Democrats had passed earlier on June 27.  The budget plan will eliminate Healthy Families by moving the 880,000 children into the lower cost Medi-Cal program; reduce child care assistance by 8.7%, which would reduce the number of slots available by 10,600; and reduce In-Home Supportive Services hours by 3.6%.  This budget relies on voters approving a compromise tax hike initiative; if it fails to pass, $5.9 billion will be cut from public schools as a “trigger provision.”

Slight Majority of Voters Support Compromise Tax Hike Plan
A Field Poll released June 9 shows a majority of 52% to 35% supporting Gov. Brown’s compromise tax hike plan, which will increase sales tax by 0.25% and personal income tax by 1% for high-earning households ($250K+ for individuals, $500K+ for couples).  This increase would expire in four years.  A competing plan, which increases taxes for all residents on a sliding scale, has less support with 42% in favor (43% against).

Proposition 29 Defeated
Proposition 29, which would have raised tobacco taxes by $1 per pack of cigarettes, was defeated by a very slim margin (50.3% vs 49.7%).  According to supporters, the tax hike would have generated about $600 million annually for cancer research, smoking cessation programs and related law enforcement efforts.

Exchange
June Exchange Board Meetings
During the two June board meetings, PricewaterhouseCoopers (PwC) presented their SHOP recommendations and stakeholder input to the board; CTO Juli Baker presented four service center options for toll-free telephone customer support; and the board passed Resolution No. 2012-30, which adopts the recommendations in the Statewide Marketing, Outreach and Education Program Work Plan and Statewide Assisters Program Design Options as proposed at Level 3.  The board also announced that Accenture was awarded the CalHEERS grant for the Exchange’s IT system, and that they have submitted a Level 1.2 establishment grant request to the federal government for $196M. All board meeting materials are available online.   All board meeting materials are available online.

The next meeting will be held in Oakland on July 19, 9am-5pm, where decisions may be made on SHOP policies, service center options, premium aggregation, and agent payment strategies.  Please note the change in time.

Healthy Families
Dissolution of Healthy Families May Cost State More Money
Governor Brown’s budget plan that will fold Healthy Families into Medi-Cal could lead to the loss of $183 million in taxes on managed care plans.  The fate of the tax, which is set to expire at the end of June, was not addressed in the new budget.  The budget plan, however, included an exception for Kaiser Permanente to keep its 200,000 Healthy Families patients as Medi-Cal clients through a direct contract with the state, allowing them to avoid paying fees to county-based health plans they already service through Medi-Cal.

§1115 Waiver
Low Income Health Program Enrollment Increasing
DHCS reports show that enrollment in county LIHP programs has steadily increased, with almost 330,000 cumulative enrollees as of March 31, 2012.  In addition, almost 15,000 additional enrollees from existing coverage initiative counties have been participating in the LIHP program.  DHCS is seeking stakeholder feedback on the draft plan to transition LIHP to ACA coverage options; comments are due July 9, 2012.

Mental Health
Hispanics Not Receiving Needed Mental Health Care
A UC Davis report found that untreated mental health care needs are a common and unaddressed problem among Hispanic residents.  The study, which was in collaboration with the CA Dept of Mental Health, found that poor living conditions and other stresses contributed to an increased risk factor anxiety and depression, especially among Hispanic youths; it recommends a culturally competent mental health work force and generating funds to help create mental health programs.

Insurance
Malpractice Insurer Agrees to 10% Rate Cut
The Insurance Commissioner announced that The Doctor’s Company, the largest medical malpractice insurer in the state, agreed to reduce overall rates by 10%, and is anticipated to save medical providers $21 million annually in premiums.  Rate reductions by CA’s top six medical malpractice insurers will save health care providers nearly $44 million annually.

Data
Premature Deaths Linked to Lack of Health Insurance
A national study by Families USA found that CA has the highest number of residents (3,164) who died prematurely due to their uninsured status in 2010.  According to the study, Californians are also less likely than other state residents to have health insurance, receive employer-based health insurance and be able to afford coverage.

Cancer Cases Increase Among Children, Decrease for Adults
A California HealthCare Foundation report finds that the rate of new cancer cases among adults dropped from 456 per 100,000 in 1989 to 413 in 2009 (9% drop), while the rate of new cancer cases among children rose from 15.4 cases per 100,000 to 17.8 per 100,000 in the same time period (15.6% increase).  The cancer mortality rate, however, decreased by 22% among adults and by 21.6% among children between 1989 and 2008.

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