Latest California Healthline Stories
Long Busy Day for the Exchange Board
The Health Benefit Exchange board issued a draft establishment grant proposal Wednesday, which is basically a blueprint of the exchange’s business and operational plan through 2017, the year it is supposed to become self-sufficient.
The board also took on a number of other issues on Wednesday, including imminent submission of its quality health plans proposal to the Office of Administrative Law. The eight-hour meeting had a get-down-to-business tone, partly in response to the reelection of President Obama, which ensures a smoother track for implementation of the Affordable Care Act.
“We’ve been moving full steam ahead for over a year now,” said Peter Lee, executive director of the HBEx board. “So this is a good meeting to have right after the election.”
‘California’s Budget Situation Has Improved Sharply’
Yesterday’s long-term budget forecast for sunnier skies in California by the Legislative Analyst’s Office could also mean good things for the state’s health care programs, according to the LAO and health experts.
“For the first time in a decade, we’ve stabilized our budget problem,” said Mac Taylor, head legislative analyst at the LAO. “We are looking at a much more positive outlook in the future. This is nothing like we’ve had to look at in the past.”
The state still faces a $1.9 billion deficit for the fiscal year 2013-14 — that’s about half current shortfall and half operating deficit for next year, according to Taylor — but that is just the current projection and could shift, based on a number of factors, Taylor said.
Health Task Force Releases Draft Report
The first task has been checked off the list. Yesterday the Let’s Get Healthy California task force met to go over the release of its draft report, the culmination of six months’ work. The final report is slated for completion by Dec. 19.
“When you look at where we are today in California, there are so many challenges we’re facing [in health care],” said Pat Powers, director of the task force. “The population is aging, there are unprecedented levels of chronic disease across the state, and alarming high rates of obesity and diabetes. For the first time in a long time, the children born in this generation may not live as long as their parents.”
That creates a moral imperative to do something to meet all of those needs, Powers said. At the same time, the task force hopes to propose changes that not only improve care but save the state money, as well, she said.
Rural Health Care at a Crossroads
How to handle and benefit from changes affecting health care will be the central topic of conversation at the annual conference of the California State Rural Health Association, according to Steve Barrow, its executive director.
The rural health conference takes place today and tomorrow in Anaheim.
Rural communities, with higher percentages of Medi-Cal beneficiaries and seniors, feel the effects of change more than other parts of California — and those percentages are increasing, according to Barrow. Add in the difficulties of distance between patients and providers and the dearth of providers in the rural setting, and you have a population that likely will be affected more by the changes at the federal, state and local levels, Barrow said.
Budget, Special Session, Exchange Votes on Tap
November and December are supposed to be off-time for California lawmakers, but not this year.
This week, the Legislative Analyst’s Office is expected to release its budget forecast. Also this week, the Health Benefit Exchange board will vote on submission of its federal establishment grant. A number of health reform guidelines are expected to be released soon by federal health officials who are also dealing with a deadline this week for states to declare whether or not they will form their own exchanges.
California’s exchange board will meet Wednesday to vote on submission of its establishment grant. That will effectively lay out the exchange’s marketing, outreach and IT plans for its health insurance offerings, now know as covered California. The exchange board also will take action on regulations for qualified health plans.
Budget Expert Unfazed by Supermajority
Fears that the Legislature might spend money faster than a speeding bullet are unfounded, despite the possibility that the Democrats in Sacramento could have a two-thirds supermajority in both houses, according to Chris Hoene, executive director of the California Budget Project.
However, if election results in several key races too close to call go in Democrats’ favor, the new supermajority could have an impact on health care policy, particularly cuts to health care, Hoene said.
“I think from a budgetary perspective, the big implication is that the approach to balancing the budget wouldn’t be a cuts-only approach,” Hoene said. “We might not be talking about just cuts as a way to move forward.”
Prop. 30 Could Stem Health Care Cuts
Lawmakers and health care experts around the state may not know what to make of it if this turns out to be the first January in a long time without significant new cuts to health care services and programs in California.
Although revenues from Prop. 30 will help fund education, if it hadn’t passed on Tuesday, the Legislature would be facing yet another massive budget shortfall and lawmakers would need to look at cutting many more millions of dollars. Health care programs and services would’ve been on the chopping block once again, according to Steve Green, president of the California Academy of Family Physicians.
“People didn’t want to think about all of the slashing and burning that would take place if Prop. 30 didn’t pass,” Green said. “It’s a tremendous relief, knowing that millions of dollars aren’t going to be cut out for the poor again. So not having to cut so much, that will help us focus more on the things that need to happen. When you’re in a crisis mode all the time, that makes it much harder to plan for the future.”
December Special Session Now ‘Full Steam Ahead’
The nation’s re-election of Barack Obama means California lawmakers will have a much busier and more productive special legislative session in December, according to state lawmakers.
Gov. Jerry Brown (D) called for the December special session as a way to make sure California is fully on board with implementation of the Affordable Care Act. The governor vetoed several bills and policies because of uncertainty about who would be in the White House next year, according to Assembly member Bill Monning (D-Carmel), last session’s chair of the Assembly Committee on Health.
“This [re-election of Obama] helps define a much more positive scenario for special session,” Monning said. “The governor was appropriately cautious, not wanting to sign onto some bills and not being able to forecast the outcome of this election. Now the special session will take a very positive tone.”
Big Changes in Store for Academic Medicine?
The financial pressure on academic medical centers has never been more intense than it is now, according to Mark Laret, CEO of UC-San Francisco Medical Center and outgoing chair of the Association of American Medical Colleges. The association, representing 141 medical schools across the country, held its annual meeting over the weekend in San Francisco.
“We have tried to use clinical income to make up for budget losses [that used to support medical schools],” Laret said. “And now that NIH (National Institutes of Health) budgets have flattened, that’s putting more pressure on, too, and increasingly we’ve had to use clinical income to support research, as well.”
In the recent past, Laret said, academic medicine has absorbed the decline in financial support for medical schools and research, but that’s changing, he said.
Healthy Families Notices Sent, Now Federal Approval Needed
The state late last week sent 415,000 notices to inform Healthy Families participants they will need to switch to Medi-Cal managed care plans on Jan. 1.
At the same time, almost two dozen organizations, including the California Medical Association, sent a letter to lawmakers and state health officials asking for a delay in the conversion for 880,000 children in California.
The 60-day notices went out on Thursday and Friday last week, according to officials at the Department of Health Care Services. That officially starts the clock ticking on the Healthy Families transition.