October 2, 2007

Health Care Reform has kicked into high gear this week as representatives from the Governor’s, Speaker’s, and pro Tem’s offices have asked CSAC to participate in ongoing meetings regarding a new draft of the health care reform bill. The bill will blend elements from the Governor’s previous proposal and AB 8, including an individual mandate, a provider fee and, perhaps most importantly to counties, a county share of cost.

As explained to us, the county share of cost would be 40% of the premium for specified enrollees in the new state plan. The new plan proposes to cover medically indigent adults at or under 100 percent of the Federal Poverty Level (FPL), and all others between 100 and 150 percent of FPL. Those who are under 100 percent FPL would be enrolled in a modified Medi-Cal plan, while those up to 150 percent would be added to the new statewide purchasing pool. Counties would then be required to contribute a dollar value for each enrollee that is 40 percent of their premium, which the Administration currently estimates is $180 per member per month (PMPM) for the under 100 percent group and $280 PMPM for the 100-150 percent group.

CSAC, along with a wide range of affiliates, has met with key Administration and Legislative stakeholders twice and will be meeting with them again on Wednesday. Our key issues have centered on how and whether the county share of cost would work; how eligibility determinations could affect the whole system; remaining county responsibility for mental health, dental, and addiction services; and the IHSS employer of record mandate.

The CSAC Health Reform Task Force met twice on Monday and is on call to meet during the remainder of the week. A smaller group has been tasked with developing specific county data that will allow us to model the new proposal. We don’t have much time, as the Governor and Leadership have set an aggressive timeline of completing language by October 9 and a vote sometime next week. Their goal is to have the bill, along with a water bond, on the Governor’s desk by October 15.

Please click on the following links for a quick outline of the bill they’re proposing as we understand it, as well as four supporting documents:

Brief summary of Health Care Reform bill
A document developed several months ago outlining the benchmarks counties have set in order to agree to  meaningful health care reform
The final Health Task Force report on the concept of universal healthcare
A breakdown of county issues regarding the Governor’s original plan
CWDA’s background paper on eligibility

CSAC will continue to keep counties informed as the discussions continue. The Health Task Force will meet this Friday, and any new developments will be communicated to counties as soon as possible.