Affordable Care Act

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March 22, 2013 | 10:04 AM | By

What’s Up With the California Health Care Overhaul Bills?

(seliaymiwell/flickr)

(seliaymiwell/flickr)

While President Obama’s health care overhaul turns three on Saturday, many states are scrambling to get everything ready for the full rollout on January 1. California was the first state to pass legislation to set up a marketplace, and the Legislature has done a lot of work since. But there’s still a lot left to do — and fast.

To bring you up to date, three major sets of bills are before the Legislature in its Affordable Care Act special session. (Six bills total; Assembly and Senate have their own versions of three proposals).

Of those, two issues are key:

  • Reforming the individual market
  • Medi-Cal expansion (the state’s health insurance program for the poor.

As David Gorn of the CaliforniaHealthline reports, the California Legislature went on spring recess yesterday. These ACA bills are outstanding, much to the frustration of advocates. These special session bills take effect in 90 days, once they are passed. ACA proponents had hoped passage would have happened already. Continue reading →

FILED UNDER: Reform, Affordable Care Act, Medi-Cal, Obamacare, Science
March 21, 2013 | 9:14 PM | By

Report: 1 Million Californians Already Benefitting from Health Care Overhaul

By Mina Kim, KQED

President Obama signs health care reform law. (Photo: White House)

President Obama signs the Affordable Care Act into law in March 2010. (Photo: White House)

Saturday marks three years since the signing of the federal Affordable Care Act, and state health officials have been celebrating by touting the benefits of the health overhaul law.

On Thursday, the nonprofit group Health Access released a report that determined more than one million Californians have been able to get coverage through new options provided under the ACA. Those residents include adults with low incomes, people with pre-existing health conditions, and young people who can stay on their parent’s insurance plan until the age of 26.

“But much more is needed to be done,” said Health Access director Anthony Wright. Continue reading →

FILED UNDER: Reform, Affordable Care Act, Obamacare
March 21, 2013 | 2:51 PM | By

Health Care Overhaul: Take the (Short!) Quiz

OK, this is not as much fun as “7 Ways to Lose Weight.” But since a national poll this week showed that a majority of Americans don’t understand how the health care overhaul (AKA: Obamacare) will impact them, it seemed like it was time to take a quiz. This one was put together by the Kaiser Family Foundation, and includes (short) helpful answers at the end.

It’s just 10 questions. Click on the box below to get started. Good luck!

(Kaiser Family Foundation)

Continue reading →

FILED UNDER: Reform, Affordable Care Act, Obamacare, Quiz
March 7, 2013 | 5:00 AM | By

How to Expand Medi-Cal? Assembly Weighs Gov. Brown’s Two Proposals

By Scott Detrow

(seliaymiwell/flickr)

(seliaymiwell/flickr)

The Brown Administration has laid out two options for expanding Medi-Cal, California’s health insurance program for the poor, and county governments don’t seem to like either one.

For decades, California’s counties have been charged with providing health care for people who fall through the health insurance cracks – that is, adults who earn too much money to be eligible for Medi-Cal coverage, but still can’t afford to buy insurance. So county governments have a lot at stake as California decides how to pay for the federal health care overhaul’s Medicaid expansion.

Some context: the Affordable Care Act initially required states to expand their Medicaid rolls so that people who earn up to 138 percent of the federal poverty line (about $15,000) could qualify for coverage. The United States Supreme Court struck down the requirement, leaving it up to states to decide whether or not they wanted to expand Medicaid.

The Brown Administration supports expanding Medi-Cal, and has laid out two different options for doing so. Option one essentially expands the existing Medi-Cal system. Option two puts each of California’s 58 counties in charge of the new coverage. That means counties, not the state, would have to pay for additional insurance costs once the federal government stops footing 100 percent of the bill in 2017.

Option One: The State Continues Running Medi-Cal Continue reading →

FILED UNDER: Reform, Affordable Care Act, Med-Cal Expansion
March 4, 2013 | 3:02 PM | By

Hard Enough Understanding Health Law in English; Try in Mongolian, Khmer or Even Spanish

By Judy Lin, Associated Press

Screen Shot 2013-03-04 at 10.15.47 AMOAKLAND, Calif. (AP) — Set on a gritty corner of Oakland’s International Boulevard, the nonprofit Street Level Health Project offers free checkups to patients who speak a total of 22 languages, from recent Mongolian immigrants seeking a doctor to Burmese refugees in need of a basic dental exam.

It also provides a window into one of the challenges for state officials who are trying to implement the Affordable Care Act, President Barack Obama’s sweeping health care overhaul.

“‘Covered California’ translates to ‘California Cubierto’ in Spanish — but what exactly does it mean?”
Understanding the law is a challenge even for governors, state lawmakers and agency officials, but delivering its message to non-English speakers who can benefit from it is shaping up as a special complication. That is especially true in California and other states with large and diverse immigrant populations.

California has the largest minority population of any state, about 22.3 million people. That’s followed by Texas with 13.7 million, and New York with 8.1 million. Continue reading →

FILED UNDER: Reform, ACA, Affordable Care Act, Covered California, Health Insurance Exchange, Limited English Proficiency
March 4, 2013 | 9:36 AM | By

Empty Promise? Experts Question Doctor Supply to See California’s Newly Insured Poor

By Emily Bazar, CHCF Center for Health Reporting

Dr. Hasmukh Amin, a Bakersfield pediatrician, accepts Medi-Cal patients but says he has to turn away 25-30 people every day who are seeking a pediatrician who accepts Medi-Cal. Here he examines Marcus and Major Thompson. (Henry A. Barrios/The Californian)

Dr. Hasmukh Amin, a Bakersfield pediatrician, accepts Medi-Cal patients but says he has to turn away 25-30 people every day who are seeking a pediatrician who accepts Medi-Cal. Here he examines Marcus and Major Thompson. (Henry A. Barrios/The Californian)

In less than one year — Jan. 1, 2014 — Obamacare’s promise to bring health care to perhaps 1 million more poor California residents will be tested. That’s when Medi-Cal, the publicly funded health program for the poor and disabled, launches a huge statewide expansion.

But making a promise is one thing, and delivering is another.

In some places, it’s already tough for many poor California residents to find a doctor who is able –- or willing — to see them when they need one.

From the sprawling Los Angeles basin to the sparsely populated rural north, many medical providers who currently see these patients say they are overwhelmed, a situation that could worsen when those newly covered by Medi-Cal arrive for care.

The epicenter is California’s Central Valley, where high rates of uninsured residents, coupled with persistent doctor shortages, create a potentially combustible brew that could thwart the success of the health care law.

“We’re not even talking about 2014,” said Carmen Burgos of the Greater Bakersfield Legal Assistance program. Burgos helps low-income Kern County residents access health care and dental services. “Good luck finding a doctor who takes Medi-Cal now.” Continue reading →

FILED UNDER: Policy, Reform, Affordable Care Act, Medi-Cal, Obamacare, Physician Supply
February 26, 2013 | 12:19 PM | By

Obama Administration Files Brief in Support of Medi-Cal Provider Cuts

In a move that is expected to have repercussions across the country, the Obama Administration on Monday filed a brief in the Ninth Circuit Court in support of Gov. Jerry Brown’s proposed 10 percent payment cuts to Medi-Cal providers.

Some background: The provider cuts were approved by CMS back in 2011, but then immediately challenged by the California Medical Association (and others) in federal court. A federal judge blocked the cuts. The state of California appealed to the Ninth Circuit. A three-judge panel approved the cuts. The CMA asked for an en banc review by all of the judges.

And that’s where we are today, with the Obama Administration’s brief.

The timing is interesting, as it comes when the National Governors Association is meeting in Washington, and the Obama Administration is trying to convince states to implement the Medicaid expansion portion of the health care overhaul. As the New York Times reports, the Administration seems to be in support of giving states flexibility: Continue reading →

FILED UNDER: KQED blogs, Reform, ACA, Affordable Care Act, Medi-Cal, Provider Cuts
February 13, 2013 | 2:03 PM | By

ACA Updates: Covered California Benefit Plans and Calculate Your Premium Online

California is first state to announce benefit plans including co-pays, deductibles

California's insurance marketplace, Covered California, will open in October, 2013. People will be able to buy insurance, which will take effect January 1, 2014.

California’s insurance marketplace, Covered California, will open in October, 2013. People will be able to buy insurance, which will take effect January 1, 2014.

Calling today a “game changer for California and a game changer for the nation,” Peter Lee, executive director of Covered California, the state’s marketplace for health insurance, announced benefit plans that will be featured in the exchange.

He also unveiled its updated website (in English and Spanish) where consumers can access what is sure to be a very popular premium calculator. People with incomes up to 400 percent of poverty are eligible for subsidies from the federal government to help purchase insurance. The calculator gives an estimate of what you will pay after the subsidy.

An estimated 2.6 million Californians are expected to qualify for the subsidy. People who receive Medi-Cal or employer-based health insurance are not eligible and will continue to receive health insurance through their current plans.

Calculate your monthly premium here.
California is the first state in the nation to release benefit packages for the public to review. ”The most important aspect of these plans is that they’re standardized. … Consumers will be able to make apples-to-apples comparisons that they haven’t been able to make in the past,” Lee said in a press conference. Continue reading →

FILED UNDER: Money, Reform, ACA, Affordable Care Act, Premium Subsidy
February 11, 2013 | 2:45 PM | By

Just What Are ‘Habilitative Services’? Hint: Think Health Insurance and Chronically Ill Kids

Taylor Gaydon (R) -- a 15-year-old with Type 1 diabetes -- prepares to zipline with friends at a weekend diabetes camp in Livermore. (Photo: Elaine Korry)

Taylor Gaydon (R) — a 15-year-old with Type 1 diabetes — prepares to zipline with friends at a weekend diabetes camp in Livermore. (Photo: Elaine Korry)

You’re likely familiar with rehabilitation — physical therapy after an injury would fall into this category. But parents with chronically ill children are all too familiar with a different type of service — habilitation service — as Elaine Korry detailed Monday morning for The California Report.  From her story:

“Habilitative services are really just making sure that a child can thrive in the world that they’re living in, so, for example, hearing aids are a habilitative service,” says Kelly Hardy, director of health policy at Children Now, a statewide advocacy group.  …

Dr. Thomas Long, a health financing expert with the American Academy of Pediatrics, says it helps young patients, like deaf kids, attain health in the first place. Continue reading →

FILED UNDER: Policy, Reform, ACA, Affordable Care Act, Benchmark Plan, Habilitative Services
January 30, 2013 | 10:20 AM | By

UC Student Health Plan Slips Through Loophole in Affordable Care Act

A UC Berkeley student discovered the limits of his UC student health coverage after a cancer diagnosis.(Studio H (Chris)/Flickr)

A UC Berkeley student discovered the limits of his UC student health coverage after a cancer diagnosis.(Studio H (Chris)/Flickr)

If you are a student at any of the UC campuses — or a family member of one — you might want to pay close attention to the case of Kenya Wheeler at UC Berkeley. A year ago he was “healthy as a horse,” the San Francisco Chronicle reports and biked to school every day.

But everything changed when he was diagnosed with cancer. He had health insurance through the UC Student Health Plan. But as medical bills mounted, he closed in on the $400,000 lifetime cap of the policy — caps that were made illegal under the Affordable Care Act.

Illegal, that is, except for self-funded college health insurance plans, such as the one UC has. In its self-funded plan, UC bears the financial risk of medical coverage. From the Chronicle:

Universities have long offered student health coverage to make sure their students have access to health care. Most college health plans purchase a group policy from a health insurance company and must adhere to the new federal requirements. Continue reading →

FILED UNDER: Money, Reform, Affordable Care Act, Lifetime Caps, Obamacare